Spotlight on Educators
Patti Gable Burke
BSN, RN, CWOCN
President‘s Message:
Lifelong Learning and Teachable Moments
Education does not stop when we graduate from school. Learning is the lifelong process that makes us the clinicians we are today and the clinicians we will be in the future. As WOCNCB-certified nurses, education is the cornerstone of our role. It allows us to impact the staff we work with, our patients and most importantly ourselves.
From the moment we chose a career in nursing, we work hard to reach our goal of graduation. The knowledge that we continually gain assists us in providing evidence-based care. We choose to ask questions and to investigate to find the answers. Our patients and the present healthcare environment offer endless challenges that occur every day and push us to identify answers. Through reading, asking questions and our quest to find the answers, we will continue to enhance our knowledge.
Whether you are giving an in-service or demonstrating a dressing to a nurse at the bedside, each moment can be a teachable moment. It is often those one-on-one teaching moments that make the greatest impact on patient care. As a very wise woman once told me, "We educate one person at a time." The success of the wound, ostomy, continence and foot care programs at our facilities is only as good as the education that we provide to the nursing staff.
The greatest impact that education has on our role is when we are with our patients. The role of the CWOCN evolved out of the need to educate patients with new ostomies. As our role expanded from ostomy to wound care and then to continence care, one thing has not changed: our role as a patient educator. Our patients are often dealing with life-altering diagnoses. We come into their lives and empathize with them, nurture them, laugh with them, cry with them and cheer them on, in order to help them learn self care. There is no prouder moment than when all those teaching moments come together and the patients become independent in their care.
Education is power, and by teaching others we are empowering staff to improve the lives of their patients and empowering patients to improve the quality of their lives. There is an old adage, "Those who can, do; those who can't, teach." The person who said this truly did not know a WOCNCB-certified nurse.
Patti Gable Burke, BSN, RN, CWOCN
President WOCNCB
WOC Nurses Go Back to School
Accreditation Policy and Procedure Manual v
© WOCN 2009
Marsha Berenson, WOCNCB Marketing Manager
By now, schools are open and students everywhere are getting back into the study routine. Some of those students are Registered Nurses just beginning their studies in wound, ostomy or continence (WOC) specialty nursing at WOC Nursing Education Programs (WOCNEP) accredited by the Wound, Ostomy and Continence Nurses Society (WOCN). Students are seeking WOCN accredited programs because of the clinical practicum and practicum completion options offered in addition to the didactic course work.
It's no surprise that many new enrollments are directly related to the payment cuts for healthcare acquired infections and pressure ulcers by the Centers for Medicare and Medicaid Services (CMS). Renee Anderson MSN, RN, CWON, Co-Director of the Wound Management Education Program at the University of Washington in Seattle has seen an interest in wound education programs because of a greater need for expertise in chronic wound management. "The population needing wound management is growing larger along with diabetes and obesity," she explains. "This brings more job opportunities in the field."
But many of the students are like you, already certified by the WOCNCB, and have gone back to school to add a "W", "O" or "C" to their current credentials. Why are they spending hard-earned dollars as well as precious time online, away from home or with local preceptors for more didactic and clinical training?
Why "tri-specialty" certification?
Ms. Bryant and Ms. Rolstad observe that many students may have been unable to take the full scope of practice due to financial concerns or other personal issues. Today, webWOC courses are attracting nurses who are returning to complete the full scope. "Being able to provide full scope services increases the student's value in their employment setting and allows the student increased career mobility," Ms. Rolstad notes.
The ostomy programs in particular are serving nurses taking the ostomy scope to fill positions that are reinforcing growing services in major medical centers, replacing experienced practitioners prior to retirement or offering new ostomy rehabilitation services in small communities.
As Paula Erwin-Toth sees it, WOCNCB-certified nurses are educating themselves to meet today's healthcare challenges brought on by the economy, healthcare availability, comorbidities and CMS "never events". "Administrators must prioritize the skills of the staff they hire, observes Erwin-Toth, RN, MSN, CWOCN, CNS, director of the RB Turnbull, Jr. MD School of WOC Nursing at the Cleveland Clinic. "We WOC nurses are facilitators, educators and caregivers, and we must look at our roles across the continuum to develop ourselves in a broad sense to increase our sphere of influence."
Dr. Janice Beitz, PhD, RN, CS, CNOR, CWOCN, CRNP, is especially concerned about comorbidities. She is a professor of nursing and co-director of the WOCNEP at the School of Nursing and Health Sciences La Salle University. "We are seeing an increasing complexity of patients. It is imperative that nurses become certified in the 'tri-specialty' of wound, ostomy and continence because we are seeing patients with problems in two of the three areas or all three at one time."
Ms. Erwin-Toth cites other important reasons for full-scope WOC certification as a CWOCN®: employment opportunities with hospitals trying to attain Magnet status, climbing the "clinical ladder" for promotions and higher salaries and as a marketing tool for patients who understand the benefits of board-certified medical practitioners.
