Thoughtful advice for a patient needing long term care for a leg ulcer

We are extremely delighted to hear from District Nursing Student, Juliet Shaw, about her thoughts on caring for people in the community with leg ulcers.

Please note that her thoughts are about how a District Nurse should approach the issues. No one should attempt any of these ideas without taking advice from someone who is qualified to carry out these procedures.

This is what she wrote.......

Recently, I was lucky enough to attend the Worcestershire Primary Care Trust's Leg Ulcer Conference and hear a patient's experience of living with a leg ulcer. - it made a great impression on me as the impact on 'quality of life' of living with these awful things is immense. Just listening to this made a great difference to me as a nurse, and I came away thinking that if I just spend some time REALLY thinking (I do of course already think about it!) about the impact having a leg ulcer has on an individual's 'quality of life' (and of course the impact is very individual to that person!), I may be able to make some difference.

For example............

spending more time listening and talking about any concerns they may have,

making extra sure that they take some analgesia before a dressing change,

spending more time washing their leg (can feel very therapeutic),

applying a bandage system that is not too bulky so that they can get their shoes on (or, if not, helping them choose some footwear that would be suitable and enable them to go out,

providing compression hosiery in a colour of their choice,

providing a 'seal-tight' waterproof leg to go over the bandage so that they can have a shower/bath (available on prescription),

ensuring that they are resting their affected leg in the best way

arranging for a bed to be moved downstairs so that they can go to bed at night (lots of patients don't go to bed - can't get upstairs or just too uncomfotable - may need a recliner chair!),

helping them gain enough confidence and self-esteem to attend, if possible, a 'leg club' where they would meet other people in the same situation and be empowered to take control over their own care.

I was so moved by this talk that I wrote to the patient and told her about the 'kissing it better' website because I thought she would really like your idea about little things making a difference! She may be inspired to put some ideas on the site herself which I am sure would be invaluable!

Juliet