Nursing student advocates for more inclusive diagnosis of bedsores

A Western student is advocating for the adoption of an updated model of assessing injuries on darker skin tones.

Third year nursing student at Western University Nyechuor Deng is dedicating her time and effort toward advocating for the adoption of a more inclusive system for diagnosing pressure injuries in darker skinned people.

“My project is all around pressure injuries… in the hospital, it is really hard to find [stage one injuries] on darker skinned people and so pressure injuries can result to infection and longer stay in the hospital, which impacts the patient’s health.”

Deng is part of the Western Black Leaders University Experience (BLUE) program, which allows students to partner with healthcare providers at London Health Sciences Centre to help improve health equity.

A stage one injury or pressure injury occurs when a patient sits on a bony prominence for a long time, which causes skin to break down – commonly known as bedsores. An early indicator of a stage one pressure injury is a shift in skin tone.

The most commonly used medical practice for categorizing skin tones was established in 1975, and only had six shades. This scale resulted in most people of darker skin tones being lumped into the same classification, while providing more specificity for lighter skinned people.

“My project is all about using a more inclusive skin tone scale, which is called the Monk Skin Tone Scale that was done by Doctor Ellis Monk in 2023,” said Deng. “Using that more inclusive scale, we can find those stage one injuries on darker skinned people, which is obviously empowering.”

Deng says that healthcare initiatives that focus on inclusivity can help deconstruct a historic misuse of healthcare against minorities, “during Black History Month we want to [focus on] making that medical mistrust go away.”