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Not sure how to handle this - Carers UK Forum

Not sure how to handle this

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Hi,
My mother who I've been caring for for 13 years with hardly a problem developed a pressure sore in January and to start with it was quite bad but over the months since then it has done remarkably well. The nurses both day and night nurses when we had those visiting too, would say how well it was healing. In more recent weeks little needed to be said about its progress though three weeks ago one nurse mentioned that it was smaller again. All good so far.

Then we started being visited by two exceptionally young nurses and they can't possibly have the experience of all the other older nurses who come to us. Twice these nurses have been out to us, one seems to be training so she doesn't get involved or pass comments but the one changing the dressing keeps making negative comments.

The first time on 10th June she asked if we still had night nurses coming in and I told her we didn't as they haven't been needed for a couple of months or more now. She said the dressing was wet and it might be an idea to get the night nurses back in. I told her that mum had opened her bowels that morning and that I'd had to use the foam spray to clean all over and the dressing got wet that way. She ignored this and said even so it might be an idea to have them back out but she'd have a word with the other nurses to see what they say as she didn't think it was healing any further since she'd seen it last (whenever that was).

Then this morning the same two arrived and just like before this nurse started asking if mum could lie on her side and I said she couldn't. She asked about a cushion under her and I told her that this had been done in the past but hadn't been done for months now as it wasn't deemed necessary. This nurse then said that she thought the mattress might be too hard and would I object to her changing the setting to soft. I said that would be ok and again she said the sore didn't seem to be improving.

There are several things I don't understand and several things I don't like. I don't understand how the mattress needs to be changed now when more experienced nurses set it at medium when the sore was much worse and I don't understand why all the older experienced nurses haven't expressed any concerns when treating the sore and yet this slip of a girl seems to have these opinions on everything under the sun all of which are negative.

She leaves me feeling anxious and worried every time.
I really don't know how to handle this one. I was feeling relaxed and confident thanks to the care of the other nurses but twice now these young ones have just been negative from the moment they arrive and I'm not sure what's going on.
Should I say something to the experienced nurses the next time they call or should I tell this nurse that she's giving me cause for concern myself so much so that I'm considering getting an independent second opinion ?

Nothing more was said about getting night nurses in and I was not happy or impressed that she totally disregarded my explanation about me having cleaned mum and wet the dressing that way. It had been dry all the days before and since. Maybe she's just over zealous and perhaps she hasn't long qualified but she's really wrecking my peace of mind.

Should I just ignore her and judge everything by how the older nurses have been ?
Hi Scruffy,
I think you should try not to overthink things and should definitely have a fairly casual word with the more experienced nurses. It sounds very likely that the nurses are young and inexperienced and they want to show that they can do their job. Put your mind at rest by getting the opinion of the ones who've seen the sore in the long term and are more used to the work. Ask about the mattress setting too. Unfortunately we can't completely rely on anyone, though!

We haven't had a serious pressure sore, but carers, district nurses and GPs are constantly driving me mad too. But I'm not in your position trying to do everything for my caree, so I can take a bit of distance from it. Only yesterday we had a new young male carer who was keen and interested, and was advising me on how to make sure we got an operation sooner. Most of what he said was useless, since I've been working on this for two years now. I found myself explaining to him how private hospitals tell us they can do it and then send us away without any help, how the NHS consultant refused to help us pay privately, how there was a 13-week waiting list locally, how my brother can't manage a long ambulance trip to a bigger private hospital. I shouldn't have got involved in this - it was just someone ignorant of the situation and assuming we don't know what we're doing, although not unpleasantly as in your case - but I just wasted my time explaining the whole story when he was there to do basic hoisting and caring! Apart from anything else, we are seeing the consultant on Thursday, so we have reached the time for things to hapen.

You know your mother's situation and you live with it every day, so try to remind yourself that these nurses are likely to be wrong and you know more about the specific situation than they do.

I hope everything else is going OK for you after all the problems you had earlier.
Hello
You are entitled to express concern. I would mention it to the experienced nurses to start with. In a kindly manner if you can. That you understand she is newly trained and expressing concern for your mother. However you are feeling uncomfortable which in turn won't be any good for your mum and please can you be reassured that all is still ok? See what the reaction is. Unfortunately, some, and not all thank goodness, are over confidant and treat us as though we have no idea. Sometimes it takes a little word from a supervisor to remind them of how to talk to relative's. I really emphasis that it's not all newly trained younger staff. Some are delightful and refreshing. Try the kind tactic Ist and see how it goes. It may just nip it in the bud. You certainly don't need the anxiety. Be aware, though that they may be defensive for a colleague.
Good luck
Someone on the forum may have a different suggestion , perhaps have been through a similar experience.
Hiya
I think I'd go with your last sentence at least for now. Are the older nurses coming back soon? There's a good chance that this younger nurse is a little over eager and anxious not to be accountable for any mistakes. There is of course always the possibility that she might be right and the sore is getting worse again. Have you looked at it yourself?
E.
Hi Elaine, Greta and Pet66,
I had a confidence surge last night and was ready to start challenging them if they came again today but two older nurses came who have been here many times in the past. As it happened, the dressing was coming away on three sides this morning when I hoisted mum up so I took the chance to check on the wound which I've deliberately avoided in the past unless specifically encouraged to look when the nurses have said it's healing and take a look, also they said it would help me to tell how it was doing later on.
So when I looked today I was stunned at how much better it was doing and it was obviously healing very well.

So when these different more experienced nurses were here earlier I told them that I'd had chance to see the wound this morning and thought it was doing well and they both said 'oh yes, it's really doing well and shouldn't be long before it's cleared up'. They couldn't have said anything better.

I didn't mention the mattress setting being changed. I thought I'd see how mum gets on with it, it might be that she is more comfortable on a softer setting. It does mean though that I can now tell them when they turn up next time that the wound is healing as both myself and other nurses have seen it and said so.

Amazing what a bit of confidence can do. :)
Thanks for replying, I was in need of a second opinion to get some balance.
Scruffy x
Hi Scruffy,

You mention young nurses. Are they nurses or are they healthcare support workers? Or, as you say, student nurses? They may have a different colored uniform.

My wife does a job similar to district nursing. Shes a qualifed RGN. MOST visits are done by the support workers with the qualifed nurses acting as managers to them and being available only when needed- there are just not enough RGNs to go around.

If they are support workers, it may be worth asking for an RGN to visit to review things properly - that is the RGNs job.