The July 1974 issue of the American Journal of Nursing features a most disturbing article; not just because of the photographs of bedsores, though these took my breath away. I have mentioned earlier that I engaged in a literature review of professional medical journals in order to learn all I could about the bedsore (pressure sore) problem that gave rise to a growth industry in medical devices and products. I had by this time seen my share of disturbing photographs but these were somehow more than I was prepared for. To this day I keep them with me to show people who think that bedsores are bad rashes. No, the disturbing quality of this article lay in the title and the message. It proved for me that I was on to something important if I could just get someone responsible, and as it turns out, courageous to listen and respond.

    The nurses in the article were speaking of the benefits of using Karya Seals for severe bedsores. They were in awe of its "magic" properties. Karya seals are O-rings that are used to protect the intentional wounds needed to facilitate ostomy procedures. These nurses used them and Saran wrap to cover bedsores and were amazed when the wounds healed. 

    Prior to this article there were not many success stories. More and more there was a tone of desperation from caregivers asked to comment on the increasing numbers of bedsores and their severity. After this article appeared more products were advertised and the race was on. It was as though someone reviewing these journals had an "aha" moment and cried, "The nurses have lost their grip." 

    Indeed, if you read the article carefully one important fact emerges and it is absolutely contrary to what the nurses report. In order for the Karya seals to work beneficially they must be changed frequently, the wounds irragated and the patient repositioned. It was the nursing care, not the Kaya seal that made the differance.

    Nurses lost their way and have yet to recover it. A vacuum was created in the early 1970's when nurses were compelled by there leadership to pursue baccalaureate degrees in the science of nursing. When they returned to the bedside they expected, understanably, to do less menial work and receive more compensation. Patients suffered and bedsores in huge numbers and severity are the evidence of it. Manufacturers of products and devices seized this moment to flood the market with a vast array of items designed specifically to bridge the gap. None of them can replace nursing care rendered, absolutely none of them.

     Nurses in the majority see me as an enemy. They see me antagonistic to their profession. Nothing could be further from the truth. My mission in this is to see them recover the ground they forsook as modern health care delivery morphed into the bizarre and monstrous entity it has become. Perhaps, only nurses can help solve the riddle but not without learning something important about the wrong turn they took. When they effectively left the bedside and picked up their charts the sheets were changed by others too few and too distracted to care. The mean sheets need changing. The paradox is in the microcosm. Quality of care delivered is on a human scale not a technological one. We must recover that truth. Solving the bedsore problem is a first step of giant proportions.