Success in Many Wound Care Hats
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Success means having the courage, the determination, and the will to become the person you believe you were meant to be. – George Sheehan
Don’t let the SAWC Host Committee hats fool you. Carolyn Cuttino, RN, BSN, CWOCN, is an experienced, dedicated, versatile wound care clinician. She attended the Medical University of South Carolina College of Nursing ([MUSC] Charleston, SC) and earned her Bachelor of Nursing degree in 1970. A member of Sigma Theta Tau Society, she began her nursing career as a registered nurse at MUSC, working in Intensive Care, Burn and Trauma, and Staff Development. She attended Emory University’s (Atlanta, GA) WOCN program in 1977 and became MUSC’s first enterostomal therapist in the 600-bed teaching institution. Carolyn served as a WOCN until her “semi-retirement” in 2002. Today, Carolyn has her own consulting company, Carolina Wound Management Consultants, Charleston, SC. She contracts with nursing homes for staff education and wound management, makes rounds to ensure quality management and proper documentation, and provides expert opinion relative to negligence and malpractice litigation. Carolyn also works part-time at MUSC, handling acute care responsibilities and collaborating with other WOCNs on professional and clinical issues. She also does presentations on wound management. “I like the variety and wide scope of practice I get to experience each day,” she says. “There is no such thing as tunnel vision in the wound care arena.”
Carolyn asserts that the big picture in wound care is not about any one site of service. Nor is it about any one best product or the best wound care modality. Instead, the big picture is about doing everything possible to promote wound healing and ensure patient comfort and safety at all times. For example, in the acute care setting, the common goal tends toward managing, not necessarily healing, the wound because the patient likely will not be there long. However, Carolyn firmly believes the goal should always be to get the wound as healed as possible before discharge. “There are more resources in the hospital setting than that in long-term care or home care,” Carolyn explains. “We need to utilize these resources before patient discharge and become familiar with the community resources to ensure appropriate follow-up.
Carolyn currently is involved in a unit that serves patients with healthcare issues who cannot be cared for at home because they have no home, family, funding, or money. Some patients are in this unit for months, even years, awaiting placement and some type of funding so they can be discharged to a residential facility or nursing home. Some patients are content to be discharged to a homeless shelter. Carolyn says barriers to securing care for these persons are the lack of resources, government regulations, and the length of time it takes to obtain assistance from state and federal programs. Carolyn urges clinicians not to be satisfied with the status quo. “As the science of wound care advances, we must advance with it,” she says. She encourages professionals to try new modalities, attend conferences, and stay abreast of new concepts in the literature. Another barrier is a lack of qualified clinicians to care for patients with chronic wounds (because time and effort are wasted). She says there needs to be some governance or criteria met before professionals can hang an outpatient wound care shingle.
Although Carolyn’s professional responsibilities in the work environment have evolved over the years, many of the patient scenarios remain.