THE OFFICIAL MAGAZINE OF THE WOCNÂ® SOCIETY
ISSUE 9, DECEMBER 2019
Enhancements to the Wound Treatment Associate (WTA) Program Page 5
Veteran Responds to Rare Genetic Mutation with Positivity Page 7
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ISSUE 9 • DECEMBER 2019
TA B L E O F CONTENTS THE OFFICIAL MAGAZINE OF THE WOCN® SOCIETY
ENHANCEMENTS TO THE WOUND TREATMENT ASSOCIATE (WTA) PROGRAM
ASK THE WOC NURSE
DANIEL SHOCKLEY’S STORY: VETERAN RESPONDS TO RARE GENETIC MUTATION WITH POSITIVITY
The WOCN® Society is a professional community dedicated to advancing the practice and delivery of expert healthcare to individuals with wound, ostomy, and continence care needs. We support our members’ practice through advocacy, education, and research.
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In It For You is a publication for the Wound, Ostomy and Continence Nurses Society™ (WOCN®) 888-224-9626 wocn.org firstname.lastname@example.org
WOCN SOCIETY BOARD AND COMMITTEE CHAIRS BOARD
President Stephanie Yates, MSN, RN, ANP-BC, CWOCN President Elect Dea Kent, DNP, RN, NP-C, CWOCN Secretary Christine Berke, MSN, APRN-NP, CWOCN-AP, AGPCNP-BC
Treasurer Vittoria (Vicky) Pontieri-Lewis, MS, RN, ACNS-BC, CWOCN
Director Diane Bryant, MS, RN, CWOCN Director Kevin Emmons, DrNP, RN, APN, AGPCNP-BC, CWCN, CFCN Director Derik Alexander, MSN, RN, FNP-BC, CWOCN, CFCN Director Jody Scardillo, DNP, RN, ANP-BC, CWOCN Immediate Past President Kelly Jaszarowski, MSN, RN, CNS, ANP, CWOCN
COMMITTEE CHAIRS Accreditation Committee Chair Kathleen McLaughlin, MSN, RN, CWOCN
Corporate Development Committee Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN
Education Committee Zoe Bishop, BSN, RN, CWOCN Finance Committee Vicky Pontieri-Lewis, MS, RN, ACNS-BC, CWOCN Forum Moderator Committee Trudy Huey, MSN, RN, CWOCN
Leadership Development Committee Carolyn Watts, MSN, RN, CWON
Membership Committee Jennifer Anderson, MBA, MSN, RN, CWCN, CFCN, CWS, DAPWCA, FACCWS National Conference Planning Committee Sunniva Zaratkiewicz, PhD, RN, CWCN Public Policy & Advocacy SWOT Kate Lawrence, MSN, RN, CWOCN Scholarship Committee Carole Bauer, MSN, RN, ANP-BC, OCN, CWOCN Wound Treatment Associate Advisory Committee Janet Ramundo, MSN, RN, CWOCN, CFCN
Updated Clinical Guideline Now Available! We are pleased to announce the release of the latest publication in the WOCN Clinical Practice Guideline series:
Guideline for Management of Wounds in Patients with Lower-Extremity Venous Disease Learn evidence-based strategies for LEVD wound management, including: w COMPREHENSIVE ASSESSMENT w PREVENTION OF VLUS w COSTS OF CARE w PATIENT EDUCATION AND RISK REDUCTION STRATEGIES w AND MORE!
PURCHASE YOUR COPY at wocn.org/bookstore and
enjoy free shipping! WOCN members receive a discount on this publication.
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W TA ENHANCEMENTS
WOUND TREATMENT ASSOCIATE
Enhancements to the Wound Treatment Associate (WTA) Program WTA PROGRAM UPDATE MAINTAINS ACCURATE AND RELEVANT EDUCATION WITH CUSTOMIZABLE SKILLS COMPETENCIES, ALLOWING COURSE COORDINATORS TO CHOOSE AND TAILOR SKILLS DIRECTLY RELATED TO THEIR PRACTICE SETTING.
