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Spotlight on Quality of Life

President‘s Message:
A Focus on Quality

WOCNCB credentialed nurses make quality a priority in the patient care they provide and the work they perform to improve outcomes. I have personally observed this quality exhibited in the many nurses who volunteered their time and talents in service to the WOCNCB.

Board and committee members are the heart and soul of our organization. These individuals demonstrate quality and dedication every day as they work to ensure that nurses certified through the WOCNCB promote the highest standard of care and safety to patients who seek wound, ostomy, continence and foot care. Their dedication ensures that the WOCNCB's credentials remain The Gold Standard for Certification^sm.

My term as President of the WOCNCB is coming to a close. It has been an honor to serve the organization and each of you for the past two years. What I have given to the Board is minimal in comparison to the knowledge I have received and friendships that I have made. I want to share with you the accomplishments that your Board has achieved during the past two years:

• Developed a new five-year strategic plan
• Reestablished the Tri-Educational Meeting, a cooperative effort of the WOCN Society, WOCN Education Program Directors and the WOCNCB
• Awarded an annual Employer of the Year Award to recognize employers that support the value of WOCNCB credentialed nurses
• Established a Marketing Manager position
• Implemented Certification Grants for exemplary WOCNCB-credentialed nurses
• Revised the Advanced Practice (AP) PGP Portfolio
• Created the AP Exam Committee to develop an AP WOC Exam
• Published the first annual Review of the Evidence for WOC Nursing Practice
• Collaborated with the WOCN Society to revise the Entry Level CWOCN Position Statement; distributed it to state healthcare associations, state boards of nursing, CMS and QIOs
• Established the Item Review Committee to review exam questions
• Completed the LPN job analysis
• Collaborated with the WOCN Society in an outreach to begin a mailing campaign to the state healthcare associations, CMS and QIOs
• Continued and expanded our marketing campaign to administrators and regulators
• Developed interactive PGP forms to simplify the PGP process. The online system will be available in January 2010
• Established an annual Nurse In Washington Internship scholarship that begins in 2010
• Formed a Public Policy subcommittee to monitor state and federal public policy that impacts wound, ostomy, continence and foot care nursing.

I would like to thank the WOCNCB office staff, the Board of Directors, committee members and reviewers for all their hard work. We could not have accomplished all these initiatives without your time and talents that you have so generously given to the WOCNCB. Organizations can't look in the mirror to see where they are going. To stay strong and viable, they must look through the window to see what potential factors will impact them. The future of the WOCNCB is strong as our visionary Board and committee members continue to work to ensure the WOCNCB credentials remain The Gold Standard for Certification.

Patti Gable Burke, BSN, RN, CWOCN
President WOCNCB

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Hearty Hellos

WOCNCB Announces 2010 Board of Directors
The Wound, Ostomy, and Continence Nursing Certification Board is pleased to announce your Board of Directors for 2010. The future of the WOCNCB is always exciting, and we know that the 2010 Board will make significant contributions to the direction and goals of the WOCNCB.

• President, Diana Gallagher, MS, RN, CWOCN, CFCN, CHT
• Foot Care Examination Committee Liaison, Laurie Ellefson, RN, BSN, CWOCN, CFCN
• Financial Officer and Chair, Nominations and Awards Committees, Marilyn Swindle, BSN, MBA, RN, CWOCN
• Professional Growth Program Committee Liaison, Mary Gloeckner, MSN, RN, CWON
• Liaison to the Marketing Committee, Public Policy Sub-committee, and Chair, Credential & Review Committee, Kathleen K. Otten, BSN, RN, CWOCN
• Liaison to the Alternative Level of Certification Committee and Chair, Experiential Pathway Committee, Jeannine Thompson, BSN, RN, CWOCN
• Wound, Ostomy and Continence Exam Committee Liaison, Amy Schaffner, MS, RN, FNP-BC, CNS, CWOCN
• Evidence-Based Practice Committee Liaison, Patricia S. Collins, MSN, RN, CNS, APRN-BC, CWOCN
• Advanced Practice Committee Liaison, Donna L. Thompson, MSN, CRNP, BC, CCCN
• Item Review Committee Liaison, Gail A. Forthoffer, MSN RN CWOCN
• Audit Committee Liaison and Public Member, Richard McCall
• Immediate Past President, Patti Gable Burke

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Fond Farewells

The New Year is a time of change, and as we welcome our newest WOCNCB Board members, we must also recognize and express our thanks to those members who have completed their terms of service.

