My Scope of Practice: The Importance of Teachers… and Time

“To achieve great things, two things are needed: a plan, and not quite enough time.” — Leonard Bernstein, American musician

  Like many in her field, Mary Jo R. Conley, BSN, RN, CWOCN, didn’t begin her nursing career in the specialty. A WOC nurse introduced Mary Jo to the challenging, rewarding arena that is wound, ostomy, and continence care; her story underscores the need for nurse educators and mentors who champion this scope of care and, most of all, are experts at time management.

  Mary Jo graduated from Muhlenberg Hospital School of Nursing (Plainfield, NJ) and the Union County College (Cranford, New Jersey) in 1983 with a diploma in nursing and an associate degree in science. She joined the Cathedral Healthcare System, Inc (Newark, NJ), which comprised Saint Michael’s Medical Center, Saint James Hospital, The Pope John Paul II Life Center (Orange, NJ), and Columbus Hospital (Newark, NJ). She began her career as a registered nurse on a medical unit at Saint Michael’s Medical Center, Newark, NJ. After several years, she became a nurse manager of a medical/alcohol detoxification unit within St. Michael’s. “The nurse educator responsible for the medical unit I worked on as a staff nurse was a WOC nurse,” Mary Jo says. “I admired her ability to teach me and my coworkers about wounds and wound healing. I respected her patience and skill, spending time with patients and their families postoperatively in order to teach them. This kindled an interest in patient education, and when she left after having twins, I applied for the nurse educator position, which came with the job of ‘wound care nurse’.”

  In this role, Mary Jo developed and implemented the nursing orientation program, nurse externship program, and nurse preceptorship program and oversaw the educational development of all levels of nursing staff in the medical/surgical division. She also began to delve into the world of wound, ostomy, and continence by holding consultations for patients with wounds, stomas, incontinence, and cutaneous tubes.

  Mary Jo realized she needed more education in the field to provide this needed service, so she wrote a proposal for a WOC nurse position for Cathedral Healthcare System, which eventually was approved.

  After graduating from the New Jersey City University (Jersey City, NJ) in 1989 with a Bachelor of Science in Nursing, Mary Jo attended the Enterostomal Therapy Nursing Education Program at the Abbott Northwest University Hospital, Minneapolis, MN that same year. She completed the didactic requirement in Minneapolis and returned to New Jersey for the clinical portion of the program, working with preceptors from Bergen and Hudson counties. She successfully completed the course requirements and testing and became certified in Wound, Ostomy, and Continence Nursing in 1990.

  Certification in hand, Mary Jo provided consultations for patients and education for the nursing staff of Cathedral Healthcare System. She began working at the Hackensack University Medical Center in 2001 as a WOC nurse, where she is currently employed. “When I began, there was one full-time position (me) and a part-timer,” Mary Jo says. “We presented our statistics and activities, were able to show the need, and were awarded another full time position. Currently, we have one part-time and two full-time WOC nurses at Hackensack.”

  With more than 20 years experience working in the hospital setting, Mary Jo can narrow down one of the biggest problems most nurses face to just one word: time. Nurses must juggle large caseloads and many projects, provide emotional support to patients and families and colleagues, and perhaps one of the biggest time issues, make the most of the restricted amount of time patients can stay in the hospital.

   “Time has become limited for patients in the hospital setting,” Mary Jo says. “The hospital stay is overwhelming. Patients may be dealing with a new diagnosis of cancer or postoperative pain. It is challenging to provide patients and their families with the knowledge and tools they need to return home in a short period of time. Shorter lengths of stays prevent the evaluation of outcomes for wound care and healing. You can initiate the best, most state-of-the art treatments, but patients are typically discharged before you can evaluate a final outcome or progress.”

  Rather than be discouraged by the lack of time available, Mary Jo works ever harder to ensure her patients have the necessary skills and confidence they need before heading home. “There is no greater reward than to see patients progress postoperatively and be discharged to home confident they can continue living a normal life despite image-altering surgery, knowing that in some way you have had a positive impact,” she says.

  Mary Jo has spent a number of years teaching patients and colleagues, but when she thinks about it, they also seem to have been teaching her. “My work has taught me the will to live a productive life is unbelievably powerful,” she says. “This will is what allows people to overcome the toughest barriers. I’ve learned the value of family both for my patients and for myself. I’ve learned to take advantage of every opportunity for fun and laughter, because life is just too short not to.” It is this ability to maximize the time she can connect with and care for patients on a personal level that helps shape Mary Jo’s scope of practice.

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