Courtesy of The Wound, Ostomy and Continence Nurses Society	More NurseWeek Features   Smoke-Free Zone   Nurses and patients tackle nicotine addiction   Bloodless Survival     Surgical techniques to use when transfusion drops out of the equation
Wound, ostomy, and continence nurses work in a variety of settings and enjoy a lot of autonomy, higher-than-average pay, and the continual education and problem-solving that WOC nursing requires.

Janice Beitz, RN, PhD, CS, CNOR, CWOCN, jokingly tells people she’s an expert in pee, pus, and poop. That may not sound like a glamorous job, but wound, ostomy, and continence (WOC) nurses like Beitz will tell you their jobs are challenging, rewarding, and increasingly in demand.

Beitz, associate professor and graduate program director at La Salle University School of Nursing in Philadelphia, said the demand for WOC nurses is, and will continue to be, spurred by the aging of the U.S. population, the rise in diabetes and its side effects, and health care’s focus on prevention.

“An increasing number of elderly people are institutionalized at extended care facilities and increasing numbers of people provide home care services,” Beitz said. “Both [populations] have wounds and have problems with continence, and some may have ostomies.”

Laurie McNichol, president of the 4,300-member Wound, Ostomy and Continence Nurses Society (WOCN), said WOC nursing is one of the industry’s newer specialties. The profession traces its roots to 1968 and a patient named Norma Gill-Thompson who received an ostomy and, after her surgery, realized how much she and others needed postoperative support from other patients and the health care profession. That lay movement gradually evolved into a nursing specialty with its own certifications and a growing body of knowledge.

That includes the WOCN, the only national organization for nurses who specialize in the prevention of pressure ulcers and the management, education, and rehabilitation of people with wounds, ostomies, and continence disorders.

Nurses needed

Not only is the population aging overall, McNichol said, but the number of “old-old,” which she defines as those aged 85 and older, is growing, too. That age group is the fastest-growing segment of the U.S. population, she said, and people in that group tend to take a number of medications that result in bowel and bladder problems.

“The need is growing and there aren’t enough of us,” McNichol said.

The WOCN website [ www.wocn.org ] documents the need as follows:

• 5 million Americans suffer from chronic wounds.
• 1.5 million to 1.8 million new wound cases are added each year.
• Pressure ulcers occur in as many as 10% of patients in acute care settings and as many as 28% in long-term care settings.
• Half a million Americans have a stoma and require teaching, counseling, and supportive care.
• More than 11 million Americans suffer from documented urinary incontinence.

The need for WOC nurses has grown so much in recent decades that some nurses have even carved out subspecialties within the specialty itself. Some focus on one area such as continence or wound care. Many WOC nurses work at wound care clinics.

Junji Navarro, RN, MSN, CWCN, CWS, a WOC nurse in Las Vegas, specializes in wound care. He’s a certified wound care nurse and a certified wound specialist. The CWCN credential is given by the WOCN and the CWS by the American Academy of Wound Management.

A proper education

Navarro, originally from the Philippines, is a full-time nurse instructor at Community College of Southern Nevada and a part-time WOC nurse at Silver Hills Health Care Center, where he formerly served as assistant director of nursing. He said the WOCN and the American Academy of Wound Management are, in his opinion, the only two reputable organizations bestowing certifications in wound management.