Wound Care Nursing: Interview with Alice Allen, RN, BSN
Using treatments and therapies to heal complex wounds
Alice Allen, RN, BSN
Inpatient Wound Care Specialist, Valley Presbyterian Hospital, Van Nuys
What can you share with us about your career path as a nurse?
I have been in the nursing field for about 16 years. I started as a LVN and then moved on to pursue my ADN. I quickly went back to school and achieved my goal of obtaining my BSN.
How did you become interested in wound care as a specialty?
My very first nursing position was as a wound treatment nurse. It was a crash course for a new grad, and I didn’t know I would fall in love with the field until after my first experience. Ever since then, I have always been involved in wound care in some way.
Please tell us the special certifications that you’re currently pursuing.
I am pursuing the OMS [ostomy management specialist] certification. Later this year, I plan to pursue the CWS [certified wound specialist] certification. I have been working in the wound care field for more than 14 years and have seen so much. Pursuing these certifications is a way to further demonstrate my commitment.
What is it about wound care nursing that feeds your spirit and keeps you coming back?
I like the excitement of watching a wound as it heals and investigating the underlying cause of why it might not heal. I enjoy helping patients find some type of resolution or obtain information. There’s nothing like seeing a smile on a patient’s face when their wound is completely healed.
Is there a HIPAA-compliant patient anecdote that illustrates the joys and/or challenges of your work?
I treated patients in an outpatient setting with a doctor. Our patients were required to have weekly follow-ups. One patient we treated had stage 2 and 3 pressure ulcers on both lateral malleoli and acquired a stage 2 wound on her sacral coccyx. We treated this patient for four weeks and the pressure ulcer on her sacral coccyx healed, but the wounds on her malleoli were increasingly progressing.
We would educate the patient on keeping pressure off of her feet and malleoli. One day, she came in for a visit and her malleoli had healed. We were so excited for her and even printed out a certificate of completion. Then, we learned that the healed stage 2 wound on her sacral coccyx opened up again. Although we healed her completely, her skin still broke down.
Education is the key, and this is sometimes challenging. Patient compliance is very important for wound healing.
Do you work with adults and children?
I work mainly with adults, but I have consulted on children, as well. I make sure to always work together with the doctor for more complicated or difficult cases.
How has technology impacted wound care nursing in the last decade?
Technology has been very good for this area. There are many advances in documentation. Programs such as WoundExpert, often used in outpatient clinics, can also be used inpatient. There also are many phenomenal care modalities and treatments now available to aid in healing. Say goodbye to the days of wet-to-dry wound dressings!
What are you seeing in terms of MRSA and other antibiotic-resistant bacteria in wounds?
Methicillin-resistant Staphylococcus Aureus (MRSA)
MRSA seems to be a hot topic, especially among many hospitals and the news media. Fortunately, from what I have seen, wounds with MRSA are treated aggressively with antibiotics, either IV or oral. Topical antibiotics also are considered and used. Most times, when a wound is swabbed, the MRSA may already be colonized. In cases where this happens, the healthcare provider may practice treating it in a conservative manner and monitor the patient’s condition as well as the progression of the wound.
Vancomycin-resistant Enterococcus (VRE)
VRE in a wound bed is treated much like a wound infected with MRSA. A patient with either type of bacteria will be placed on contact isolation and, if the patient is at home, the patient and caregiver are educated about proper hand-washing and laundry care. This is to ensure the safety of family members and prevent the community from contracting these super bugs.
I’ve heard that many wound care advancements come from the military and battlefield medicine. Is this true, and where else do you see advances coming from?
I believe that many advancements have come from the military, especially post-9/11. During wartime, we see injuries that are atypical and some may fall outside of certain protocols. I used to work for the Veterans Administration hospital in West Los Angeles and the access to different advanced therapies was impressive.
Cost has always been an issue in the private sector, but in the military, these soldiers are able to receive the highest grade of wound care and prosthetic products and treatment. More of our single or double amputee soldiers are able to go back to work full-time in the military and this is because of the new advances.
What do you find most challenging about your work?
The most challenging aspect of my work is not being able to heal a wound. As a wound care nurse, I want to heal the world! When I do not get my way, I get a little frustrated.
What certifications are required?
Along with experience, there are several certifications necessary to becoming a specialist: WOCN [wound ostomy continence nurse], CWS [certified wound specialist], WCC [wound care certified], CWCA [certified wound care associate] and OMS [ostomy management specialist].
Do you have future career goals that you would like to share with us?
I plan to continue in this field. I also plan to obtain my MSN/NP, specializing in nurse education and wound care. I want to give back to the nursing community by educating future nurses about the importance of proper skin care and wound management.
Is Wound Care the Right Specialty for you?
Alice Allen offers the following career advice to nurses considering this field:
1). Do your research on wound care. Find out what’s available in the way of education, seminars, etc.
2). Find a preceptor. You want someone who loves the field and is still excited about their career path.
3). Obtain the certifications that will increase your knowledge. This will increase your marketability as well.
4). Do not fear the unknown. You will see different types of wounds that are not typical. Remember, you will be an expert in your field and nurses, doctors and other allied healthcare workers will depend on your expertise.
5). Have fun with wound care. This is an ever-changing field and there are lots of new advancements.
Keith Carlson, RN, BSN, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students.
This article is from workingnurse.com.