Change Can Be Good For Your Patients

Dear Readers,      Change—have you heard enough about that lately? Everywhere we turn we are blasted by the message that we need change. Unfortunately, we are told little about what we need to change; we just need to change to something different. Many times the decision as to whether the change is good or bad depends on who is recommending the change! In medicine and especially wound care, change can be good if improvement in patient care and outcomes is achieved.      Unfortunately, change in medicine is slow. Many people resist change, some for no reason other than it will result in something different. Everyone should be familiar with the story of Semmelweis who spent most of his medical career trying to convince colleagues that washing their hands prevented the spread of infection. Despite having evidence his approach was correct, his pleadings were to no avail, at least during his lifetime. The fear of change for whatever reason is irrational. Dr. Wilfred Trotter rightfully said, “The truly scientific mind is altogether unafraid of the new…”¹ He is entirely correct in his assessment. What is there to fear with change? It my take us out of our comfort zone. It may require that we learn something new and different. It may even require putting aside the old “tried and true.” Nevertheless, if one is changing to or toward something better that will ultimately help patients, then why not at least evaluate the change?      In my travels around the country, I never cease to be amazed at how many respected practitioners have yet to understand the detrimental effects of dry dressings on an open wound and to appreciate the benefits of moist wound healing. This information is hardly new, so why is there no change? My mother recently had an injury to her leg. As I was directing her wound care by long distance (she lives in Texas), she had the audacity to argue that leaving the wound open would make it heal faster! It took several phone calls before I was able to straighten that out.      Sometimes the hardest part of accepting change is putting aside old thoughts and ideas that probably were originally based on incomplete or inaccurate ideas. Techniques and procedures we were taught in our training programs have held us in good stead for many years. Why change now? An analogy I can make is that most of us have driven automobiles of some type since we were 16. My first car was great and got me where I needed to go, but I don’t drive a 1960’s vintage automobile any longer. I drive a much newer model. There have been improvements in the drive train, which makes today’s cars ride much better. The safety features in today’s cars are great compared to the nonexistent safety features of the old cars. Yes, I could drive a car from the 1960s, but I choose to enjoy the benefits and comforts of technology afforded by newer automobiles. Why choose a bandage the ancient Egyptians used centuries ago when dressings with the benefits of modern engineering and technology are available today? Today’s moisture retentive dressings have been shown to be superior to gauze in nearly every evaluative category.^2–5      As we move into 2009, have a “scientific mind” and do not fear the new. Also, do not be afraid to put aside old ideas that have outlived their usefulness. Some change might not be so bad.