Wound, Ostomy and Continence Nurse

A wound ostomy-continence nurse (WOCNs) cares for patients who have active wounds or the potential to develop wounds. They also care for patients who have ostomies. Wounds may be surgical in nature or may be the result of skin breakdown, disease or injury. A wound ostomy nurse’s job is to make sure wounds don’t become infected and that they heal properly.

Education Requirements

In order to become a wound ostomy-continence nurse, a student must first complete a four-year Bachelor of Science nursing program or a Master’s of Science nursing program. Afterwards they must pass the National Council Licensure Examination (NCLEX). It would benefit a nurse to work on a med/surg unit for a year or two to become familiar with different types of wounds. Afterwards a nurse can apply for an entry-level position as a wound ostomy-continence nurse and train under an expert.

Wound Ostomy Nurse Certification

Becoming certified demonstrates expertise and differentiates between an entry level wound ostomy nurse and an expert. Certification provides more job opportunities for nurses as is assures employers of the nurse’s knowledge and skills. Nurses must be recertified every five years to maintain certification.

Characteristics of a WOCN

• Leadership skills
• One who takes the initiative
• Not afraid of change
• Does not fear challenging cases
• Excellent communication skills
• Excellent teaching skills
• Patience
• Dedication to always learning new techniques

Job Description & Duties

Wound ostomy nurses work as part of a healthcare team: a doctor who approves orders of a WOCN, a dietician, who makes sure the patients are receiving the right nutrients in their diet to heal, and a social worker who makes sure patients receive resources they need at home for their wounds. This team of healthcare providers give patients the best possible care.They care for patients who have acute or chronic wounds. WOCNs collaborate with physicians about wound care and write orders for nurses to follow. Wound ostomy nurses work in hospitals, clinics and in home care. They are used as resources for nurses who have patients with challenging wounds and are often requested for patient consultations.

Some Types of wounds WOCNs care for:

• Surgical wounds – Surgical wounds are wounds intentionally made by a surgeon to perform a necessary surgical procedure. After surgery, the surgeon orders a specific type of wound care to aide in healing of the wound. Sometimes surgical wounds are left open to heal from the inside out. These types of wounds require daily packing to promote the healing process.
• Ostomy– an ostomy is an opening in an area of the bowel or bladder. The opening is covered with an apparatus which collects bodily fluids. This opening has to be properly cared for to prevent irritation of the surrounding skin and infection. Certain types of dressings are used around these openings. A wound nurse monitors the integrity of ostomies and teach patients, family members and healthcare staff how to care for them.
• Injuries – Wounds from injuries may or may not require surgical intervention. They may have jagged edges which are a challenge to approximate, in which case surgical intervention would be the best route. A wound ostomy nurse would care for the wound as ordered by the surgeon.
• Disease Process– Diseases such as diabetes or peripheral vascular disease cause poor circulation which are a potential for wound development. Wound nurses monitor these patients and prescribe treatments to prevent skin breakdown.
• Bed Sores – patients who are bedridden have the potential to develop sores from pressure on bony prominences. If patients are turned and repositioned frequently, bedsores can be prevented. Sometimes, even with the best of nursing care,patients still develop bedsores, because their nutritional intake is low and skin integrity is poor.

Job Outlook and Salary

The job outlook for wound ostomy-continence nurse is very good as people are living longer in the United States and need more health care. Wound ostomy nurses earn approximately 90,000 annually, depending on experience and geographical location.

Job Duties of Wound Ostomy Nurses:

• Assess patient’s skin integrity
• Suggest ways to keep patients skin integrity intact
• Write care plans for wound care
• Prevent skin breakdown in hospitalized patients
• Treat wounds of surgical patient
• Treat patients on an outpatient basis
• Patient teaching
• Staff education
• Perform specialty services such as wound dermabrasion

Resources

• Wound Ostomy and Continence Nurse Society: www.wocn.org