Kara S. Couch, MS, CRNP, CWS, is a nurse practitioner in the Division of Rheumatology. She practices at the Limb Preservation Center at the George Washington (GW) University Hospital. Prior to joining the staff at GW, Kara worked at Medstar Georgetown University Hospital and Walter Reed National Military Medical Center. She srves as a member of the International Consolidated Guidelines Task Force for the Association for the Advancement of Wound Care and is the co-leader of the International Consolidated Venous Ulcer Guideline which was updated in 2015. She lectures nationally on wound care topics and has been published multiple times in peer-reviewed journals and textbooks on wound care.
National Nurses Week, celebrated May 6-12, 2017, offers an opportunity to reflect on the art and science of the profession, which combines clinical knowledge and the ability to make a difference in lives, which can only be gained through hands-on experience.
National Nurses Week (May 6-12, 2017) is a time to celebrate our profession and reflect on the impact we’ve had on people’s lives through our work. I earned my credentials as a nurse practitioner and certified wound care specialist through a rigorous nursing curriculum and countless hours of specialized training, which prepared me to address patients’ physiological needs. It took first-hand experience treating patients, however, to fully equip me to take care of the person beyond their clinical diagnosis.
That’s because nursing—one of the nation’s fastest growing professions—is a career that blends both art and science: it takes clinical knowledge to recognize and understand a patient’s disease process and illness, but knowing how to really make a difference in patient care is cultivated through experience.
The Art of Wound Care Nursing: Holistic Healing
For wound care nurses, in particular, making a difference in the lives of our patients requires a holistic approach. Our relationships often span many years, as we care not only for patients’ chronic and difficult-to-heal wounds over time, but also address their nutrition, ability to function, and lifestyle habits. We offer reassurance, guidance, and education as they endure complicated and frequently painful procedures and surgeries. We serve as their advocates, cheerleaders, health and wellness educators, and weight loss coaches.
Good nursing care is the science of treating the problem at hand and the art of understanding the big picture regarding a patient’s individual needs. And these go hand-in-hand; you cannot have one without the other.
For example, at George Washington University Hospital where I serve as a nurse practitioner in the Wound Healing and Limb Preservation Center, 10% to 15% of my patients are homeless. Another 10% to 15% of my patients use illicit drugs. As their healthcare provider, part of my job entails having honest and realistic conversations—direct, but without judgment—about the realities of their personal situations and the impact these situations have on the wound healing process.
Wound care nurses have these types of conversations with patients every day. We talk about lifestyle choices, habits, financial concerns, the patient’s emotional state, and a variety of other factors that can be deeply personal but also incredibly relevant to their wound healing journey.
Patient-centered wound care is not learned in a textbook—it is borne from experience. Wound care nurses are uniquely adept at providing this care and adjusting treatment plans, suggesting new treatment options, and helping the patient advance on the path to healing.
The Science of Wound Care Nursing: Creating a Wound Care Plan for the Patient
Wound care is a specialty of increasing importance as more and more Americans suffer from complex conditions that can lead to chronic and hard-to-heal wounds. For example, of the 29 million Americans living with diabetes today, 1 in 10 will develop a diabetic foot ulcer (DFU).1 Without timely, appropriate and effective wound care, approximately 15% of patients with a DFU will ultimately undergo a life-changing lower-limb amputation.1 In fact, according to the Amputee Coalition, these non-healing wounds now represent the leading cause of non-traumatic lower extremity amputation in the United States.
The statistics are alarming, but tempered by our growing ability to employ state-of-the-art treatments backed by science. Whereas once our options to treat these wounds were limited to cleansing, painful debridements, and simple dressings, today we have access to advanced, FDA-approved and FDA-cleared therapies that help patients at all stages of wound healing.
Biomedical advances have provided clinicians with numerous options for products that can treat chronic diabetic foot ulcers and venous leg ulcers as well as other types of wounds. With so many treatment options on the market, success comes with understanding the best options for a patient’s given circumstances. Wound care nurses play an important role in applying the science of wound care to a particular patient’s treatment plan. By knowing what products are on the market, and which products are backed by sound clinical data, wound care nurses can help identify the best product for a patient’s specific situation.
Healing Wounds, Changing Lives
Every patient — and every wound – is different. As wound care clinicians, our treatment goal is to heal the wound so that patients can do the things that they choose, whether it be returning to work, spending time with friends and family or simply just taking a shower. This is very personal for me: I am so deeply gratified when I have successfully worked with a patient to heal their wound and been a part of helping them get back to the life they want to live.
The job of a wound care nurse extends well beyond hours spent in the clinic as the lives and wellbeing of our patients are never far from our minds. We work continuously to revise treatment plans based on wound progression, personal circumstances, and available treatment options.
As we recognize National Nurses Week in May, I’m overwhelmingly proud to be a part of this great profession and to stand among my colleagues across the country who are dedicated to both the art and science of healing — it’s that passion that sets our work apart and truly makes a difference in peoples’ lives.
1. Morbach S, Furchert H, Groblinghoff U, et al. Long-term Prognosis of diabetic foot patients and their limbs: amputation and death over the course of a decade. Diabetes Care. 2012;35(10):2021-2027.