1. Home
  2. Community
  3. I’ll bill you
The nursing profession’s potential impact on policy and politics

I’ll bill you


Mrs. Anderson is a well-spoken, poised black woman with a flawless face. She is surrounded by silk-encased pillows and is wearing a tasteful dressing grown with a coordinating turban on her head. She is not at all what I was expecting when I entered her room to perform a skin assessment for pressure injury risk. She doesn’t even look like she needs to be in the hospital. But I soon discover why she scored so low on the Braden scale when I ask her to reposition herself in bed.

“I’ve had over a dozen operations.” She tells me. “It is very difficult for me to move because of the pain.” And under her dressing gown I see multiple keloid scars crisscrossing her abdomen. She points out each one and recites each procedure that resulted in the hypo-pigmented, raised cords of tissue. I assist her as she slowly turns to her side to allow me to continue the head-to-toe assessment. I find more keloid scars running up and down her spine.

I complete the survey of Mrs. Anderson’s skin without finding any pressure injuries. But I educate her on the importance of frequent turning and repositioning for prevention of skin breakdown. She looks at me intently as I speak, and when I finish she says, “Can I ask you a personal question?”

“Of course,” I reply, sounding more confident than I feel.

“How did you get your scar?” She asks.

Mrs. Anderson is referring to the healing incision on my neck. “I had part of my thyroid removed a couple of months ago,” I answer.

“Oh, so it was recent?” She asks.

“Fairly recent, yes,” I reply.

“Well, I had an incision in that same spot!” She tilts her chin back indicating that I should take a closer look. I am surprised to find nothing there, especially considering all the keloid scars I visualized just moments ago.

“Really?” I ask incredulously.

“Yes. I had cervical spine surgery and the incision was where yours is now,” She explains. “I was so upset when I found out I was going to have an incision there because I just knew it would leave a keloid scar like all the others. I know that sounds silly.”

“Not at all,” I confide. “I was more upset about the prospect of having a visible scar than I was about having the surgery itself!”

“Vitamin A.” She whispers conspiratorially.

“Really?” I whisper back, playing along.

“Yes,” Mrs. Anderson elaborates, “But you have to get the capsules and squeeze the Vitamin A onto your incision. The topical stuff just isn’t the same,” she winks knowingly.

“Well, thank you so much for sharing your secret with me!” I exclaim. “Seeing you has given me hope for my scar.”

“You are very welcome,” she nods.

“You know, it’s ironic,“ I muse. “I entered your room with the intention of helping you. But I’m pretty sure you helped me more.”

Mrs. Anderson chuckles and, with a smile, says, “I’ll bill you.”

Jennifer J. Brokaw is a wound and ostomy specialist at Tampa General Hospital in Tampa, Florida.

The views and opinions expressed by Perspectives contributors are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. These are opinion pieces and are not peer reviewed.

Leave a Reply

Your email address will not be published. Required fields are marked *

Fill out this field
Fill out this field
Please enter a valid email address.

cheryl meeGet your free access to the exclusive newsletter of American Nurse Journal and gain insights for your nursing practice.

NurseLine Newsletter

  • Hidden

*By submitting your e-mail, you are opting in to receiving information from Healthcom Media and Affiliates. The details, including your email address/mobile number, may be used to keep you informed about future products and services.


More Perspectives