The Value in Becoming a Certified Ostomy Nurse

Patients with an ostomy continue to be an underserved population. There are between 725 000 and 1 million people in the United States living with an ostomy or continent diversion, and approximately 100 000 ostomy surgeries are performed each year.¹ The American Association of Colleges of Nursing reports that there are 3.8 million registered nurses in the United States.² According to a personal communication with the executive director of the Wound Ostomy Continence Nurses Certification Board (WOCNCB), there were 6177 nurses certified in ostomy care at the end of 2020. Those are staggering numbers that reflect a large gap between the patients who need a certified ostomy nurse and the number of available certified ostomy nurses. This gap is even greater in rural areas and exists in all health care settings, including acute care, home care, outpatient care, long-term care, and rehabilitation facilities. The goal of this article is to inspire more nurses to join this specialty profession.

Importance of certification. Of course nurses can go through the coursework to learn how to provide the physical and emotional aspects of ostomy care without pursuing certification. However, by taking the next step to certification, nurses demonstrate that they have acquired the additional knowledge, skills, expertise, and even attitude to provide high quality care to patients and their families. It also shows a current or future employer that the nurse is a lifetime learner who cares about quality and excellence in health care delivery. Certified ostomy nurses also have the confidence that they are providing the most up-to-date, evidence-based care. Recent studies show the value of care provided by wound, ostomy, and continence (WOC) nurses on patient outcomes, including a reduction in complications that develop in the home health care setting.³ Another study found patients experienced significant improvements in health-related quality of life when they received care from an ostomy nurse specialist in hospitals when compared with those who did not receive care by specialty nurses.⁴

A nurse certified in ostomy care can add value to the staff in a health care facility in the following ways:

• Assist the surgeon in siting a manageable place for independent and successful care of a stoma
• Teach staff nurses how to care for a patient with an ostomy
• Provide best practice standards of care as recommended in the Ostomy and Continent Diversion Patient Bill of Rights (https://www.ostomy.org/bill-of-rights/)
• Collaborate with industry in providing the best products for ostomy care
• Assess and treat peristomal skin and stoma issues that can result in hospital readmissions
• Ensure that patients have a reliably fitting pouching system to avoid leakages, thus improving patient outcomes
• Inspire and influence change; many ostomy nurses have influenced their facilities to start outpatient ostomy care clinics
• Provide ongoing expert knowledge and fill a role as a professional resource

In contrast, facilities that do not have a certified ostomy nurse may encounter the following difficulties:

• Higher rates of poorly placed stomas
• Higher incidence of pouch leakage and poor quality of life for the patient
• Higher incidence of stoma and peristomal skin complications leading to increased hospital readmission rates and emergency department visits
• Poor overall patient satisfaction with their hospital experience

A NURSE’S STORY

My name is Kristy Staebel, and I am a certified WOC nurse. Early in my adult life, I went through a period during which I had no idea what I wanted to do professionally. I obtained my first bachelor’s degree in my early 20s, which was in Speech Communications. I jokingly look back and have determined that this was partly due to the fact that the only talent I felt I possessed was the gift of gab. My mother and grandmother were nurses, which may have been part of my inspiration to finally decide to go to nursing school. I was not completely confident that this career path would prove to be successful for me, not knowing if I had truly inherited the nursing gene. This, combined with my tendency to avoid anything deemed to be “gross” (which was quite a lot in my 20s), gave my family little hope that my nursing endeavors would prove successful. However, 18 years later, I have not been disappointed or swayed from my career choice.

Many nurses, friends, and members of my family have asked me throughout the years why I chose to further my career and specialize in wound and ostomy care. Wounds were my first passion, as I learned about caring for them from the physical therapists that I worked with as a part of my clinical experience during nursing school. I found I was fascinated by them. However, I was not prepared for how much I would fall in love with the world of ostomy and this patient population, which started upon my entry into the WEB WOC Nursing Education Program (https://webwocnurse.com).

In wound care there are many health care professionals, such as registered nurses, physical therapists, podiatrists, and medical doctors, who have specialized to care for patients with wounds. However, there are very few health care professionals who have the skills and expertise of a certified ostomy nurse, such as a Certified Ostomy Care Nurse (COCN) or Certified Wound Ostomy Continence Nurse (CWOCN), to provide ostomy care. We are truly needed by the person facing ostomy surgery or currently living with an ostomy, their caregivers, and other health care providers.

While working with this patient population, I began to realize what a traumatic experience it can be to go through this surgery. I also began to understand my vital role, which includes being not just a care provider, but being a counselor as my patients and their family members share their stories and try to navigate their concerns for living life with an ostomy. I help them to set goals for moving forward and try to instill in them a confidence that they still can lead a good and full life, enjoying things just as they did before the ostomy surgery. I have been so blessed and happy to provide the much-needed care and comfort to some of the most vulnerable patients. Becoming a CWOCN has been the most rewarding certification that I have obtained, and I highly encourage other nurses to also obtain this certification.

CLOSING REMARKS

United Ostomy Associations of America, Inc. and the WOCNCB encourage more nurses to consider becoming a certified ostomy nurse to better help this patient population heal and thrive successfully. Patients who have the experience of being cared for by a certified ostomy nurse adapt more easily to an ostomy, have more success with self-care (which leads to their independence), and are more confident in their ability to self-advocate.⁴ They are also better able to return to the functions they love in their community and are more likely to be mentors to others who face ostomy surgery.^5,6

Join us in raising awareness about this type of nursing. Any nurse who has known and observed a certified ostomy nurse is quite amazed at their ability to combine both art and science into patient care. If you are already a certified ostomy nurse, help to increase visibility for this profession by speaking at nursing schools, writing for professional journals, and educating and mentoring others to become certified ostomy nurses. Many certified ostomy nurses say that being an ostomy nurse is one of the most fulfilling and rewarding things that they do in their lives. They are able to help patients who have faced a life-altering illness that affects them physically, emotionally, and spiritually. These patients often feel lost, overwhelmed, depressed, and cannot imagine how they can live with what has happened to them. Certified ostomy nurses are able to help them grieve, cope, adapt, and finally thrive as they learn and finally believe that their ostomy saved their life.

LEARN MORE

In a WOCNCB podcast, Jeanine Gleba, the Advocacy Manager at United Ostomy Associations of America, Inc. discussed the value of specialty nursing with Joanna Burgess-Stocks, CWOCN. They addressed the positive difference access to a certified ostomy nurse has on patients, families, and the health care facility staff. Listen to it here: http://wocncb.org/get-involved/wocncb-certification-inspiration/episode-9.

For more information about this specialty nursing certification, please visit the WOCNCB at www.wocncb.org.

Kristy Staebel is a certified wound, ostomy, and continence nurse and is a volunteer with the Wound Ostomy Continence Nurses Certification Board. Joanna Burgess is a co-chair of United Ostomy Associations of America’s (UOAA) Advocacy Committee. Inquiries can be made to: advocacy@ostomy.org. Information in this article was provided by UOAA. UOAA does not endorse particular products, manufacturers, providers, or other sellers of ostomy products.

This column was not subject to the Wound Management & Prevention peer-review process.