RachRN11

To become a CWOCN (WOC certification), they require a bachelor's degree. There are other options, however. Look into wcei.net they offer a wound care specialty.

I wasn't sure if there was such a thing so I just googled it and this is what I got out of that search - CNA - MA Wound Certification Course | Certified for Nursing Wound Care Wound Care Training for Certified Nursing Assistants (CNAs) Skin and Wound Resource CNA Class — News Room - UNC Health Care Good luck with your endeavor!

Good questions. I'm not sure if my answer is the correct one but for the first one I would document something like "previously unstageable, now stage III ulcer presents with...etc" And same with the 2nd one "previously suspect deep tissue injury has evolved into unstageable with wound bed 100% covered with slough...etc."

I have a patient that we don't know what to do with. She is limited in her mobility so TCC may be a safety issue (more falls) but she isn't compliant with keeping pressure off her heel. How often do you use a total contact cast on a diabetic heel (plantar surface) ulcer? If you do use TCC, how often is the wound successfully healed? Thanks!

I was very fortunate with my job situation. I had made it known to my director (at the time) that I had a goal to become a wound nurse. Luckily, at the same time the wound clinic in the same hospital was looking for a wound nurse. So my name was passed along, they sent me to become certified (also very fortunate as it can be expensive) and had a new job when I returned. Technically I started working as just a WOC nurse (obtained the education but wasn't certified) and within the next 6 months I took the tests and became a CWOCN. I don't think that it's a dead end certification but that most places don't realize that they would benefit from having a CWOCN. You may have better luck marketing yourself to nursing homes or home health care agencies if you can't find an actual clinic. It also might help if you're willing to move, I occasionally see listings for wound nurses but they're often in other states (I live in Illinois) I had a classmate that got the certification without having a job to go back to (she returned to work on a general medical floor in a hospital) but within 6 months or so she got a new job at a new hospital as a CWOCN. It's tough going to achieve something without knowing whether you're wasting your time, but I do think if you obtain your CWOCN you will find a job eventually..it just might take a few months.

Please don't mistake me for confrontation, I was just curious as to why you'd use santyl if there is no slough? I'm thinking there's a secondary use that I don't know about and I would like to learn more :)

I think it depends on the clinic and what they want from their employees. For example, the clinic I work at is currently looking for an RN to hire with experience preferred but not required. We'll probably ask them to eventually get certified but they can begin working without one. We're a smaller wound clinic trying to build ourselves up. So, I think it's mixed and (not to be cliche) the best way to know is to ask the clinic you want to apply to. Sorry, I'm not much help! As for certification, there are options. You can become a CWOCN (certified wound, ostomy, continence nurse) which is typically seen as the "gold standard". Visit www.wocncb.org to get more info. There is also WCC (wound care certified) and DWC (diabetic wound certified) which I believe are just a one week classes then you probably have to take a test. Check out www.wcei.net Also CWS (certified wound specialist) which I don't know too much about but my co-worker did it online and then had to take a test. Hopefully some of that can get you started. Good luck!

I've been a CWOCN for only 2 years so I may not know a lot of info. But to answer some of your questions: I work in a hospital where we have an outpatient clinic and I also see inpatients as well when I'm consulted. On the inpatient wound side, I'm consulted when a patient has a wound that needs more of an "expert" opinion on it's treatment. I evaluate the wound and come up with what I think is the best treatment. Whether that be some type of dressing or even referring out to a specialty practice (podiatry, vascular, surgery, etc.). I don't do every dressing change (unless it's a wound VAC or compression wrap), I come up with the plan that the floor RNs can carry out then I re-evaluate the patient and the treatment once or twice a week depending on how extensive the wound is. On the inpatient ostomy side, I'm mostly consulted for new ostomy patients or if a patient is having trouble with their ostomy. For patients who don't have an ostomy but will be getting one, I teach them about basic ostomy care and mark their abdomen where an ostomy could go (surgeon ultimately has the final decision). For a new ostomate fresh out of surgery, I meet with them about 3 times (or more if needed) and teach them how to care for their ostomy. Inpatient continence side isn't really used. If I worked with a urologist I would definitely use the continence aspect of CWOCN more frequently. I do caution other RNs that catheters and rectal tubes can damage sphincters and that they should be removed as soon as possible otherwise the patient may face incontinence issues in the future, but that's about the extent of it. On the outpatient wound side, patient's get referred to our wound clinic. We meet, evaluate and come up with the best treatment. Depending on the dressing, we'll teach the patient how to change it or the patient will come back to use every so often and we'll change the dressing. Sometimes they have home health care or are from a nursing home, so we pass our recommendations on to them. I occassionally get a referral for an person with an ostomy who is having trouble with their pouches or has skin breakdown. They come in on an outpatient basis where I evaluate what's going on and try to come up with a solution. Whether this is field is in demand is kind of mixed. Yes, I think it should be in demand because there are a lot of wounds out there that aren't being treated appropriately. We have patients who come in after having the same wound for years and years. From what I've seen, you won't see many job postings looking for a CWOCN. What you may have to do is market yourself and tell them why having you would be greatly beneficial. I was very fortunate to get to where I am now - I was interested in becoming a wound nurse, the wound clinic needed one and viola, I had a job. I know this isn't reality for a lot of people but I do still think it's worth obtaining your CWOCN. It'll definitely make you more marketable! For my training, I went to Cleveland and had education at Cleveland Clinic. I actually lived in Cleveland for 2 months (how long the on-site education is). I believe the online version is 6 months then you have to find a preceptor to get your clinical hours in, but I may be wrong. Once you get your education, you're then a WOCN. You'll have to take 3 tests (one for wound, one for ostomy, one for continence) in order to be fully certified. Now, you can always opt out of taking any of the 3 tests. So, if you only want to be certified in wound, you can choose to not take the ostomy and continence version. Your certification would be CWCN (certified wound care nurse). Ostomy only would be COCN, CCCN would be continence only. You can mix and match as well (be certified in 2 and not all 3). You have to recertify every 5 years, which means you'll have to take the 3 (or however many you want) tests again. I suggest going to wocncb.org . That's the certification board's website. It will walk you through the different cities that offer education, what all you need to be accepted into the class and whatever else you need. That's where I got all of my information when I was looking, anyway. Good luck in whatever you decide to do! I'm okay with (trying to) answer any more questions if you have any!

