Chronic wounds – or pressure wounds – appear to be facing epidemic proportions.
These wounds, which include pressure and venous insufficiency and diabetic ulcers, affect around 6.5 million Americans and cost more than $25 billion for treatment each year. An estimated 2 percent of people in the United States has a chronic wound that is secondary to pressure, venous or arterial disease, or as a complication of diabetes mellitus.1 These numbers are only rising because of an aging population and an increased prevalence of obesity and, with that, diabetes.
With all of this, there has become a high demand in all patient settings — acute-care, nursing home and long-term care, the physician’s office and home — for nurses who have the knowledge and skills to help prevent and manage wounds. Yet we find there is a shortage of certified wound ostomy and continence nurses (WOCNs). Wound care nurses are aging out, and we’re not replacing ourselves.
There is no single answer for why, other than new nurses and nursing students have more exposure to other advanced practice opportunities.
In my experience, the pathway for nurses to specialize in wound care is varied, oftentimes occurring by happenstance; nurses find their way into the specialty if they’re treating patients with chronic wounds on med-surg, critical care or oncology units, the operating room (OR) or post-anesthesia care units. As a sub-specialty, wound ostomy and continence nursing is not standard curriculum for most undergraduate or even graduate nursing programs other than opportunities such as shadowing experiences.
This was my introduction to wound care — shadowing a wound ostomy and continence nurse in the hospital setting when I was in nursing school. What immediately attracted me to the field was the opportunity to have great one-on-one interaction with the patients I was treating and, from a clinical standpoint, acting like a private investigator — unraveling what is causing a specific wound and what’s required to get it to heal, while having great relationships with my patients, their families and caregivers.
Chronic wound care is not about changing dressings. It’s an opportunity for nurses to really put their clinical, critical thinking and diagnostic skills to work. The pathophysiology is so complex that nurses drawn to this specialty will never become bored. Where it was once considered “folk medicine,” wound care in some cases has become so advanced — negative pressure wound therapy, for example — that it is being done in the OR and has become attractive to physicians.
Now, under the new healthcare model, as care shifts to the post-acute setting, we’ll see more patients with chronic wounds being treated at home or in long-term care facilities — many of which are looking to become wound care centers of excellence and will need WOCNs.
The need and the opportunity for wound care and management expertise is why campaigns like “Why Wound Care” have been established to drive awareness. (Cardinal Health is a founding corporate sponsor.)
“Why Wound Care” was developed to address healthcare workforce issues that may affect optimal care for patients with chronic wounds or who are at risk for developing chronic wounds. The statistics I’ve shared in this article come from the campaign’s website. Its goals are to:
- Provide nursing students and recent graduates access to a wide variety of wound care resources
- Provide nursing faculty educational resources and guidelines for integrating wound prevention and care into nursing curricula
- Provide nursing students, recent graduates and nursing faculty with information about rewarding careers in wound care
The website, guided by wound care and management experts from across the country who make up the “Why Wound Care” Advisory Board, also offers complimentary best-in-class wound care educational resources for current and recently graduated nursing students to stimulate their interest in a specialized wound care nursing career. Nursing school faculty members are also welcomed to take advantage of this resource.
The good news is that there are many accredited WOCN education programs across the country for nurses to consider – some come with certification, some do not.
Wound care is one of the most independent roles in nursing, and the career is anything nurses want to make of it. As a private practice nurse, for example, I consulted with different entities that treated wound care patients. Nurses can work part time or full time. They can travel. They can teach. They can have a powerful impact from a system perspective. We just need to help get the word out.