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Writer's pictureJennifer Tipton

The Story of Advocating for Fernanda

This is a glimpse into one of the most compelling stories from my book. There were so many remarkable home health stories to share that I had to break them into three chapters: Advocacy, Heartache, and Friendship. The tragic story of Fernanda is a story of advocacy. What I discovered was so shocking that I felt it necessary to speak up on her behalf.

"Fernanda" means brave journey




Fernanda was not yet seventeen when she had the surgery. It was an elective surgery. However, I've often wondered if she would have proceeded had she known the outcome.


As nurses, we are frequently presented with an opportunity to advocate for others, whether for the patient, the family, or both. Never underestimate your power to affect an outcome - speak up.







The young girl suffered from hyperhidrosis, a condition that causes excessive sweating. One can only imagine the stigma that a high school girl would face if she were routinely soaked in perspiration. No doubt, the condition brought her a considerable amount of awkward embarrassment and public shame.

There are over-the-counter products available to manage hyperhidrosis. Topical agents and anticholinergics are also available by prescription. However, if these prove ineffective and the individual is determined to find a solution, they have no choice but to seek more aggressive treatment. Fernanda sought treatment.

Her treatment plan involved major thoracic surgery to remove the overactive sweat glands. I accepted the case to care for her postoperatively, and I anticipated that there might be potential post-op problems, but I had never considered what I found. It was horrifying.

As I entered the home, I was escorted to a small bedroom where Fernanda sat patiently on the bed, her mother sat eagerly in a chair at the bedside, and her sister stood beside her mother. Everyone was delighted to see me and excited to see the surgery results. I knew right away that surgery had sent my young patient home with a wound VAC, but it wasn't until she removed her blouse for the dressing to be changed that I realized the extent of it.

In all my years of nursing, I've seen some horrific wounds, and this was amongst the worst. The black foam dressings were everywhere: under both arms, on her chest and sides, and extending to her back. The depth was also significant, and as I tried ever so gently to remove the foam that covered the recently excised tissue, it revealed beefy red, dark cavities of horror. Fernanda's sister screamed and fled the room; her mother clutched the cross that hung from a chain around her neck and wept hysterically while praying aloud. And although I, too, could not believe the extent of the damage, it was necessary that I remained expressionless. So, I held my breath as I climbed onto the bed with her, and I positioned myself up on my knees to remove the dressings on her back. She was a motionless symbol of stoicism, and I didn't dare ask her to move as I made every effort to calmly reassure her. It was indeed one of the most difficult dressing changes that I have ever performed. When I finished, I gently told Fernanda what a brave, brave girl she was. Then I stepped outside, phoned the surgeon, and proceeded to tear her a new one. I unashamedly informed her that this was not appropriate for home care, and if she expected the dressings to be done at home, then we were going to need some drugs - serious drugs! We needed drugs for this poor girl to endure such torture, and we needed a little something for the family and maybe even myself too... Be a nursing advocate (and don't take drugs - I was only kidding!)


To read this story in its entirety, check it out in:


To learn more about hyperhidrosis, click here


Here's a great book on Advocacy

And another for dealing with Heartache

I found a lovely gift for Friendship and a FUN ONE too!


Published by Jennifer Tipton / This post may contain affiliate links.

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