Wound, Ostomy, and Continence Nurses Week is recognized this year from April 16 to 27 and honors nurses in this specialty while also calling attention to WOC nursing careers.
Dea Kent, DNP, RN, NP-C, CWOCN, and president of the Wound, Ostomy, and Continence Nurses Society (WOCN) shared some insight about WOC nursing and how it’s made such a meaningful impact in her own life and that of her patients, too.
How did your career as a WOC nurse begin and evolve?
When I was a newly graduated RN in 1988, I got information in the mail about a wound school. Because we had a local “Enterostomal Therapist” (ET), which is what those who may/may not have been nurses that helped those with new ostomies were called, I thought what she did was cool. However, at that time, I was a new nurse, a newlywed, and the thought and finances involved in going away for many weeks was not an option. A decade or so later, though, the ET retired, and I was nursing at a long-term acute care hospital. Boy, there sure were wounds there, and some like I could have never imagined.
I noticed that wound care was pretty far down on the priority list, and I felt that part of that likely had to do with the fact that no one was trained to care for these complexities. So, I asked if I could try. The deal was that they would not allow me overtime or extra pay, but anything I could do to help would be welcome. Quickly that turned into a part-time job, which turned into a full-time job. I started checking into going to a Wound Ostomy Continence Nurse Education Program (WOCNEP).
I asked my employer to help with school cost. They told me to write a proposal, so I wrote a proposal with three options. Fortunately for me, they took option number 3, which was full scholarship, and paid me for my time and my clinical time. Once I became certified, the local hospital also wanted my services, and in my community, my practice bloomed. In the last 23 years, I have spent time devoted to this specialty, which I absolutely love!
What attracted you to this specialty?
When I was in nursing school, I remember learning about leeches, and I NEVER wanted to be the “maggot” nurse for sure.
However, I think that what attracted me was that there were unmet needs in really sick patients; wounds were a puzzle; ostomies were interesting and it was satisfying to help someone get their life back after they contemplated that an ostomy would ruin it; and I learned a lot all the time and continue to learn.
As a student, I was the only one who would take care of this lady who was dying with this terrible fungating tumor on her chest. I held her hand, talked to her … the wound smelled horrible, and she knew that. But I didn’t want her to be alone or to feel like she was repulsive. I remember wishing I could do something to help her. I think of her very frequently, and hope she knows that partly I am trying to make other’s better because of her experience.
How are technological advances or industry advances changing WOC nursing?
When I started as a nurse, there were no fancy wound dressings. There was betadine and sugar, and there was antacid that we used, and of course wet to dry dressings, but there was nothing else.
I recall when the first “freeze dried” hydrogel hit the market, second to hydrocolloids. But in my 35 years as a nurse, we have evolved to complex technology with thousands of wound, ostomy, and continence supplies on the market. We know about wounds on a molecular level. Ostomies may be able to be done laparoscopically now, and even require little stay times.
Adhesive technology on ostomy products has also had an influence on the adhesives of medical tape. We understand continence and it’s effect on the skin as an organ, and we understand that the skin, the largest organ of the body, can fail, just as other organ systems do. We have research that has produced a robust foundation for evidence-based decisions, and we continue to expand that research as technology evolves and people get sicker. We know that wound, ostomy, and continence issues can be influenced by social determinants of health, and that we must see the whole patient to facilitate the best outcome.
We have standards for pressure-reducing surfaces, and we have clinical decision support tools for health care professionals and consumers alike that are evidence based. The evolution has been a revolution, and there is limitless potential as we go to continue to learn, research, develop solutions, and evolve.
What would inspire nursing students to consider this specialty as a career path?
On the outside looking in, nursing students may be intimidated or even put off by the wounds or ostomies. I think what many should consider is that a wound patient is very complicated—a mystery that must be unraveled. An ostomy patient is someone who has had a perceived life altering procedure, and while it can be life altering, many times it improves the life.
People who deal is continence issues or experience continence issues may feel isolated. WOC nursing provides complexity and the ability to enhance quality of life for individuals who are dealing with things that make them feel unaccepted or ostracized. There is no better feeling that making ostomy care successful or seeing a wound close. So, I would say, shadow a WOC nurse and just see if you think you might be up for a challenging and rewarding career!
What might surprise people about your role, all you do, and your connections with your patients?
The role of the WOC nurse is one that is very interprofessional. We become trusted and relied upon by others on the care team in the inpatient and outpatient settings. We are valued and sought out. We make long-term relationships with our patients. Sometimes those relationship are life long because the patients are seen episodically.
It is very gratifying to be able to step into people’s lives when they are vulnerable, scared, and embarrassed. Having the privilege of doing so has a lot of the “feel good” moments that nurses love. We sometimes experience the heartache of a patient having to lose a limb or live with a permanent impairment. But the rewards of actively participating in their wins along their healing path is extraordinary.
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