My Scope of Practice: Relationships Affect Care
Donna Morrow, RN, WCC, DWC, OMS, knows building the provider-patient relationship is crucial to successful ostomy and wound management care plans. Research continues to highlight the benefits of informed patients. “When a patient feels he or she is not only involved in but also the one driving care, successful outcomes are more likely to follow,” Donna says. “In order to fully heal, patients must understand the steps of their care, feel they are supported, and comply with their treatment regimen.”
Donna is an ostomy wound specialist and wound and ostomy nurse manager with Nizhoni Health in Somerville, Massachusetts. She stepped into the supervisory role in 2013 after 25 years spent honing her nursing and wound care skills at various Massachusetts health care facilities. She received her nursing degree from Regents College (now Excelsior College, Albany, NY) and her certifications in wound care, ostomy, and diabetic wounds from the Wound Care Education Institute (Plainfield, IL). Through her wealth of experience, Donna developed a passion for patient and nurse education.
“I love that this is a highly specialized field, and I love working to educate other nurses about it, helping build their knowledge and love for the specialty,” Donna says. “When you teach a nurse a new skill or approach, it’s like teaching 100 people something because wherever they go, they can teach more.”
Often, patient lifestyles and environments can impact compliance with as well as understanding of care plans, especially at the home care level. Returning to a regular routine without regard to cleanliness and healing can slow progress and prolong healing. Donna believes the key to a lowered chance of relapse and success is to fully involve the patient through a personalized care plan, focused education, and a support system built on trust.
“I’ve found that once patients understand you are sticking around, they become intrigued as to what you can do to help them,” Donna says. “They start believing there is hope that maybe this time [their wound] will heal. Sometimes that is all that is needed to inspire patients to want to do things to better themselves and help with healing that wound.”
Donna speaks of a particular patient who required an extra provider “push” to stay consistent with her treatment plan. “I once treated a woman in her 50s who had the same wound for more than 3 years when I took on her case,” Donna says. “She basically asked me to leave, saying there was no way I could help her. It was clear she was discouraged by past experiences, but I was not going to give up. I said to her, ‘I am going to find why this wound won’t heal and find the right product to heal it, and together we are going to heal this wound.’ Right then, she understood I was there for her and was going to closely follow her progress and address possible setbacks.”
Wound and ostomy care requires patience and persistence throughout the entire process. As the specialty continues to evolve and expand, nurses have been tasked with additional responsibilities, including working with insurance companies, vendors, and health and home care teams. The amount of time available to treat patients seems to be shrinking due to costs and restrictions. Donna, however, appreciates the growing awareness of the specialty.
“A lot of people now recognize the importance of proper wound care,” she says. “As a result, we are seeing rapid improvement in the products and treatments we are able to offer patients. Thankfully, the days of wrapping a wound in gauze and hoping for the best are behind us. It is my hope to be able to continue to focus on doing what is best for our patients.”
When she is not putting the pieces of a wound care puzzle back together, Donna manages the wound department of Nizhoni Health: scheduling visits across the state for 4 other wound specialists, reviewing all consults and treatment recommendations, coordinating with other department managers, and auditing the wound care program to ensure the department’s high standards for patient care and trust. She periodically meets with industry representatives to stay current on new products and treatments that may be beneficial to patients and keeps up-to-date on research and best practices through e-newsletters and her monthly copy of Ostomy Wound Management.
“As a manager, I work through the night,” Donna explained. “We have a small team and I’m always on call. My entire family knows and understands that what I do is a 24/7 job. I’m not a person who shuts down when I’m not in the office or field; it’s part of my overall life.”
Although it sometimes may seem like every step forward in care also comes with 2 steps back, wound and ostomy care professionals can help patients in dire health situations by providing care in a gentle, compassionate manner and building a relationship with the common goal of healing. “A wound is a puzzle,” Donna says. “If you’re someone who is intrigued by puzzles, this is the area for you. Educate the patient, laugh with the patient, and try what they think might work. Doing so will help to build a strong relationship with your patient, and that relationship can make all the difference.”
Building strong provider-patient relationships through education and empowerment is just a small part of Donna’s scope of practice.
This article was not subject to the Ostomy Wound Management peer-review process.