he WOCN Society strives to advance the quality of care delivered to patients with wound, ostomy and continence care needs. This desire to ensure all patients receive high quality and evidence-based care led to the creation of the Wound Treatment Associate (WTA) Program in 2012. Since its inception, the WTA Program has provided evidence-based wound training to over 7,000 nurses, therapists, advanced practice providers and medics. In October of this year, revisions and enhancements to the program were launched by the Society based on feedback from participants, course coordinators, Society leadership and the WTA Advisory Committee. The changes have been to ensure continuous quality improvement in the education available to the healthcare community. Recent enhancements made to the WTA Program include updates to education modules and participant resources to accurately reflect changes to support surfaces and pressure injury terminology. The competency section of the program has expanded to allow for more flexibility based on the area of healthcare for the participants. Braden Risk Scale for Predicting Pressure Injury Risk and Wound Identification are two additional competencies added to the program. This change gives Course Coordinators the ability to choose four of the six possible competencies tailored to the specific educational needs of the participants. Additionally, ANCC-accredited Contact Hours for nursing increased from 24 to 32.25 to accurately reflect the amount of time spent completing the program.
The WTA Program enhances clinician ability to facilitate optimal care for patients with acute and chronic wounds under the direction of the WOC specialty nurse, WOC advanced practice registered nurse or physician as members of a collaborative wound care team. For more information about the WTA Program, click here.
Sara Coverstone, RN, MA, CWON
WTA Advisory Committee Member, Illinois
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Jennifer DeLegge, RN, BSN, CWOCN WTA Program Course Coordinator, Illinois
ASK THE WOC NURSE
the WOC Nurse
Should CWOCN positions be unionized? Giving a specific “yes” or “no” answer to this question is not an easy task because there is no right answer currently. Over the years, studies have been conducted to discover if unionizing nurses in general is beneficial to the nurses, patients and facilities. The answers were inconclusive and sometimes contradictory. It may be helpful to look at some of the pros and cons of unionizing to determine if this is a viable option for certified wound, ostomy and continence (WOC) nurses. To be sure, the advantages of belonging to a union are numerous. Members have guaranteed wages, pay increases, no mandatory overtime and have job security. Workplace safety is generally improved by the increase in nurse to patient ratio and enhanced standards and protocols for both staff and patient safety. These are just a few of the most significant perks in belonging to a union. But there is the other side of the coin as well…the cons. In my opinion there are three major concerns when answering this question: mandatory striking, advancement based on seniority rather than performance skills and knowledge, and fees and dues associated with membership. The first two of these knocks at the heart of any nurse. The patient remains our primary interest and concern; and in both mandatory strikes and promotion based on seniority instead of skills and knowledge base, the care and welfare of the patients may be greatly hindered. This in and of itself influences balancing the pro and cons of joining a union. In addition, the costs encountered when joining and continuing membership in a union are most often automatically deducted from your paycheck. Like many other organizations, union dues increase over time. This additional expense needs to be considered. The pros and cons listed here are a few, but important ones that need to be part of the decision process. Should CWOC nurses unionize? That question can only be answered after thoughtful consideration and honest communication with those who are encouraging or offering membership in a union. Sincerely, The WOC Nurse
If you have a question for the WOC Nurse, please fill out an anonymous form at wocn.org/askawocnurse.
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DANIEL SHOCKLEY’S STORY
Veteran Responds to Rare Genetic Mutation with Positivity
tarting at age 50, it’s encouraged that individuals get regular colonoscopies to screen for colon cancer. At the age of 51, Daniel Shockley went to his gastroenterologist for his first colonoscopy. 100 polyps were discovered throughout Dan’s colon, rectum and anus, along with a large mass in the ascending colon causing an 80% blockage. Dan was diagnosed with Attenuated Familial Adenomatous Polyposis (AFAP), a rare mutation and a subvariant of Familial Adenomatous Polyposis (FAP), which affects approximately 0.3% of the population and increases the risk of colon cancer. Unlike most people when given a bleak diagnosis, Dan was not scared. He embraced the diagnosis from the onset and did everything he could to learn about this mutation, a process that provided a lot of comfort to him. Two months after his diagnosis, Dan underwent surgery to remove his entire colon. Seven months after his successful surgery, Dan met Dr. Lynch— the father of hereditary cancer research who discovered the AFAP mutation in 1992. Dan was honored to have had the opportunity to meet Dr. Lynch to share his journey with him, and to receive his world-renowned expertise. The two bonded over the rare condition and their military backgrounds and kept in touch over the years. Seven years after receiving his diagnosis and undergoing surgery, Dan is living his best life and is fully retired after serving in the Navy for 22 years. Just because Dan is retired doesn’t mean he’s not busy! He devotes almost all his time to spreading awareness
ABOVE: Dan served in the U.S. Navy from 1981–2003 until his retirement. BELOW: On June 2, 2019, National Cancer Survivors Day, Dr. Lynch passed away at the age of 91. Because Dan has the mutation that Dr. Lynch discovered, Dan feels it’s his duty to continue to share his journey with the medical community and the masses pertaining to his mutation and stressing the importance of early detection.