Carol Calianno, MSN, RN, CWOCN, CRNP Term: 2006 - 2009
Carol served as Financial Officer for two years, Chair of the Credential & Review Committee for four years, Chair of the Awards Committee for two years and Chair of the Experiential & Graduate Pathways committee for one year.

Donna L. Loehner, BSN, RN, CWOCN Term: 2006 - 2009
Donna served four years as the Professional Growth Program (PGP) Committee Liaison, which included presenting PGP seminars at the annual WOCN Society Conferences.

J. Frank Perdue Term: 2006 - 2009
Frank served as the Public Member of the Board of Directors, ever reminding us of our mission to promote the highest standard of consumer care and safety.

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Quality of Care Restores Quality of Life

Marsha Berenson, WOCNCB Marketing Manager

I have this recurring nightmare where I walk into an important meeting and realize I'm in my pajamas - or less. That feeling of fear and vulnerability sometimes stays with me for the rest of the morning.

Barbara Twedt had the same feelings, only hers were from something real. Earlier this year a temporary ileostomy had her feeling all those feelings and a few more. The disgust and repulsion she felt is not uncommon, as you ostomy nurses know. It was care by WOCNCB-certified nurses that helped Barbara understand and deal with her ostomy and her fears.

In the summer of 2009, Barbara learned that her weakness and lack of appetite was due to severe diverticulitis. When her doctors at Deaconess Medical Center in Spokane, Washington, explained that they would have to remove a section of her colon and perform a temporary ileostomy, she was scared and repulsed. But on that same day she was visited by two WOCNCB-certified nurses, Linda Kemnitz, RN, CWON, and Jill Lay, RN, CWON, who helped her with her fears by explaining the procedure and demonstrating the ostomy equipment.

Those fears did not leave her entirely. Barbara remembers, "Even when I was still in the hospital and used it, it was still repulsive. Poop in a bag! And it was scary because I knew I had to take care of it."

Barbara's post-surgery WOC nurse, Linda Kemnitz, was supportive. "She helped by explaining everything to me." Barbara recalls, "She had a fantastic sense of humor, which really helped. In the hospital, it was so new and I was so scared and apprehensive. Her place was to begin the education process and to get me laughing!"

As Barbara healed and the time to leave the hospital approached, new fears surfaced. "I'd love to get out of that room, but I was scared because Linda would not be there with me. The nurses were my security to answer my questions. I said 'I can't do this when I get home!'"

Help at home came from Barbara's very supportive husband, Lyle, and from home healthcare expert Amy Schaffner, ARNP, CNS, CWOCN. "The day I got home Amy came," she recalls. "She was here a couple of hours, and she was extremely positive and encouraging and made everything seem manageable. She would always affirm Lyle and me for our teamwork as we changed the ostomy bag. As time and weeks went on my attitude changed from 'I can't' to 'I can.'"

Barbara still felt apprehensive, and because she had to empty the ostomy bag every two hours, she was sure she'd be confined to her home. Her biggest fear was that the bag seal would leak. "Amy was extremely encouraging and would say, 'Let's work on this,' and showed me how to pack the things I need. 'What about movies?' I asked. Amy gave me a tip - that if I ate two marshmallows, it would slow everything down!" Soon Barbara was able to take care of the bag and was able to go on shopping trips because she knew she could manage emptying the bag in public restrooms.

Now that the ileostomy has been taken down and her colon reconnected, Barbara looks forward to going back to her job at the Spokane Public Schools where she is a junior high school secretary. She also plans to take more walks, see more movies and spend time with her husband and their six children and four grandchildren.

