My Scope of Practice: The Art of Listening

The most basic of all human needs is the need to understand and be understood. The best way to understand people is to listen to them. — Ralph Nichols, author

 Be patient, be kind, be helpful — words of wisdom that express how Christa M. Heinsler, RN/NP, CWOCN approaches her life and her work. As a wound, ostomy, and continence nurse, Christa, along with her colleagues, cares for patients who have not only a wound, but also, in many cases, a new lifestyle to manage. In such situations, nurses must treat the whole patient, helping them to physically and emotionally heal. As Christa has learned, sometimes the best way to help is to listen.

  Christa’s path toward wound care began at St. John’s University (Jamaica, NY) where she earned her bachelor of science degree in Biology; she then went to Columbia University (New York, NY) and earned her BS in Nursing and to University of Rochester (Rochester, NY) to earn her masters in nursing degree.

  While she was in graduate school, Christa began working as an advanced practice nurse on a general surgical unit at Rochester General Hospital (Rochester, NY). Approximately 25% of surgical patients had ostomies, and Christa began to participate in their postoperative care. She took a special interest in helping them adjust to life after surgery. When she learned there was a nursing specialty that focused on the care of patients with wounds, ostomies, and continence problems, Christa was immediately interested. A colleague she met during a clinical rotation in graduate school was hired by the hospital as an enterostomal therapist and became Christa’s mentor. In 1994, Christa earned her WOCN certification from Albany Medical Center (Albany, NY). She joined the Wound, Ostomy, Continence Nurses Society to make the most of her role as a WOCN and to take advantage of the resources; currently, she serves as President of the Western New York affiliate of the Northeast Region.

  In her current position at Strong Memorial Hospital (Rochester, NY), Christa spends the majority of her time in an outpatient ostomy clinic using a holistic approach to care. “Each patient’s physical, emotional, social, and psychological needs as they affect recovery are addressed to help them get back into life,” Christa says. For many patients, this healing process starts right after they find out they will need an ostomy. Christa’s outpatient position allows her to work with patients preoperatively, educating them about their surgery, answering questions, and providing reassurance. She may see these patients during their hospitalization, and then work with them after they are discharged home. Getting to see patient’s progress through this process is rewarding. “It is very gratifying to have patients and families learn to independently care for their ostomies and resume a normal lifestyle,” she says.

  Some patients find getting back in the swing of normality more difficult than others, but Christa has learned the value of being serene and understanding. “Sometimes when patients are stressed, they do not hear or follow instructions,” she says. “This makes caring for them more challenging, but the rewards are great when healing occurs and patients and family adjust to the ostomy.”

  Although Christa already is working more than 20 hours a week in the ostomy outpatient clinic, she hopes to see her position, and the clinic as a whole, expand exponentially. “In addition to the current surgical patients, we hope to reach patients in the surrounding area who had surgery many years ago,” Christa says. “They now may be experiencing bodily changes, such as weight gain and loss of vision or dexterity that may make the appliance they originally wore no longer practical. These patients often are socially isolated because of the unreliability of their current appliances and are unaware of how to obtain help for these problems.”

  Christa is confident that no matter what physical and emotional challenges patients face, the medical and nursing staff at the outpatient clinic can provide options and hope. “If you search and think hard enough, there is usually a solution to pouching the complicated ostomy or fistula or dressing the challenging wound,” Christa says.

   “I have learned to listen to my patients, to hear what is really going on. I try not to pre-judge patients or situations, but instead to explore available solutions,” Christa says. This understanding that sometimes listening and caring are the best medicine is what distinguishes Christa’s scope of practice.

This article was not subject to the Ostomy Wound Management peer-review process.