Today we were able to sleep in because we thankfully did not have to meet in the lobby until 8:30 this morning. This gave me a little extra time to shower and eat breakfast. The buffet style breakfast at the hotel is very nice, I like being able to choose what I want to eat and fuel me until lunch. After breakfast, we walked back to the BCU South Campus to have skills lab.

For skills lab we were broken up into two smaller groups. My group went with Chinenye first to learn about wound care. We started by learning the different ways to assess wounds and then learned about different treatments. One of the things we learned about were the three methods of sloughing used in the UK: chemical, surgical, and maggot therapy. Chemical sloughing is the process of removing dead tissue in a wound with various chemical agents, like honey. Chemical sloughing is very accessible but also takes the longest of the three methods. Surgical sloughing is when a surgeon cuts away the dead tissue in a wound. The third method of sloughing that we learned about was maggot therapy. A medical team will order sterile maggots from a facility, the maggots will arrive in a gauze bag, and the bag is packed against the patient’s wound under the dressings. Over the course of three days, the maggots will release enzymes that digest the dead tissue. At the end of the three days, the maggots are removed and the dead tissue is gone. Maggot therapy was definitely the most interesting method of sloughing to me because I had never heard of it before. Chinenye is certified for maggot therapy, and her teaching kit had a cute squishy maggot named Marvin the Maggot.

After learning about different wound treatments and how to properly care for a wound, we were all able to practice cleaning and dressing a small wound. We learned what questions to ask a patient before dressing the wound, how to maintain a sterile field, and how to prevent contamination in the wound. Next, we learned how to wrap an ankle, wrist, and stump to help keep dressings in place. I practiced wrapping a stump on my partner and my partner wrapped my wrist. When we were done practicing that skill, Chinenye shared a story with us. She told us that once she cared for a woman with a 19-year-old wound. The woman had had surgery on her leg, and some lymph nodes removed. After the surgery, the woman was unable to care for the wound properly. So, when Chinenye met the woman, her leg had swollen three or four times the size of her other leg and she was not able to walk. Chinenye treated the woman with honey sloughing, saline water, and proper dressings. Over the course of three meetings, Chinenye taught the woman how to care for her leg by using crepe fabric as wrappings and different methods to help drain the lymph from her leg by exercises and massaging. When Chinenye saw the woman three months later, the swelling in her leg had greatly and she was able to walk again. In just three months, a wound that lasted almost 20 years was managed. This story just shows the importance of patient teaching and accessible care. If the woman had initially been taught how to take care of wound, the following 19 years could have been avoided. In my nursing career I will ensure that patients know how to take care of themselves when leaving my care so that their health outcomes may be improved. Additionally, finding accessible alternatives is vital when managing low-income patients. The woman could not afford compression socks or gauze, so Chinenye had her use crepe which is a cheap, elastic fabric and taught her how to clean the fabric. Thinking a bit outside the box to find alternatives for patients could greatly improve their health.

The second half of our skills lab was with Blessing. She taught us how to insert a catheter. My partner and I inserted a male catheter. We first sterilized the area, then administered anesthetic gel, inserted the catheter, and inflated the balloon to stabilize the tube. After we practiced inserting and removing the catheter, Blessing demonstrated how to insert a feeding tube. The process was surprisingly similar to a catheter. When the skills concluded, Blessing sat us down and explained the importance of kindness in nursing. She told us a story of the one time she made a medication error but because she was kind, her patient and manager stood up for her and she was not gravely punished. As a nurse, I will encounter patients from all backgrounds and beliefs but no matter what, I must do everything in my power to not only help them, but go beyond and be kind to my patients. Not just because they may help me in the future, but because they are human just like me and deserve to be treated with kindness.

We ended the day with dinner at the Grand Central Station where we got to pick our own food. We then went on a ghost tour of Birmingham. Our tour guide was a charming Brum with an umbrella he used as a walking stick which he tapped on the ground for dramatic effect while telling us stories. He was so lovely we almost forgot how cold it was.