My Scope of Practice: Innovating Through Educating
Nursing has many facets: caring for patients, consulting with physicians, and performing diagnostic tests, to name just a few. Aleisha Walburn, RN, BSN, WCC, OMS, willingly adds educator to the top of her list of roles and responsibilities.
Aleisha is a graduate of the nursing program of the University of Phoenix (Tempe, AZ) and received her certifications in Wound Care and Ostomy from the Wound Care Educational Institute (Plainfield, IL). “I see myself first as an educator, then as a wound care nurse,” Aleisha says. “Our primary job is to work with patients to educate them about their wound, treatment options, care plan, and how they can help foster successful outcomes. Education is so important — the person receiving care needs to understand exactly what is happening, what products and medications are being used, and why.”
At the Nizhoni Health Wound Management Program (Somerville, MA), Aleisha serves as the Ostomy Management Specialist, overseeing patient care for a small team of health care professionals. After being assigned to a patient’s case, Aleisha heads to the patient’s home to work on promoting a successful health outcome. In these settings, she develops an individualized treatment plan in consultation with the home care nurse and the patient’s physician. Once each member of the wound care team signs off on the plan, the educator role of nursing takes center stage to help the patient understand how to achieve the best possible outcome.
For Aleisha, taking the time to teach patients leads to the most satisfying part of the job: improvements. “The most rewarding part of my job is hearing good news on a patient and seeing the results of the trusting relationship I’ve built with them,” she says. “It is extremely gratifying to see how a patient’s wound is improving because you’ve taken the time to establish a rapport. Knowing that your time spent with them has actually led to a successful outcome is a great feeling.”
Not every case goes smoothly. Some may take a little out-of-the-box thinking and creativity. “I once worked with a patient who had recently been discharged from an acute care facility with an unstageable pressure-related skin injury on his coccyx,” Aleisha says. “He also had pneumonia and was on a ventilator. He was very hesitant to let anyone care for him because he couldn’t see the wound and didn’t know or understand what was being done. Unfortunately, the patient initially developed an infection, which required a hospital visit for surgical debridement. Despite initially refusing treatment following discharge, I was persistent, personally teaching him the ins and outs of the treatment approach and the benefits of a second attempt. Eventually, he became more confident and supportive of his treatment plan.”
There was an additional glitch: the insurance company limited the number of allocated dressings for monthly treatment. “The primary nurse assigned to his case and I worked very hard to come up with solutions to account for the shortage, and eventually worked with our vendors to determine we could use suitable substitutions,” says Aleisha.” Even with the limited product allowance, his pressure area healed in a few short months. I have never seen a man and a family so grateful for care provided. He must have thanked us a million times for helping him get his life back. It was such a rewarding experience and renewed my faith in the old motto ‘If at first you don’t succeed, try, try again’!”
Aleisha also believes education can help patients feel more at ease and seek the assistance and education they need. This especially true for persons with ostomies. “My hope is that as my role as an ostomy management specialist becomes more widely understood, requesting help will become more commonplace.”
Tied to this is personal education. Aleisha is always seeking new resources and patient education tools to stay up-to-date on techniques and information. Because wound care is an ever-evolving field, the number of treatments and therapies continues to grow, giving health care professionals new tools for achieving patient health and happiness. Aleisha subscribes to numerous e-newsletters (including Ostomy Wound Management) to stay current, and she uses mobile apps such as Wound Central (Wound Care Education Institute) to troubleshoot in the field. And, of course, trial and error is an important educational tool.
“The first time you recommend something to a patient or a nurse doesn’t mean it’s going to work or be a lasting solution,” Aleisha says. “You need to work with the patient to see what is best for his/her specific situation. It is crucial to conduct visits with an open mind and refrain from passing judgment. You need to establish trust with your patients in order for them to open up and tell you what is and isn’t working. This is essential to developing and implementing an effective care plan.”
Aleisha says you should never give up, even when times are frustrating. “Be patient, consider all the facts, and make the most informed decisions you can,” she says. “Seeing your patients heal and get back to their standard routines and lives is worth it.” Bridging gaps among patients, the health care team, and the treatment plan through trust and education is key to Aleisha’s scope of practice.
This article was not subject to the Ostomy Wound Management peer-review process.