Dr. Dea Kent's articulate President's Message in the November/December 2021 issue of the Journal of Wound, Ostomy, and Continence Nursing (JWOCN) struck a chord with me as one of the chartering members who gathered at the Cleveland Clinic in January 1969. Now in the autumn of my life, at 83 years, I am ready to get in my husband's lift chair, elevate my legs, and ruminate on the amazing accomplishments of a relatively small cadre of seed-sowers in leading medical centers and communities large and small across our country, as we championed the needs of patients with ostomies, complex wounds, and incontinence. Today, 53 years later, we have every right to reflect on stellar achievements and contemplate new strategies for taking our Society forward. We must not, however, become the least bit complacent about our original and sustaining mission.
As the leaves have fallen this autumn, the bare branches and bright sunlight have exposed failures and incompetence in ostomy and wound care right in my own backyard. As our members make scientific and organizational advances that would have been unimaginable to our founders, I beg you not to abandon the raison d'etre of the WOCN Society that motivated your founding members. So many of us, over the past 53 years, have devoted incalculable time and energy promoting improved patient care. We cannot abandon or reduce time at the bedside in favor of outcomes, legislation, and research. In the following text, there are 2 egregious examples of patient experiences in a world where we imagine ostomy and wound care standards are being taught and promulgated.
The first involves a gentleman in his 50s who was discharged from a teaching hospital. A mutual friend suggested his wife call me to find out how he could enjoy his swimming pool with this new ostomy bag. Her husband had had an ostomy nurse, his wife thought, but she did not remember a name or how to contact his ostomy nurse after discharge, and neither the patient nor his wife had any recollection of being told how to prepare to return to the pool he loved so much. He was not provided a referral to another person living with an ostomy or the UOAA (United Ostomy Associations of America) to find out about such an important quality-of-life issue. He was not provided enough information about who could help in his postoperative adjustment to life with an ostomy as the fog from surgery and anesthesia began to lift.
Even more recently, a family relation experienced a significant wound disruption after cosmetic surgery this past October in a metropolitan southeastern city. She sent photos to the plastic surgeon, who recommended wet-to-dry dressings 3 times a day. Specifically, he recommended topical therapy comprising application of wet gauze, which is allowed to dry, and then pulled off to debride the wound. The patient sent photos to the hospital-based wound care clinic 10 minutes from her home. She was told she could be seen in 5 weeks and advised to continue wet-to-dry dressings until her appointment. She was not counseled about negative pressure wound therapy, which would have provided a clean and granulating wound in days and weeks and would have resulted in half the scarring she will now bear for life. She was not counseled about moist wound healing principles. No dressings specifically designed to promote and sustain wound healing and keep this working mother of 2 young children comfortable were recommended.
As we move into a New Year and toward the midpoint of a decade, I am tempted to conjure a cold, barren winter metaphor. Instead, let's just resolve to remember the past to act in the present to serve the future. Continuing good wishes....
Katherine F. Jeter, EdD, ET
Columbus, North Carolina