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Nurses are the standard-bearers

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VOL: 98, ISSUE: 44, PAGE NO: 43

Christine Moffatt, PhD, MA, RGN, NDN

The Leg Ulcer Forum was set up a decade ago, and during that time we have seen major advances in the care of patients with chronic wounds. Nurses have been at the forefront of these developments and have demonstrated the important role they play in developing an area of expertise.

The Leg Ulcer Forum was set up a decade ago, and during that time we have seen major advances in the care of patients with chronic wounds. Nurses have been at the forefront of these developments and have demonstrated the important role they play in developing an area of expertise.

I take great delight in seeing the growth of clinical nurse specialists and nurse consultants in wound care. It is important to reflect that 15 years ago specialist posts were a rarity and education in wound care unknown.

Like any major advance, wound care has had to struggle with many issues. First attempts at introducing wound care and leg ulcer management into higher education in the late 1980s were met with apathy or the belief that leg ulceration was the domain of medicine and not for nurses to dabble in. Use of Doppler ultrasound as part of a nursing assessment was seen as an encroachment on medical practice rather than a vital aspect of nursing assessment, and nurses often struggled with their employers to gain training and access to equipment.

We have come far since then, with nurses taking on complex roles of diagnosis and treatment and playing leading roles in wound care services.

Perhaps one of the greatest developments in our understanding in the past decade has been the impact that wounds have on the lives of patients and their families. In an increasingly technological health care arena nurses must not forget the importance of these issues or reduce their care to a set of procedures.

The research in wound care has shown that many patients experience tremendous suffering. Venous leg ulceration used to be described as painless in medical text books - a far cry from the reports of patients, 80% of whom experience pain, many severe in nature.

Wounds affect many aspects of people's lives. The evidence shows that patients with wounds are more isolated than people of a similar age without, and depression and anxiety are common features. However, research also indicates that effective care provision significantly improves patients' quality of life.

While healing remains the primary goal, quality-of-life improvements can be made in the small, but important group of patients for whom healing cannot be achieved. Nurses must strive to develop their practice and ensure the care they provide is of the highest standard.

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