Home > RNJ > 2005 > May/June > Commentary: Wound Management in Vulnerable Populations

Commentary: Wound Management in Vulnerable Populations
Catherine A. Warms, PhD RN CRRN

This article views a common and important rehabilitation nursing problem, wound management, from a vulnerable-populations perspective. Although the principles of caring for wounds are universal, the characteristics and situation of each person with a wound are unique. Certain groups of people are known to be more susceptible (vulnerable) to health problems because of circumstances that limit their care opportunities and resources. Vulnerable populations may include women, children, ethnic minorities, immigrants, refugees, homeless people, people with chemical dependency, seniors, people with disabilities, people with low literacy, and people living in poverty. The author of this paper focuses on vulnerability related to poverty, culture, and literacy, and describes how these particular factors affect wound care and wound healing.


A vulnerable population’s perspective may be overlooked in rehabilitation nursing practice. The article suggests specific considerations for nurses working with patients with wounds who may have added risks and complexities to their care due to personal, situational, and environmental conditions. Suggestions for rehabilitation nursing practice include to


  • become informed about various health insurance programs and how to access them for vulnerable patients
  • work with various health payers to get medications and supplies your patients need
  • think creatively and work with community agencies to coordinate wound care
  • identify and coordinate community resources to provide essential needs (nutrition, transportation, dental care, shelter/housing, etc.) that are not being met
  • ask questions about cultural issues that are likely to affect wound care (e.g., what pain means to the patient, whether home remedies are being applied, whether a family member can be asked to help with wound care)
  • develop wound care literature that is appropriate to the patient’s language and reading level, or consider ways to educate patients that do not involve written materials
  • involve interpreters whenever a misunderstanding related to language is possible.

Following suggestions put forth by the author of this article, and increasing your own sensitivity to issues surrounding vulnerability are likely to improve your rehabilitation practice with wound patients in all settings.


Meeting the healthcare needs of various populations requires understanding that patients’ abilities to influence their own health depends on having the resources necessary to meet the challenge. It is like a puzzle where you must fit the needs and resources of the individual to the demands and resources of their environments. Vulnerable populations are often less powerful and less able to use the healthcare system to their own advantage than other populations. But, nursing “has the potential to affect resources, relative risk, and health status directly as well as indirectly” (Flaskerud & Winslow, 1998, p. 70) and applying a vulnerable population’s perspective in daily nursing practice is one good way to enhance that potential.




Flaskerud, J. H. & Winslow, B. J. (1998). Conceptualizing vulnerable populations health-related research. Nursing Research, 47(2), 69–78.