My Scope of Practice: Caring for the Skin in the Game
Connie Hatley, EdD, RN, CNOR, CLNC always believed “the possibilities are endless” with a nursing career. With 40 years of experience, Connie has worked in nearly every nursing specialty. Her career, like medicine, has evolved and grown as the times change.
In the late 1970s and early 1980s, Connie, a State University of New York-Albany graduate, worked as a wound specialist at a facility in Beachwood, Ohio. This was before the industry standardized wound specialization and implemented certification programs. “Wound care and prevention have always been something I enjoyed,” she says. “As a perioperative nurse, I know positioning and preventing nerve and skin damage is paramount to patient safety.”
Later in her career, Connie served as a health care coordinator and adult career development coordinator at a career technical school in Tulsa, Oklahoma. There, she worked with the Oklahoma Board of Nursing to develop curriculum for nurses who had disciplinary action against their licenses. She then obtained a legal nurse consultant certification, creating an opportunity to grow her interests in nursing jurisprudence and risk management. After serving as an education team lead, Connie became a compliance and regulatory specialist for St. John Medical Center (Tulsa, Oklahoma), a position she holds today. “I presently draft policies and work instructions for St. John and often the entire health system,” Connie says. “This role has been self-expanding, a true learning experience, and at times very rewarding. I really love what I do because it’s challenging doing the research and figuring solutions to problems.”
Connie is aware the skin often is overlooked in the operating room. Many perioperative nurses are not formally trained in wound care; their concerns center on what happens on the operating table. A 2012 study by Braden has shown 25% of pressure ulcers are acquired in the operating room, where patients can be immobile for lengthy periods, including time in the holding area, on the OR table, and in recovery. A pressure ulcer can appear as much as 10 days following surgery, and deep tissue injury is common. To offset the potential for pressure ulcers in this setting, Connie shares the wisdom of her experience through training sessions and inservices to help nurses gain critical skills to prevent ulcer development. The roots of her career led Connie to what she calls an easy decision to protect patients when they are most vulnerable; she has formed policies for treatment with those most critical patients in mind.
Teaching nursing competency melded perfectly with Connie’s background in wound care to prepare her for her role in compliance and regulatory affairs. One major challenge in this regard is staying current with regulatory changes in the industry. For example, the Centers for Medicare and Medicaid Services do not reimburse for pressure ulcers that occur while a patient is in the hospital, underscoring the importance of prevention awareness.
Connie also credits her work environment with the ever-evolving policies and procedures at St. John Medical Center. “I have been very fortunate to work in a department where our director and managers can be as enthusiastic about education and research as I am,” she says. “Because our patients’ safety is our number one responsibility, they appreciate my ideas and support me.” Connie initiated a quality improvement project (and related research) to protect patient skin through education, awareness, and the development of related processes that involve applying a protective topical dressing when appropriate. Her project, along with the joint decision-making of the department, led to the continued use of the study product.
One of the most valuable lessons Connie has learned from her work over the years is to keep learning and keep reaching. Lining the shelves of her personal home library are The Association of Perioperative Registered Nurses Journal, the Tulsa County Bar Association Magazine, and a plethora of nursing leadership and health-related books. She looks forward to adding Certified Professional in Health Care Quality (CPHQ) to her credentials in the near future.
Despite being a knowledgeable resource for a network of facilities, Connie still finds quiet comfort outside of work. She calls herself an avid reader, taking time to unwind with classic novels by Jane Austen and biographies such as the one she just finished about George Washington. She is enjoying “turning her new house in Tulsa into a home” where she lives with her husband, a musician, composer, and university professor.
When asked for words of wisdom for anyone interested in her area of practice, Connie simply says, “Be fearless and don’t limit yourself. It may not happen overnight, but if you keep focused on what you really want, you’ll get there.” With skin and wound care still in the forefront of Connie’s education journey, there truly are endless possibilities for growing her scope of practice.
This article was not subject to the Ostomy Wound Management peer-review process.