My Scope of Practice: The Importance of Passion

“To be successful, the first thing to do is fall in love with your work.” — Sister Mary Lauretta   

Of wound, ostomy, continence nursing, Dorothy (Dot) Paone Goodman, RN, BSN, CWOCN, says, “It is not just a job. You need to have a passion for this work.” With more than 30 years in the nursing field, 26 as a CWOCN, Dot’s passion is evident.   

In 1970, Dot graduated from the 3-year diploma program of Holy Name Hospital School of Nursing (Teaneck, NJ). The first 10 years of her nursing career were spent as assistant head nurse, head nurse, and Nursing Coordinator. While Dot was a Nursing Coordinator at Cedars-Sinai Medical Center in Los Angeles, she managed a surgical unit. One particular patient under her care awakened her desire to learn more about wound and ostomy nursing. “A 35-year-old man was dying of colon cancer,” Dot says. “He had a high-output small bowel fistula causing a significant amount of pain. His skin was burned on his abdomen because of the fistula output. He died while he was a patient on my floor, and I vowed to learn more about how to care for patients like him.”

  Dot also credits her interest in ostomy care to Jo Martinson, a “wonderful ET nurse at Cedars-Sinai.” “Jo was the only ET nurse for 1,180 beds,” Dot says. “She gave loving, individualized care, and she allowed me to learn from her and see her patients when she was away. I accompanied her to a national meeting of enterostomal therapists in San Diego, where I met many other ET nurses who were passionate advocates and role models. I was truly inspired.”

  After realizing her passion for ostomy nursing, Dot attended Sloan-Kettering Memorial School for Enterstomal Therapy (New York, NY). She completed the program in 1980 and has worked in the field for the past 33 years. But back when she started, the title was still Enterostomal Therapist. “Our focus was the patient with an ostomy,” she says. “We provided care for patients with skin problem, wounds associated with surgical procedures, and patients with fistulas, but chronic wound care was not yet a focused specialty. Over the years, the specialty of wounds and continence developed; now, clinicians can be certified in all three areas (wound, ostomy, and continence [WOC] nursing). Along the way, the title changed to better reflect what we do.”

  In order to further advance her education and career, Dot went back to school and graduated from George Mason University (Fairfax, VA) in the spring of 1996 with a Bachelor of Science in Nursing. Since then, Dot has worked in home care, acute care, and outpatient clinics and has been a consultant in long-term care.

  One aspect of WOC nursing Dot particularly likes are the opportunities to develop the plan of care, provide hands-on care, and most importantly, teach that care to patients and caregivers. Dot considers herself fortunate to be able meet most of her ostomy patients before surgery. The patients and their families are afraid and anxious, and giving them information and allowing them to participate in marking the stoma site and answering their questions is a great way to establish a relationship of trust and confidence. “As WOC nurses, we meet people in both physical and emotional pain,” Dot says. “Giving people relief from that pain is what this specialty is about.”   

   Currently, Dot is a full-time WOC nurse at Georgetown University Hospital (Washington, DC). Along with her partner, another WOC nurse, Dot consults with the nursing and medical staff and is involved with direct care for patients with ostomies and fistulas, draining wounds, pressure ulcers, leaking tubes, continence issues, and dermatological conditions. However, she is not limited to those areas — there is no place in the hospital to which she hasn’t been called at some point, including the ER, OR, PACU, or MD’s office. “I have to remember that if someone is calling, it is because they have a need,” she says. “I may not be the best person to call, but I listen so I can help or refer. I have been around a long time, so I usually have some suggestions.”

  Most of all, Dot enjoys sharing her love and passion with nurses at all levels of education through precepting. “I am most proud of the 38 CWOCNs I have precepted,” she says. A specialist in any area of nursing must have the knowledge and skill to fulfill that role. A person seeing a specialist expects to receive state-of-the-art of care, requiring training, experience, and especially in Dot’s case, passion, essential elements in her scope of practice.

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