Tough Love

After working in home care in Puerto Rico and the U.S., Juanita Reyes-Tineo, RN, CWCN, made a promise to herself. If she had the opportunity she would become wound care certified.

"In Puerto Rico, I saw so many patients with ulcers," Reyes said. "I asked myself 'why there was no treatment for them?' When I came to New York City, I saw the same thing - patients in the home with untreated wounds."

While working at Beth Abraham Family Health Services, Comprehensive Care Management, Bronx, NY, Reyes got the opportunity to become wound care certified and took it. Today, she is the wound care specialist there.

"I am hands on," Reyes said. "I need to feel those wounds. I need to smell those wounds. I need to see them. It is not just what the other nurses tell me. I have to be there for the patient."

Healing Hands

Reyes, who has been with Beth Abraham for 15 years, works primarily with arterial, venal and diabetic wounds, pressure ulcers and some burns. Wound management may include cleaning the wound, removing dead tissue, and applying dressings onto the wound.

"Patients come to me with wounds they have had for so many years," she said. "They have had no results. If we catch them in time, we can heal them in just a few months and sometimes less."

Reyes remembers a patient who almost lost his leg as a result of a diabetic ulcer. He was a candidate for amputation. But she worked with the doctors, suggested they change the patient's treatment plan and coached the patient back to health.

"I say to them, 'this is your leg. This is your body,'" Reyes said. "'Because we love you, we want you to help. What I do here is not enough. I need you to listen to the instructions I give you.' We make a deal, and we shake hands."

Reyes tailors an individualized treatment plan for every patient. She takes pictures and compares the progress of the healing process from month to month to see whether the treatment is working. She shares the information with the patients. As a result of her efforts this year, her patients are almost free of wounds - with few complications and amputations.

Resiliency

The tenacity Reyes demonstrates with her patients comes from years of hard work and adversity. She grew up in Puerto Rico as the thirteenth of 14 children. She immigrated to the U.S. in 1959. She attended Bronx Community College for 2 years to learn English and other basic skills. After a divorce, she took her four children back to Puerto Rico and attended nursing school.

Her career in nursing spans more than 25 years. She has seen a lot of changes in the area of wound care and increasing interest among younger nurses. There was a time, she said, when nurses did not get involved in wound care.

"Wound care was not a topic for conversation," Reyes said. "But now it is lovely to hear the younger nurses talk about wound care and explain it and use sophisticated terminology I didn't expect. We are getting better in the area of wound care because more nurses are getting involved."

Nancy Malaga is regional editor at ADVANCE.