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DANIEL SHOCKLEY’S S T O RY
V E TE RA N RE SPO NDS TO RA RE GE NE TIC MUTAT ION WITH PO SITIV ITY (CONT 'D. )
LEFT: Dan with his dog Sam, an adorable chihuahua-dachshund mix ABOVE: Dan and his dog Sam stopped at Continental Divide, New Mexico, on their road trip from Texas to California.
about his mutation. Dan’s purpose is to educate the world about his mutation, being a hereditary colon cancer survivor, and the importance of early detection. He speaks at various support groups and educational events around the country, where he shares his journey, discusses the mutation, stresses the importance of early detection, and talks about how both the mutation and early detection have impacted his life. One way that Dan spreads awareness about his mutation is through public policy. During his time in Hawaii, Dan reached out to Governor Neil Abercombie, Senator Brian Schats, Representative Colleen Hanabusa and Honolulu Mayor Kirk Caldwell to proclaim March National Colon Cancer Awareness Month in Hawaii. Dan received proclamations from all four of them in support of the campaign. Hear from Dan's certified wound, ostomy and continence (WOC) nurses about the impact Dan had on local ostomy communities:
“Almost 5 years ago, a small group of ostomates got together with a strong WOC nurse in our community and started a support group...One of our former members was Daniel Shockley, who contributed in many ways. Not only to the support group but also to the entire state through a proclamation from our governor related to rare diseases. Although Daniel relocated to the mainland, he continues to provide guidance, connects people to resources and others living with similar conditions, helps those affected by rare conditions and continent diversions and their loved ones with practical support, and advocates on their behalf. We in Hawaii miss Daniel’s physical presence but knowing that he’s only a “click” away is very reassuring. Aloha, Doreen Akamine, CWOCN 8 IN IT FOR YOU w ISSUE 9, DECEMBER 2019
Daniel Shockley was involved for a short time in our Boise Idaho Ostomy Support Group until he left us for more adventures in Texas. He was such a positive influence on our members, and even presented his story to our group. He did a great job discussing his rare disease and sharing how he was able to cope and “forge ahead with purpose”. I appreciated his work to designate a “rare disease day” for the state of Idaho as well. What Daniel is dealing with is a very serious form of FAP that has affected his colon and various other organs in his body as well. His example of maintaining a positive attitude and helping others is commendable. I also admire his persistence in educating himself and reaching out to experts in the field to help him to better understand and manage his illness. Thank you so much Daniel for leaving a positive footprint in the great state of Idaho!! — Julie Olson, RN, CWOCN
DANIEL SHOCKLEY’S S T O RY
V E TE RA N RE SPO NDS TO RA RE GE NE TIC MUTAT ION WITH PO SITIV ITY (CONT 'D. )
Dan is now focused on getting Texas, his former home state, to be the first to designate March as Hereditary Colon Cancer Awareness Month. Dan reached out to Senator Donna Campbell to sponsor the Hereditary Colon Cancer Awareness proclamation request. After 6 months, Senator Campbell granted the sponsorship— a designation that’s the first of its kind! Dan also reached out to Congressman Chip Roy, a cancer survivor, to consider introducing a bill about this awareness campaign to become part of the agenda in the next Texas legislative spring session in 2021. Until then, Dan will reach out to Senator Ted Cruz and Senator John Cornan to get their sponsorship. He aims to get sponsorship from all 50 states, along with Puerto Rico, Guam and American Samoa to have a Senate Resolution officially designating March as Hereditary Colon Cancer Month. It sounds daunting, but Dan is up to the challenge.