Many of you are already working toward the tri-specialty certification. "Between 70 and 80 percent of our students that graduate from our Wound Specialty Program recognize the need to obtain the full-scope education and certification," says Jane Carmel, MSN, RN, CWOCN, co-director of the Harrisburg Area WOC Nursing Education Program. "In response to this demand, we offer an ostomy and continence bridge program to our wound course graduates and to graduates from other accredited WOC programs."
Ms. Anderson is also seeing this interest at the University of Washington. "Students that have completed our wound course go back into the clinical setting and see the need for further education in ostomy management and return for additional education," she explains. "The wound care nurses are seeking more in-depth knowledge regarding tube, drain and fistula management."
Greater focus on evidence-based practice, graduate studies
The WOCNEP program directors are seeing other trends in wound, ostomy and continence education. Dr. Beitz is seeing and responding to a greater industry focus on evidence-based practice. "WOC nurses must be able to read research studies to glean more information about treatment," she asserts. "Because of that, we are pushing research critique in our program. It is a skill that nurses must have - the ability to determine which research studies are useful and which are unreliable." The webWOC educators are also emphasizing this skill, and requiring that all students read the literature and cite references in their class work.
The importance of this skill is emphasized by Dorothy Doughty, MN, RN, FNP, CWOCN, director of the WOC education program at Emory University in Atlanta. "The WOC role means you have to be evidence based," she says. "You must know the science, but never lose sight of the patient - truly a blend of art and science." Her conviction to this idea led Ms. Doughty to contribute to the WOCNCB's recent evidence-based practice literature review, which was published as a supplement to the July/August Journal of Wound Ostomy and Continence Nursing. The URL for the online supplement is http://journals.lww.com/jwocnonline/toc/2009/07001.
Another trend that is gaining momentum is enrollment at a graduate level. Because the La Salle and webWOC programs give 10 graduate credits to the WOC program graduates, many enrollees come for the certificate and end up going on for a master's degree in nursing. Some LaSalle students come for the Nurse Practitioner program but go on to complete the WOC program. Dr. Catherine Ratliff, PhD, APRN-BC, CWOCN, is also seeing this trend at the University of Virginia, where she is the WOC program director. The nurses who take the program as an elective get nine hours of graduate credit. "Once they graduate from UVA, they will have a master's degree in nursing, will be nurse practitioners or clinical nurse specialists and are WOC nurses who eligible to sit for WOCNCB certification," she explains.
While the wound program at the Medical University of South Carolina does not grant graduate credits, Director Dr. Phyllis Bonham, PhD, MSN, RN, CWOCN, DPNAP and current President of the WOCN Society is also seeing more nurse practitioners interested in the specialty. "They are finding their practice is closely involved with wounds and find the need for WOC education," she observes.
The need for WOC nurses to treat active and retired military personnel is a trend that led to the establishment of the VA Eastern Kansas Wound Management Academy in Leavenworth, Kansas. It is the newest WOCNEP and was established in 2007. The wound course is open to up to 10 students per class, and four seats per class are reserved for VA Eastern Kansas Health Care System nurses. Since the founding of the program, 13 VA Eastern Kansas HCS nurses have graduated from the course. "We needed to do something to take better care of the Veterans we serve and follow the VA Directive on Prevention of Pressure Ulcers by educating and certifying as many nurses as possible. That was our main goal," says Sharon Saim, RN, MSN, ARNP-C, CWCN. "And it is rewarding to watch our students go back to their units and take leadership roles in identifying wound and skin issues, treatment modalities, prevention, selection of support surfaces and become members of the wound management team for our Topeka and Leavenworth campuses."
Ultimately, taking better care of patients is why you became WOCNCB-certified nurses. That is why it is so important to continue educating yourself about the newest evidence-based practice, to add a "W", "O" or "C" , or perhaps an "FC "for foot care or "AP" for advanced practice to your credentials. You, your facility, and your patients will be glad you did.
More than One Way to "Hit the Books"
Marsha Berenson, WOCNCB Marketing Manager
Online, Web-enhanced, and distance-learning programs
WOC Nursing education program directors are making more elements of the didactic and theoretical parts of their programs available using learning methods that could be 100% online, Web-enhanced (meaning some part of the program is supported with online technologies) or through distance learning programs, which are defined as working with learners far from the institution through e-mail or postal mail communication.
One example of a Web-enhanced course is the wound program at the Medical University of South Carolina (MUSC). According to Dr. Phyllis Bonham, PhD, MSN, RN, CWOCN, DPNAP, director of the program, her institution's Web-enhanced course uses interactive online discussion boards, chat rooms, and online testing. Students then complete the clinical portion onsite at MUSC or in their own communities.
The University of Washington also Web-enhanced its wound program to shorten learners' time away from home. Its Web supports include: online lectures, self- assessment exams, online articles and interactive exercises, says Renee Anderson, MSN, RN, CWON, co-director of the Wound Management Education Program (WMEP) and Ostomy Management Education Program (OMEP) at the University of Washington (UW). In addition, the online ostomy program offered by UW includes an interactive classroom with daily access to faculty and even an online ostomy simulation program highlighting stoma site marking and interactive pouching case studies.
