Pressure Damage as an Indicator of the Quality of Care

Can you imagine what it feels like to have a pressure wound? They are undoubtedly painful, and that pain may vary depending on several factors and the person's perception of pain.

It may be sporadic and aggravated by movement, or continuous and unrelenting. Pressure can cause such significant damage to the nervous system that the person suffers neuropathic pain. People with pressure damage can see the pain exacerbated by the management of the damage—dressing changes are likely to be painful. Descriptions of the pain of pressure damage have used words such as ‘throbbing, sharp, gnawing, aching, tender, exhausting, miserable’ (Gorecki et al, 2011). What does pressure damage that inflicts those feelings in patients say about the care they have received? How should nurses feel when a patient develops pressure damage, particularly at grade 3 or 4? In her Notes on Nursing, Florence Nightingale wrote, ‘If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease, but of the nursing.’ Recognition of pressure damage precedes Florence Nightingale by several thousand years—pressure damage and treatment of it has been seen in Egyptian mummies.