My Scope of Practice: Keeping Care a Laughing Matter

“Laughter is the shortest distance between two people.” — Victor Borge, classical pianist   Good attitude is key to successful adaptation, but sometimes keeping a positive outlook is difficult when you are faced with life-altering surgery. For Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN, CRNP, APNC, MAPWCA, FAAN, encouraging smiles is an important item on her patient “to do” list. “When dealing with people preparing to have an ostomy or who have a diversion, the underlying rule is to nurture a sense of humor,” Dr. Beitz says. “Humor helps with adaptation and recognizing you can have great quality of life even with an ostomy. Appropriate humor can really help patients do better and heal faster.”   Doing better and healing faster are always Dr. Beitz’s main objectives. As a seasoned professional, she has the knowledge and experience to tackle most situations quickly and effectively. But back when she was a recent Germantown Hospital School of Nursing (Philadelphia, PA) graduate working in the operating room, many procedures were new and unfamiliar. Dr. Beitz recalls caring for a patient with an ileoanal reservoir (J-pouch) and having no clue what it was. Like any good nurse, she did some research, but instead of taking away only what she needed to care for the patient, Dr. Beitz, intrigued by this creative surgery, wanted to learn much more about it and nursing in general. She went back to school and earned a Bachelor of Science in Nursing degree from LaSalle University (Philadelphia, PA) in 1983 and a Master of Science in Nursing degree with a focus on Nursing Education from Villanova University (Philadelphia, PA) in 1986. Meanwhile, Dr. Beitz continued to work in the operating room and found herself continually drawn to the wound, ostomy, continence nursing field. “I spent a great deal of time assisting with gastrointestinal, urological, and endoscopic surgical procedures, so I was exposed to the care required by WOC patients,” she says. In the early 1990s, Dr. Beitz attended the Wound Ostomy Continence Nursing Education Program (WOCNEP) at Albany Medical Center (Albany, NY) and became a certified WOC nurse.

Over the years, Dr. Beitz has practiced clinical nursing in a variety of roles, including medical-surgical and cardiac critical care, and has consulted for healthcare organizations, particularly hospitals where as a clinical nurse specialist for WOC nursing she scrutinized their care delivery programs. In her WOC role, Dr. Beitz recommends needed interventions for therapy, her decision-making based on years of formal education and clinical experience treating patients with disorders of the skin or wounds, ostomies, and fecal and/or urinary incontinence.

Since graduating from Villanova, Dr. Beitz has taught full-time in baccalaureate and higher degree nursing programs and earned her PhD in Educational Psychology from Temple University. Her passion for teaching and education complements her passion for clinical practice. She is currently a professor at Rutgers University School of Nursing (Camden, NJ) teaching Undergraduate Nursing Research, Adult Health, Pharmacology, and a new Doctoral level course in evidence-based practice. “I have the pleasure of teaching neophyte nurses about pharmacology and adult nursing and educating new WOC nurses for the future of healthcare,” Dr. Beitz says. “Since Rutgers University-Camden’s WOCNEP is taught at the graduate level, our students not only receive the best clinical preparation in the three areas, but also learn about how to teach staff, use research findings, and incorporate the best evidence into practice. In contemporary healthcare, evidence-based care has to drive WOC nursing practice.”

Recently, Dr. Beitz returned to school part-time (as part of a sabbatical) at La Salle University to obtain a post-master’s certificate to become an adult nurse practitioner. This new role gives her more ability and freedom to provide direct clinical care, which is still as much apart of her life as education. For Dr. Beitz, it is gratifying to improve the lives of patients both directly and indirectly.

Through her career, Dr. Beitz has taught physicians, medical students, nursing staff, and other health professionals about WOC topics. This entire realm of practice recently has become profoundly important because hospital-acquired pressure ulcers are no longer reimbursed by the Center for Medicare and Medicaid Services. All related disciplines must be up-to-speed on wound assessment, documentation, and therapy (prevention and/or treatment). There is no cutting corners. The same quality of care must be provided across all disciplines and settings and populations... and always with a smile.

 “We all must remember to humanize care,” says Dr. Beitz. “My many years in the operating room taught me to pull down my mask, hold the patient’s hand, and say, ‘Hello, I am Janice, and I am your OR nurse. I will be here with you the whole time and when you wake up’. It may seem like a small thing to do, but the effects can go a long way.”

Dr. Beitz has published numerous evidence-based articles, worked to redefine appropriate care to ensure it is based in science not ritual, and mentored and taught countless young people as they began their journey into nursing. Her efforts have helped shape wound care and the people who dedicate their lives to provide it. Her patients might contend it is that extra minute spent comforting or laughing, offering a smile or a kind word, is what really defines Dr. Beitz’s scope of practice. This article was not subject to the Ostomy Wound Management peer-review process.