Q1 – In the case that Farhan’s pilonidal sinus is no longer healing with the dressing (over granulating tissue) I would take action of option 2. I would not keep using th dressing as it is clearly no longer appropriate and it could further his issues with it. I would therefore reassess the wound and see which dressing is now going to be more appropriate for this kind of wound care – every wound is different!
Q2 – I would choose option 2. It is important to communicate to your patients in a way that they will understand and feel comfortable. If adapting my communication means speaking slower, using physical body language, or cue cards with pictures then that is what I would do. However, speaking to a relative (option 3) isn’t a bad idea as relatives know best! They could advise me on how Farhan understands things better, what he likes and dislikes in terms of communication and this therefore would enable me to tailor my communication to him in a way we can converse.
Q3 – Wrong, each patient needs to be treated as an individual. Needs change and you need to establish the cause for admission in the first place.
Conversations need to be had with Farhan’s assisted living accomodation – why has his sore gotten so bad to begin with? are they sufficiently managing his diabetes as they should be? The diabetes specialist team, ?tissue viability, nursing staff and potentially safeguarding could investigate this and hopefully there is no cause for concern and Farhan can be discharged safely and accordingly, hopefully reducing any future hospitalisation!
