Wound, Ostomy and Continence Nurses

Wound, ostomy and continence (WOC) nurses are experts at providing wound care. All types of wounds are becoming increasingly problematic. For example, pressure ulcers are increasing in prevalence. These costly, ongoing problems have attracted attention to the practice of wound care and the need for wound specialists who can meet the growing demand for effective preventive care and management.

As the Centers for Medicare and Medicaid Services (CMS) transitions to value-based purchasing, the value of WOC nursing becomes apparent as facilities and agencies implement best practices to prevent and manage pressure ulcers and other acute and chronic wounds. This emphasis on preventive care is mandated across all care settings, including home health care, particularly as families increasingly care for aging relatives with functional declines.

WOC nurses are experts in planning and providing the comprehensive preventive care necessary to reduce the frequency of these conditions. Research has shown that patients in agencies with WOC certified nurses who provided in-person consults or telehealth consults, compared to those without WOC certified nurses, were nearly twice as likely to have improvement in pressure ulcers and 20-40 percent more likely to have improvement in lower extremity and surgical wounds, respectively. Each WOC nurse serves as an educator, consultant, researcher and administrator.

By Mary Arnold Long, MSN, RN, APRN, CRRN, CWOCN-AP, ACNS-BC, Wound, Ostomy & Continence Clinical Specialist, Roper Hospital

At the age of 7, Dana Davis learned she was suffering from type 1 diabetes. She had no idea what lay ahead.

Growing stronger

“I knew it meant one shot a day and I was scared of needles, but I didn't understand what the impact would be,” she says. “It wasn't until I got my first wound when I was 20 that I realized there would be complications.”

And there have definitely been struggles for Davis, who serves as executive director of the Children's Diabetes Foundation. Setbacks from diabetes led to the eventual amputation of her big right toe. She's undergone three painful surgeries to treat septic arthritis of the knee, and balance issues brought on by multiple sclerosis force her to walk with a cane.

More than a wound

Davis, a philanthropist and daughter of the late billionaire and former 20th Century Fox owner Marvin Davis, admits it's frustrating when people have a limited perception of her.

“You feel like you're a giant wound, and that's all people want to talk about. Doctors may only see you for your wounds, when they should know what else is going on in your life. You often feel embarrassment and shame, and have self doubt, because society says we're supposed to look or be a certain way.

“A lot of the time,” Davis adds, “I felt like I must be doing something wrong. But I wasn't doing anything purposely to get these wounds.”

Communication is crucial

Having endured countless hospitalizations and close to 60 foot wounds, Davis says it's important for patients to speak up during treatment. “You have to realize your voice matters and counts. If something doesn't feel right, you have to say it.”

Having a support network also makes a difference, along with maintaining a sense of humor. Says Davis, “Being able to laugh is so important. It takes away the wound's power."

SOLE COMFORT: Having gone through eight diabetes-related corrective foot surgeries, Davis launched a line of comfortable, luxury shoes that allowed her to make something more of her diagnosis.

Moving forward

In order to advance wound care to the next level, patients and clinicians need to recognize the importance of a positive attitude.

“Dealing with wounds gets to be a downward spiral for many people. I think you heal better when your head's in the right place. I'm very passionate that you can lead the most normal life you can, and not feel like your wound is all you are. It only defines you in that it makes you strong, and you have to find new and different ways to do things.”