Profiles in Caring: Brian De Castro RN, ADON
October 18, 2017 - Skilled Wound Care
Meet Brian De Castro: an amazing wound-care certified nurse who’s changing lives (part one of two).
Welcome to the first installment in our PROFILES IN CARING series, where we’ll introduce an amazing doctor, nurse, or provider who’s changing lives through better wound care. Today, we’re excited to present the first half of our interview with Brian DeCastro, assistant director of nursing at San Fernando Post-Acute Hospital.
Brian De Castro just plain cares: he cares about his family; he cares about playing music; he cares about details: crossing t’s and dotting i’s; but mostly he cares about the patients in his facility, and the fellow healthcare providers who surround him. We sat down with Brian to learn more about how he got into nursing, what keeps him going, and what he thinks about wound care in the long-term care setting.
Brian got into nursing because he needed a job - his great passion was playing the trumpet in a band with his brothers up in the Bay Area. But it quickly became more than just a job: he began working part-time as a freshly-minted RN at San Fernando in 2011, but soon transitioned into a full-time position, and before long, into a supervisory position. He was voted “Best Supervisor of 2013” by his patients and peers, and in 2015, became the Assistant Director of Nursing.
“My job now, I’m basically a firefighter,” says Brian, as he checks his phone to monitor a patient’s status during our interview. “Every day is different. I really couldn’t tell you what a typical day looks like: I get here in the morning, and it kind of goes from there.”
“But wound care is always my baby,” he adds. “I’ve made sure to keep tabs on that.”
Brian took his first wound care certification course two years ago, and sat for his recertification successfully a few months ago. (“I forgot that it was good for three years, not two,” he admitted, laughing.) He credits Skilled Wound Care with igniting a passion for wound care in him, and points to his weekly interactions with Skilled Wound Care provider “Bek” (short for Bekele Haimanot, PA) who rounds weekly at San Fernando. “He always take a lot of time to explain what we should be doing,” he says. “It’s great. I learn so much. And the courses are wonderful, they’re really amazing.” Brian just took the Skin, Ostomy, and Wound Care course again in Orange County.
“Henry [Okonkow, PA], Dr. Anvar, those guys really know their stuff,” he says. “And this last time we had another teacher [Phyllis Matthews, RN], and she was a nurse, and she was talking about what it was really like taking care of patients. That was just so great,” Brian says, “to have someone who could talk about it from a nurse’s perspective.”
“Skilled Wound Care really helps us,” he says, “and they really help our patients. I’m trying to learn more myself, take more courses, and I’m trying to set up training for our staff. I’ve already done one in-service where I talked about wound care myself - and I’m trying to set up another for our staff with Bek. I know it would help everybody, to hear from him.”
Wound care is a major concern in Brian’s facility - as, of course, it is in most long-term care settings. “Most of our patients, when they come in, they’re pretty sick,” says Brian. “A lot of them are older folks - not everybody, but a lot - and many of them have complicating conditions or other concerns. And usually, what do people die from? They die from organ failure.”
“The skin is the biggest organ in the body,” he continues. “People forget that, but if we can keep the skin healthy, it’s a really big deal.”
Brian tells us about a patient he and Bek have cared for recently:
“She was an older lady, she came from the hospital in bad shape. And she had a pretty bad wound, too --” he makes a circle with his hands about the diameter of a large coffee cup. Brian and Beck worked diligently to heal her wound, keeping a constant watch on it and taking every step they could to improve her condition. “We were doing so, so good at closing it,” Brian says, “it was almost healed. Down to maybe, this size--” he makes a circle with his fingers the size of a quarter.
“But then something happened with her - not anything to do with her wound, but something else, and she had to go back to the hospital. And when she came back to us, it had opened all the way back up. They didn’t take care of it there - it was like we’d never done anything.” Brian says, as his shoulders drop.
“That was heartbreaking. It’s hard to watch someone do well and then head to the hospital and get worse,” he says. “When I can heal a wound, I feel fantastic. But when I can’t, it’s terrible. That’s a terrible feeling.”
He brightens a little, though, and says, “But we started working on it again, and we’ll see if we can’t get it to close.” This constant and undaunted optimism is a hallmark of Brian’s approach to healing - and it resonates with the patients around him.
As we walk through the halls at San Fernando with Brian, he greets patients by name, and they often reach out a hand to grasp his as he passes. He is brisk and warm and surprisingly relaxed for someone who’s fighting fires every day. It’s clear that they appreciate him and that he, in turn, appreciates them as well.
Join us next time for the second part of Brian’s interview, where he’ll talk more about his experience learning about healing wounds, and about his experiences in long-term care.
Skilled Wound Care is a mobile surgical practice committed to transforming the chronic wound care model in nursing facilities. Wound care experts make weekly bedside visits to patients in long-term care facilities, avoiding transfers to hospitals or clinics. Our expert physicians give patients the most up-to-date and effective wound treatments, and educate facility staff on how to help patients continue to heal quickly and effectively between visits. This model of collaborative care allows SWC’s physicians to improve patients’ lives and health outcomes, to empower nursing staff, and to raise public awareness. Skilled Wound Care, along with its nurse and nursing home partners, is working every day to positively transform traditional nursing home wound care.