In my role as a certified wound/os-tomy/continence nurse (CWOCN), I often feel humbled to be able to provide care, hope, and
comfort to individuals. I am energized when I feel I have treated the "whole" person, not only the "hole"—wound or ostomy—that
the patient has. This essence of nursing was vividly reconfirmed for me recently.
Managing conditions
A patient, let's call her Sylvia Reed, was one month postpartum and had developed right breast mastitis. Despite appropriate
outpatient treatment, she had become febrile and needed hospitalization for an incision & drainage (I&D) of an abscess and
intravenous antibiotics. The cultures grew methicillin-resistant Staphylococcus aureus (MRSA).
As I entered Ms. Reed's room the day after her I&D, her frightened look and upright and tense body revealed she was scared,
but she wanted to cooperate. I learned that this was her first child, a healthy baby girl named Katy. "I so want to be with
my baby, but don't want to harm her since I have this infection." I assured her that we would help her get through this and
back home as quickly as possible. She started to relax. I explained what I would be doing and then gently removed the packing. "Ms. Reed," I said, "this wound is deep, but the tissue
is so healthy and clean that I know you will heal rap-idly." She smiled in relief. I inquired if there was someone at home
who could help with dressing changes. "Yes, I am so lucky," replied Ms. Reed. My mother is a retired nurse."
Seeking positive solutions
Packing her wound with a silver alginate dressing, I explained its purpose and the steps. I had competently dealt with her
"hole," but what about Ms. Reed's "whole" being? At the end of this initial time with her, she said, "I guess I will need
to stop breast feeding since I have this infection." I sensed breastfeeding was a heartfelt desire for her, but I did not
know the answer. I offered to call the lactation specialist (LS) on staff who could knowledgeably discuss her options.
The next day, Ms. Reed was beaming, noting that the LS had visited. "Not only am I able to continue breast feeding, but antibodies
for MRSA are present in my breast milk and this will be good for Katy. I am so happy." Thrilled for her, I completed the dressing
change and finalized all discharge plans for the next day. Since I would not see her again, I gave her a hug and said my goodbyes.
Nursing is most rewarding when we treat our patient as a "whole" person. I was only a part of Ms. Reed's life for 24 hours,
but I know in my heart that I made a difference for her. This, my friends, is the joy of nursing.
JULIA RINGHOFER, RN, BSN, CWOCN, is a certified wound/ostomy/continence nurse at Scripps Mercy Hospital and Health Center
in San Diego.
Practice Tools