Yes, what you're feeling is normal. YOU are normal! Nursing school is rough..really, really rough. I'm pretty sure I wanted to switch my major every semester because nursing school stressed me out too much. But hey, I made it and YOU WILL TOO! Honestly, the best answer I can give is that you will feel more comfortable the more experience you get. I would be willing to bet that if you look back on this post come the end of the semester or your clinical rotation you will feel 10x better about things. It's good to have a little stress, it shows that you care and you want to do a good job. However, be kind to yourself. You are still learning. You're still a student. You don't know everything (heck, no nurse knows everything!) and if there's a time to make a mistake, it's while you're in school (although you will continue to make mistakes after school...that's life). The instructor points things out that are "wrong" in your charting to help you learn, that's their job. Even if you were the best student and hardly made a mistake, I bet your instructor would still tell you that something needs fixed. If you are really worried, ask your instructor how you're doing and if they feel like you're staying on track. Don't give up. Just keep on keepin' on and be kind to yourself. Give yourself the chance and opportunity to learn and grow not only into a nursing career but as a human being. It's okay to be stressed, it's normal to be anxious. You are fine and you will continue to be fine and one day you will be on the other side of this and be giving other stressed out/anxious students advice and encouragement!

Well some of these aren't the nicest of comments. We all have bad days and we all rant. I would certainly rather you rant on here than take out your frustration on a patient and/or family member. Pretty sure I've written down things about what I wish I could say to patients but can't...I KNOW everyone has thought of it so to say that you should re-evaluate your quality of care is just plain rude and unneccessary. Health care is very frustrating. Patient's and family members can be difficult to deal with but that doesn't mean you aren't doing a good job. Some people are just plain difficult, end of story and no matter what you do they will stay that way. Nursing is an often thankless job, we hear that over and over again. I'm all for ranting and writing out your feelings so you can get them out and not internalize them. Keep doing you and ignore those who say you aren't doing a good job because they obviously have no idea if you are or are not based on one single post.

I can understand annoyance, but this is a free website that invites anyone to sign up. Also, you can simply just stop clicking on the question links and your problem would be solved.

I wear Skechers Go Walk (or Go Walk 2), they're slip-on shoes with memory foam. Super comfortable and light weight.

Whoa....calm down, it's just a cartoon (and website).

I think you need to just breathe and be kind to yourself. You haven't failed at those things you mentioned in your post. You are still a student and you are still learning. I can also be an overly anxious person with the first gut reaction of running and quitting, but you have to dig deep and push yourself through uncomfortable situations. We've all made mistakes, a lot of mistakes, that's how we learn. By the way, does BSL stand for blood sugar level? If so, next time have the patient put their hand in a dependent position (hanging down) so blood will go to the finger tips. You can also try a warm blanket to help dilate the capillaries. It's okay to not want to hurt the patient, but sometimes you have to cause a little pain. If it happens again, just laugh it off and try again. Give yourself a chance to keep trying. If you need to, find a quiet corner, bathroom stall, or stock room to breathe and calm down for a minute or two. Then give yourself a quick pep talk and get back out there! You got this!

When I was a student, I once "wasted" 3 catheters on the same patient because I kept hitting the wrong hole. Don't sweat it, nursing takes practice and you'll get there :)