Dan at Castle Rock State Park, California
Despite having the AFAP mutation, which is permanent without reversal and has already begun taking over other organs in his body, Dan maintains a positive outlook on life. Dan undergoes endoscopic procedures and biopsies every six months, along with an annual CT scan. “The doctors exhaust all of their scopes during the procedures. If they had a periscope, they would use that too,” Dan joked. Dan loves having the mutation and loves having an ostomy. “In life we can react, or we can respond. I respond by using my military training to adapt, improvise and overcome. Attitude is forever. Mood is temporary,” said Dan. “I maintain a positive attitude for my health. No pun intended, it’s in my DNA. My attitude is embedded in me, it’s something I had in me all along. I didn’t know how positive I was until this happened. I continued to hear kind words from individuals who heard or read about me and it continues to remind me each and every moment to just continue, keep plugging away.” When Dan isn’t speaking at events or advocating for legislation, he enjoys being active and exploring the great outdoors. He’s traveled along the West Coast sightseeing, hiking and spending time with family and friends, and his dog Sam who goes everywhere with him. Dan loves the game of baseball and recently joined the Central Valley Vintage Base Ball Club (CVVBB) in Sacramento, where they play by 1864 rules, such as not using gloves, pitching underhand, and wearing vintage era replica uniforms. Dan thinks about his mutation the same way he thinks about baseball. “What do life and baseball have in common?” said Dan, “Neither one of them has a time limit. In baseball, if the game goes into extra innings, that’s free baseball. As a colon cancer survivor, my life is extra innings. That’s my story and I’m sticking to it!”
Dan at Big Basin Redwoods State Park, California
Dan was raised in the Philadelphia area. Here he is seen with his favorite Phillies pitcher and friend Randy Lerch.
Dan “Dry Dock” Shockley and players of the Woodland, California CVVBB team 9 IN IT FOR YOU w ISSUE 9, DECEMBER 2019
W O C TA L K INFO
The WOCN Society’s podcast channel, WOCTalk, has officially hit the one-year mark in October 2019! WOCTalk is your opportunity to learn more about advocacy, education, and research that support the practice and delivery of expert healthcare to individuals with wound, ostomy, and continence care needs. Here’s a look back at everything we’ve accomplished in our inaugural year of podcasting!
DOWNLOADS FROM 50+ COUNTRIES
ABOUT THE HOSTS: Jody Scardillo, DNP, RN, ANP-BC, CWOCN
Clinical Nurse Specialist/Nurse Practitioner J ody has over 20 years of WOC Nursing experience. She is currently a Director serving on the WOCN Society’s Board of Directors, the Abstract Chair for the WOCN Society National Conference Planning Committee and the Web Editor for the Journal of Wound, Ostomy and Continence Nursing (JWOCN).
Kevin Emmons, DrNP, RN, APN, AGPCNP-BC, CWCN, CFCN Clinical Associate Professor of Nursing
WOCTalk covers hot topics in WOC nursing and healthcare including deep tissue injuries, opioid usage and related wounds, legal issues in nursing, CAUTI, PMARSI and more! Here’s a look at our Top 10 most downloaded episodes to date:
r. Kevin Emmons is a Clinical Associate D Professor of Nursing, Director of Undergraduate Traditional Nursing Programs, and Wound Faculty in the graduate Wound, Ostomy and Continence Nurse Education Program at the Rutgers School of NursingCamden. He is currently a Director serving on the WOCN Society's Board of Directors. He is a board certified Adult-Gerontologic Nurse Practitioner, Certified Wound Care Nurse, and is a Certified Foot Care Nurse. Additionally, Dr. Emmons is an Officer in the United States Army Reserves-Nurse Corps and has deployed to Iraq where he closely worked with Iraqi forces and international coalition partners regarding health practices.
• Wounds Among Persons Who Inject Drugs • Deep Tissue Injuries: The Future is in Your Hands • Slowing the Flow: Dietary, Fluid & Medication Management of the Patient with a High Output Stoma • Keep it Simple! Basic Ostomy Skin Care: A Guide for Patients and Health Care Providers • Pouching Made Easy: Creating an Essential Ostomy Tote for Emergency Room Nurses • Using a Collaborative Team to Reduce Pressure Injuries Originating in the Perioperative Division • Protecting Your Present and Future: Legal Issues, Being a Witness, EMR Documentation • WOCNext 2019: What to Know Before You Go If you think you’d be a good guest for an upcoming episode, you have an idea to share with us, or you’d like • Development of a Patient Peristomal questions or issues addressed in an upcoming episode Skin Assessment Guide of WOCTalk, send an email to email@example.com. • All About Nashville: A Sneak Peek at our WOCNext 2019 Destination
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NEW WEB-BASED CLINICAL TOOL FROM THE WOCNÂ® SOCIETY
Body Worn Absorbent Product Guide An evidence- and consensus-based algorithm for selection, use, and evaluation of body worn absorbent products for the management of individuals with urinary and/or fecal incontinence.
Access the Body Worn Absorbent Product Guide at bwap.wocn.org
Funded by an unrestricted educational grant from