The Day I Fired Pillows
When I was fairly new to nursing, I was assigned to care for a patient that would change the trajectory of my life forever.
At the time I was working as a floor nurse in a hospital medical-surgical unit.I was assigned to a patient with an admitting diagnosis of pressure injuries. I’ll never forget what the ER nurse said to me during report. “Brace yourself. It’s bad”.
I wasn’t intimidated. The dressing care orders were in, and I thought I knew exactly what to do.
So, armed with dressings and a pile of the newest, puffiest pillows I could find, I marched into the room with all the confidence of a veteran nurse.
I might have been prepared for what I saw, but I was not prepared to help this patient.
She had three colossal stage 4 pressure injuries on her sacrum and both hips (aka greater trochanters). She also had opening deep tissue injuries on both heels. She even had pressure injuries on her ears.
Sure I could dress the wounds. But obviously, even if the pillows could hold her up (which they could not) no matter how I positioned her, it was impossible to support her body without putting pressure on at least one of her wounds with these pathetic simple pillows.
With one glance you could read the whole backstory on her daughters face: Fatigue, frustration, hopelessness, guilt, grief.
“I have to work” she said. “My mom only qualifies for a caregiver 3 times a week for 4 hours. They don't know what to do and neither do I.”
My first impulse was to call out her caregivers for not doing their job. “What do you mean they didn’t know what to do?" I thought. "What about turning every 2 hours and supporting with pillows?”
Then I looked at my patient. The ER nurse had crammed pillows under her just before she was transported up. Maybe a half hour had gone by. Those pillows were flat as a pancake, and she was flat on her worst wound.
Even if the caregivers could have turned her every 2 hours. Pillows support the turned position for like, 15 minutes.
My next thought hit me like the proverbial “palm-slap-to-the-forehead”.
Is that shy we're supposed to do it every 2 hours? Because pillows don’t work for even 15 minutes?
There has got to be a better way to do this.
It was on that day that I fired pillows. Well ok, it was more like a demotion. How did we ever come to rely on the simple, run of the mill pillow to do the tough job of pressure injury prevention? It’s like putting wagon wheels on a car. Like filling the gas tank with only enough to travel 2 miles. Like using a screw diver to hammer in a nail. Its just wrong.
I had to excuse myself from the room. I needed to contemplate a solution to this problem. Little did I know it would take me over 6 years to figure it out!
Pressure injury prevention is a science. Its a process, and it’s an art. Pressure injuries are usually preventable. But to be successful, we have to do a lot of right things, the right way, at the right time. You can create the right environment to support best possible pressure injury prevention and healing, but you cannot leave caregivers without the support we need to do it right.
It all boils down to this: The only thing that can stop pressure injuries is caregivers. Caregivers who have access to quality time and resources, good training, good skills and of course, good will.
I didn’t just fire pillows that day. I began quest to stop bedsores. I am on a mission to inspire, empower and make quality pressure injury prevention and healing possible and attainable to all caregivers that need it.
If you would like to be a part of my mission, or you could really use my help, book a call with Jewell Nursing Here, visit our website or just watch for more good stuff coming soon through these emails.
Thank you for all the good work you do.
Your success is our success,
Gwen Jewell, Clinical Nurse II, BSN, CWS
The Day I fired Pillows
Founder and Pressure Injury Preventionist
Jewell Nursing Solutions