My Scope of Practice: A Calling Within a Calling

“Some stories don’t have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next. Delicious ambiguity.” — Gilda Radner, American comedian and actress

  In 1975, Pamela Wilson, MSNEd, RN, CWOCN, started school part-time at the University of Pittsburgh (Pittsburgh, PA). She enrolled in night classes and worked for several years during that time as a Physical Therapist Aide at Kane Hospital (Pittsburgh, PA). Although she wasn’t entirely sure what career she wanted, she knew helping others needed to be a part of it. When Pam’s interests turned toward nursing, she transferred to a hospital-based school to gain more clinical experience. She became a registered nurse at the UPMC Shadyside School of Nursing program (Pittsburgh, PA), then finished her degree at Pennsylvania State University (McKessport, PA) in 1988. More than 20 years later, Pam’s career has come full-circle — she works at a nursing home and rehabilitation center, not as the physical therapist she once pictured, but as the Director of Wound Care.   Initially after earning her nursing degree, Pam worked part-time as a nurse in acute care and home care and focused on starting and raising a family. In 2001, her life took an unexpected turn when she was diagnosed with breast cancer. Surgery and months of chemotherapy and radiation followed. The process changed her perspective on life, and she emerged ready for a new challenge: wound care. “Ostomies were interesting, and I saw a huge teaching need, which also interested me,” Pam says. “A coworker, Mary Shannon, had completed a WOCN program and inspired me to pursue certification. The home care agency we worked for, Visiting Nurses Association (VNA) of Western Pennsylvania, believed in the value of a WOCN; Kristy Wright, a well-respected WOCN, was the CEO. The company was looking for employees who wanted to go to school.”

   With the encouragement of her family, colleagues, and supervisors, Pam attended the Wicks Educational Associates (Mechanicsburg, PA) program on wound, ostomy, and continence nursing in 2003. The newly certified CWOCN continued working for the VNA of Western PA, caring for wound and ostomy patients; consulting at the local hospital for patients with new colostomies; and conducting inservices for nurses on wound, ostomy, and continence care within the VNA and the hospital. Her desire to teach continued to grow, and in 2006 Pam began work on her Masters of Science in Nursing Education at the Indiana University of Pennsylvania (Freeport, PA). After completing the program in 2008, Pam began teaching first-year nursing students at Butler County Community College (Butler, PA).

  Pam is the kind of teacher you hope all aspiring nurses experience during their education. She’s skilled and passionate about what she does, which is evident in the way she fights for her patients. “You have to be nonjudgmental and accepting of the patient’s situation,” Pam says. “You also must be the patient’s advocate. I’ve fought with insurance companies that wanted to limit the type and amount of supplies an ostomy patient can receive. Many facilities and organizations providing home care restrict their formularies. But one size does not fit all, especially in difficult pouching situations. You must advocate for your patients to get them what they need. I’ve called surgeon’s offices countless times to request products to replace the old normal saline, wet-to-dry dressings. Many surgeons are open to new wound care treatment, but others are stuck in a rut.”

  Pam says a lesson vital not only for students, but also for experienced nurses and doctors is to keep learning. Pam encourages clinicians to attend conferences, if possible, and to remember the availability of rich print and online resources that can keep them up-to-date. “After you learn the basics (best practices, rationale, and product application skills), awaken your creative side,” Pam says. “Think outside the box. Every case is different, and some are more challenging than others.”

  Pam currently works at the Sunnyview Nursing and Rehabilitation Center as the Wound Care Director and Infection Control Nurse, so her job isn’t strictly limited to wounds. “We wear many hats in long-term care,” Pam says. Regardless of what hat she is wearing — teacher, nurse, mother, cancer survivor, clinician — Pam is always ready to embrace the challenges that come her way both in her personal life and in her scope of practice.

This article was not subject to the Ostomy Wound Management peer-review process.