When she thinks back to her experience, Barbara sees that it was not as daunting as she thought it would be. She also remembers the personalities and character of the WOCNCB-certified nurses who helped her heal and change her attitude. "They would help dispel my biggest fears. They really lifted my spirits, which is so important in quality of life. I was so down and busy with dealing with it all day and through the night. Thank God I had them to help me through and make it clear I could do more than I thought I could."

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I'm Lucky to Be Alive!

Marsha Berenson, WOCNCB Marketing Manager

That was Lisa Davis's reaction when her doctor in Moscow sent her to London to find out what was causing her shortness of breath and rectal bleeding. And when she learned she had a stage two tumor and needed a colostomy, she burst into tears.

It was 2007, and Lisa was in the Foreign Service working as a secretary for the United States Ambassador in Moscow, and although the Moscow facility had an employee medical office, the trip to London was necessary for a final diagnosis. While in London, Lisa visited an Enterostomal Technician who let her handle the ostomy equipment. "It wasn't so bad - I'd envisioned an old-fashioned hot water bottle," she recalled.

Lisa's surgery took place in Arkansas, where she and husband Jerry, who is also in the Foreign Service, have their home. Before surgery, Lisa worked with Diana Gallagher, MS, RN, CWOCN, CFCN, CHT to mark the site for the stoma. "She had me bend and move to find the best place for it," Lisa remembers. "She gave me one to wear for a day, and I thought, 'It's not as bad as I thought,' although it was sweaty in the hot and humid weather."

Her work with Diana and all the literature she had been reading made Lisa feel more confident about living with an ostomy, but she still had some tough physical and emotional realities to go through. In her four days at the hospital she dealt with one staff nurse whose answer to her leaking bag was merely to tape it. After leaving the hospital, there was intense pain, six months of chemotherapy and six weeks of radiation.

Some of the toughest times are now some of Lisa's funniest stories, as when the time came for her bandages to be removed. Jerry, who was standing behind her, said, "Honey, we have to talk." The surgeon had sewed her "glutes" together! Lisa now refers to her new look as her "Barbie butt."

After her surgery, Lisa continued to receive support from Diana at the hospital's wound clinic. On their first visit, Lisa and Jerry spent three hours asking questions and getting practical answers. According to Lisa, "We had questions about our sex life, and the doctor got so embarrassed and sent us to Diana. She was frank and open and helpful. And that's something people are interested in."

When asked about the benefits of working with a WOCNCB-certified nurse, Lisa tells of a situation that could have been fatal. In February of 2009, Lisa had hernia surgery that did not heal properly. A loop of bowel had caught in the hernia mesh, and the bottom of the incision never closed. The surgeon at the Washington, D.C. hospital advised her to stuff the incision with gauze until it healed. It continued to leak, and she was sent to a urologist who found nothing wrong with her bladder.

When Lisa returned to Arkansas and visited the wound clinic, Diana cleaned it, cultured it, and dressed it. The culture revealed an aggressive form of MRSA, and Lisa was justifiably upset about the situation. "It was a big ball of pus when they cut it open! A board-certified nurse in Washington would have made all the difference. I'm lucky to be alive!" she exclaims.

Lisa is quite enthusiastic about her quality of life and still finds time to do all the things she used to do, like biking 16 to 18 miles weekly, swimming, singing in the church choir and working on a Gospel CD. "The only difference is I have an ostomy kit with me and a change of clothes at work, and I only had to use it one time," she says. She has added a monthly ostomy support group meeting to her busy schedule, and is now in a program to become a human resources officer for the State Department.

In the two years since her diagnosis and ostomy, Lisa has had many interactions with healthcare professionals, including WOCNCB-certified nurses. She has clear advice for others in her situation: "The board certification is ENORMOUS! The board-certified nurse knows her stuff! Everyone who has this type of operation should see a board-certified nurse."

We can't help but agree.