Are you a wound care champion? Do you advocate for evidence-informed wound treatment within your agency or organization? Perhaps you’ve simply become interested in the field over the course of your work as a nurse.
If you fit into one of the categories above, you’ve likely considered acquiring wound care expertise. Enterstomal therapy (ET) nursing—an area that also includes ostonomy—may be the best path to achieving this goal.
Considering it makes sense. At a time when chronic disease rates are higher than ever before, the demand for nurses who can manage wounds is growing.
Unfortunately, achieving expertise isn’t as straightforward as it could be. It’s true that there have been significant advancements in wound care in recent years. But a lack of standardization may make it difficult to know how best to expand your scope of practice.
As the wound care landscape shifts, how can you be sure your actions will result in better, higher-quality care? In this post, we’ll look where the field is headed—and what nurses can do to break into ET nursing in the years ahead.
Wound care as a field has received an uptick in attention from the medical community in recent years. But it’s certainly nothing new.
Of course, best practices have evolved rapidly in the last couple of decades. Advanced research has led to a myriad of new treatments and technologies. There’s no doubt that these developments are lending a newfound credibility to the discipline.
That said, nurses have been healing and caring for wounds for a very long time. Recall Florence Nightingale’s contributions during the Crimean War. She stands as a testament to the keen eye and intuitive understanding that nurses have long had with regard to wound care.
More recently, enterostomal therapy (ET) nursing has emerged as its own discipline. According to the Canadian Association for Enterstomal Therapy (CAET), Canada’s first school devoted to the field opened in 1980. By 1982, this scope of nursing practice (formerly focused on ostonomy) was expanded to include the treatment of acute and chronic wounds.
In the years since, the demand for ET nursing has been growing steadily. A big part of the reason for this growth has to do with the increasing rates of conditions that cause chronic wounds. In Ontario alone, there were nearly 1.6 million people living with diabetes in 2016.
There’s no doubt that the need for wound care expertise is great. And there simply aren’t enough qualified nurses available to provide it. Not only that, but the need for will likely increase in the years ahead.
But the desire to specialize in wound care is about more than meeting an existing demand. If you want to get into ET nursing, it’s probably because you’ve witnessed the serious pain that chronic wounds can cause. You’ve likely seen how they can impact a patient’s health, mobility, quality of life—even her mental wellbeing.
These experiences can instil a nurse with a passion for wound care. But how can you translate this passion into a fulfilling career?
If you’re a wound care champion or advocate, you’re driven to improve the way wounds are treated. But would you make a good wound care expert?
Like any specialized practice area, ET nursing comes with a unique set of responsibilities. as a result, it’s important to explore some important questions before making a commitment.
How empathetic are you? It goes without saying that every nurse needs empathy. But many people—nurses included—have never experienced a chronic wound. As a result, practitioners have to be truly adept at putting themselves in the shoes of patients.
For example, many people would have trouble imagining the shame and embarrassment that can accompany symptoms such as wound odour. An ET nurse should be able to pick up on these feelings and respond sensitively.
Do you have desire to drive advancement in a relatively new area of nursing expertise? In many ways, ET nurses who spend time dealing with wounds are trailblazers. Wound care knowledge is growing everyday. Aspiring practitioners want to be a part of it.
Being a trailblazer also means being a teacher. Helping patients and other health care professional understand wound care basics is part of the territory. If you’re passionate about providing on-the-job education, wound care is an area where you can make a difference.
Ideally, an interest in wound care means an interest in complementary fields, which may include nutrition, social work, and physiotherapy, among others. The best wound care is holistic, which means those who play an integral role in treating wounds should be aware of the benefits of an interdisciplinary approach.
Once a nurse has thought long and hard about his interests—and how well they match up with the day-to-day tasks performed by an ET specialist—he’s ready to move forward.
Once you’ve decided that ET nursing is right for you, it’s a matter of becoming qualified. The Entrostomal Therapy Nursing Education Program (ETNEP) is highly credible. The program is provided by the CAET, an authoritative organization in the field.
That said, the association acknowledges that the value of qualifications isn’t always recognized. The CAET website notes that some practitioners use the term ET nurse “indiscriminately,” which can have the effect of “weakening the value of the title.”
Luckily, in addition to completing a credible wound care program, aspiring experts can receive certification through the Canadian Nurses Association (CNA). After completing the exam, you can use a protected certification.
But the lack question of just what makes an ET nurse is having a major impact on wound care in general. A recent article in the CAET’s publication, Wounds Canada, looks at issues surrounding credentialing in the field.
Unlike many other areas of health care in Canada, wound care doesn’t have standardized education and credentialing systems. This is a problem. Without agreed upon standards, it’s difficult to ensure the same high quality of care for all Canadians.
As the CAET article notes, advanced practice nurses and other relevant experts have been organizing to address this oversight. As just one example, the Ontario Wound Care Interest Group (OntWIG) has been working to explore the potential for standardization.
Part of choosing to get into ET nursing is recognizing the direction that wound care is headed in. As more provinces create initiatives aimed at improving wound care, it’s only a matter of time before ET nursing becomes more standardized across the country.
It’s clear that the future of wound care will be more standardized, evidence-informed, and holistic. During this time of transition, the path to becoming an advanced practitioner may seem unclear.
But one thing is certain: those who aspire to be ET nurses should engage in ongoing education. A relevant program paired with the right resources can lead to significant professional development. Because wound management is about so much more than cleaning and and dressing.
Feature image courtesy of Jeff Turner