My Scope of Practice: Growing Through Her Partnerships

There is no peace among equals because equality doesn’t exist in the universe. Either one prevails and the other follows, or both negotiate their differences and create a greater partnership. – Harold J. Duarte-Bernhardt

  Throughout her career as a nurse, clinical nurse specialist and wound, ostomy, continence nurse, partnerships have been important to Mary Arnold-Long, MSN, RN, CRRN, ACNS-BC, CWOCN-AP.

  Arnold-Long had chosen to work for the Franciscan Health System of Greater Cincinnati, OH, partly because of their mission: the healing ministry of Jesus Christ. Nineteen years ago, after working for this system for nearly 14 years, Arnold-Long and colleague Rita Pochard were offered the opportunity to attend an Enterostomal Therapy Nursing Education Program (ETNEP). Arnold-Long studied at Abbott Northwestern Hospital, Minneapolis, MN; Pochard, at the Cleveland Clinic. They benefited from sharing different learning and clinical experiences. Shortly after they received certification in 1994, their healthcare system reorganized. Pochard chose to work for the system’s home health agency; Arnold-Long relocated to Indiana.

  Not long after, Arnold-Long achieved certification through the American Nurses Credentialing Center (ANCC) as a Medical-Surgical Clinical Nurse Specialist (now Adult Health CNS) and worked as the inaugural clinical nurse specialist at Hancock Memorial Hospital, a county facility. A large component of that role was wound, ostomy, continence (WOC) nurse duties, including the facility’s pressure ulcer incidence and prevalence survey, support surface selection, and revision of the facility’s policies and procedures. Arnold-Long saw patients in the hospital, in a home health setting, and in physician offices. Although she didn’t have a WOC partner during this time, she worked with Pharmacy Director Diane Detering on policy and procedure revisions, along with other projects. Arnold-Long reached out to another WOC nurse in the area — Mary Baker — who introduced her to other local WOC nurses and became a great resource. When Baker’s partner at Community Hospitals of Indianapolis resigned, she and Arnold-Long became formal partners working for a Clinical Nurse Specialist, Jan Bingle, dividing their duties among their institution’s campuses. About this time, Arnold-Long became active with the Mid East Region Wound Ostomy Continence Nurses Society and participated in her first WOCN regional conference.

  In 2000, Arnold-Long returned to Cincinnati to work at Drake Center, a long-term acute care hospital, rehabilitation, and skilled nursing facility. Initially, her partners were four other clinical nurse specialists; as the wound care program expanded, Trish Hoge, another CWOCN, became her partner. She and Trish initiated development of the Advanced Wound Care Team at the center. Arnold-Long underwent surgery in early 2005 and left Drake for a year; Trish departed for acute care at Bethesda North Hospital. When Arnold-Long returned, Anne Blevins became her partner, providing insights into pediatrics and burns. Blevins had attended the WebWOC program, and Arnold-Long had been her preceptor. They worked together for 5 years.

  Currently, Arnold-Long is employed at Roper Hospital in downtown Charleston, SC. Roper St. Francis Healthcare is South Carolina low country’s only private, not-for-profit healthcare system. The 657-bed system consists of 90 facilities and provides services in seven counties. Member hospitals include Roper Hospital, Bon Secours St. Francis Hospital, Mount Pleasant Hospital, and Roper Rehabilitation Hospital. With more than 5,100 employees, Roper St. Francis Healthcare is Charleston’s largest nongovernmental, private employer. Its medical staff includes nearly 800 physicians representing every medical specialty. Ranked #41 among the Top 100 Integrated Health Networks in the nation, Roper St. Francis Healthcare recently earned 96 national awards recognizing high levels of patient, physician, and employee satisfaction. In 2011, Roper St. Francis was named among Modern Healthcare’s prestigious list of “Top 100 Places to Work” and additionally listed among the Top 25 Connected Healthcare Systems in 2010. In October 2011, the organization contributed more than 78,312 hours of staff time and $47.3 million to benefit the community, serving nearly 264,000 community residents.

  Arnold-Long’s current partners are Mary Kate Skinner and Faith Singleton (see photo). Both partners attended the Medical University of South Carolina (MUSC) wound education program and the Emory ostomy education program and are certified in wound and ostomy care by the WOCNCB. Singleton primarily covers the St. Francis facility, and Skinner and Arnold-Long cover Roper as inpatient wound, ostomy, and continence consults and outpatient ostomy consults with the nursing staff and the medical staff, including Dr. Lagarres-Garcia, the only colorectal surgeon in South Carolina doing laparoscopic colorectal surgery. He performs the fourth highest number of laparoscopic colorectal cases in the United States. St. Francis is an ANCC Magnet facility, and Roper is currently on its Magnet journey.

  In addition, Arnold-Long has her own company, WOConsultation, LLC. She contracts with agencies, including hospitals and schools of nursing, to present programs. A current program, presented throughout the country for PESIHealthcare, is called “Wound Care Challenges: Tools for the Healthcare Professional.” She also provides consultation for attorneys and on a per-patient basis to HealthSouth Rehabilitation Hospital in North Charleston.

  Arnold-Long remains involved with the WOCN as a member of the National Conference Planning Committee and as Secretary of the Board. She reviews manuscripts for the Journal of Wound, Ostomy, and Continence Nursing and serves as a preceptor for wound, ostomy, and continence nursing education programs. A speaker on wound, ostomy, and continence issues, Arnold-Long also has participated in the Nurse in Washington Internship. Jean Schmidt, her Ohio congresswoman, called her the “Granny Stocking Nurse” because she lobbies for coverage for compression stockings.

  Whether partnerships are formal or informal, Arnold-Long believes all of them are important to promoting and developing collegiality within and across specialties as she and her partners strive to achieve healing for patients and promote their scope of practice.

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