One program that is no novice when it comes to use of the Web is the webWOC Nursing Education Program, which has been in operation for 10 years. The program is 100% online and does not require travel for the theory parts of the course. Demand has been so great that the program increased faculty over the last few years. "The literature shows that successful teaching online requires more faculty time than face to face teaching," say R. Bryant, RN, MS, CWOCN and Bonnie Sue Rolstad, RN, MS, CWOCN, Program Director and Program Administrator, respectively, of the Minneapolis-based program. This tech-savvy program continues to investigate and use new technologies to increase interactions among learners and faculty. For example, webWOC conducts weekly live webcast classes where learners interact in an environment similar to a face-to-face classroom. They have recently added 1:1 academic telephone support for learners who have individual learning needs. The latest addition to the webWOC whiz-kids' technology is live video conferences for 1:1 or small group learning using Skype software. To help nurses who are unfamiliar with or nervous about using Web technologies, webWOC also offers live orientation labs prior to the start of the semester.
Split options, onsite immersion also popular
Nevertheless, onsite, "face-to-face" programs continue to experience steady or increasing enrollments. "Many learners prefer this style because the group dynamics, the sharing of experience, is a valuable experience," explains Paula Erwin-Toth, RN, MSN, CWOCN, CNS, director of the RB Turnbull, Jr. MD School of WOC Nursing, an onsite program at the Cleveland Clinic. Another benefit is the ability to focus exclusively on learning. "Our three-week onsite wound specialty course is an immersion program that we call boot camp," laughs Dr. Bonham. "We do 20 days including weekend hours and start and end on a Saturday; it's very intensive. We live, eat and breathe wound care," she adds.
So - which is best? Onsite, online, distance, or Web-supported learning? There is no right answer, but the WOCN-accredited programs are rich with options to offer nurses
opportunities to improve their skills in patient care.
Is Stimulus Money Allocated to Nursing Education Start of a Trend?
Marsha Berenson, WOCNCB Marketing Manager
If any good news about healthcare has come out of Washington D.C. this year, it's a focus on nursing education, a focus that will benefit nurses, nurse educators, healthcare facilities, and most importantly, patients.
In February, the United States Congress approved the American Recovery and Investment Act, which includes $500 million to address the current nursing shortage and the future shortage expected as Baby Boomer nurses retire. The Recovery Act split the funds with $300 million for the National Health Services Corps (NHSC) and $200 million for the Health Resources and Services Administration (HRSA). Other stimulus funds were allocated to the National Institutes for Health, which includes the National Institute for Nursing Research.
According to a report from www.surgistrategies.com, Recovery Act funds totaling $13.4 million were released on August 12. The Nurse Education Loan Repayment Program administered by the HRSA received $8.1 million. The funds will be used to help registered nurses pay between 60 and 100 percent of their nursing education debt in exchange service in areas with a nursing shortage. The remaining $5.3 million was released to the HRSA's Nurse Faculty Loan Program. These monies will fund 500 masters and doctoral nursing students who will become nurse faculty. The loan program will allow graduates to cancel up to 85 percent of their loan debt in exchange for four years of full-time teaching at a school of nursing.
Is this funding just the beginning of a national focus on financially supporting nursing and nursing education? Signs are encouraging.
In March, President Obama added $15 million to the 2009 fiscal year budget for Title VIII Nursing Workforce Development Programs to provide funding for nursing education and training.
In July, the U.S. House of Representatives' Labor-HHS-Education Appropriation Committee approved a spending budget for fiscal year 2010 that includes education funding to reduce the nursing shortage. The bill, H.R.3293, increases nurse education and training spending by $137 million over fiscal year 2009. (It also includes $204 million to reduce Healthcare-Associated Infections, a topic dear to WOC nurses' hearts.) The bill still needs to go through the Senate and under President Obama's pen before it becomes a law, but recent news from the Senate is encouraging. Last month, according to an August 26 article in Healthcare Finance News, Senator Jeff Bingamen (D-N.M.) introduced his own legislation to address the nursing shortage, and one key provision calls for grants to nursing schools to increase enrollment in doctoral programs.
These recent bills bear close watching as they are debated over the next few months. Now is a good time to call or write your senator with your opinion about the importance of supporting the nursing profession and nursing education. You can find your senator's contact information at http://senate.gov/general/contact_information/senators_cfm.cfm
When Money is Tight, the WOCNCB Benevolence Fund Helps Cover Exam Fees
In times like these when so many Americans are struggling with foreclosures and unemployment, it can be a hardship to pay the fees for recertifying your professional credentials.
In 2007, the WOCNCB established a benevolence fund to help certificants maintain their designations. Some circumstances that can qualify for a benevolence award include financial hardship arising out of severe illness or accident, death of an immediate family member, a natural disaster such as fire, flood, or weather and other personal tragedies.
To qualify for an award, the applicant must
- currently be certified through the WOCNCB,
- demonstrate financial hardship that prevents the candidate from recertifying, and
- submit a complete application including your most recent Federal Income Tax Return.
All applications are reviewed by the WOCNCB Audit Committee and Board of Directors and are kept in complete confidence.
Please don't let your certifications lapse due to financial issues. Click here for more information and to download an application.
