My Scope of Practice: Leading the Way for Wound and Ostomy Care

When seemingly more complex comorbidities compete for attention, making wound, ostomy, and continence (WOC) care a priority can be difficult. Despite a steady increase in patients requiring a dedicated WOC practitioner, the field has yet to be recognized as a specialty or subspecialty. Corey Heerschap, MScCH (WPC), BScN, RN, CETN(C), IIWCC, is one of a growing number of clinicians leading the way for greater recognition of the importance of WOC management and education. 

After graduating with a Bachelor of Science in Nursing degree from the collaborative program offered by Laurentian University (Sudbury, Ontario, Canada) and Cambrian College (Sudbury, Ontario, Canada) in 2012, Corey joined a new wound care program initiative in his region, the North East Patient Centered Wound Care Program. During this initial experience as a community registered nurse, Corey came to appreciate the intricacies of wound care management, which eventually translated into a position as the first wound care resource nurse for his organization, a branch of Bayshore Home Health. Within 2 years, Corey completed the University of Toronto International Interdisciplinary Wound Care Course and the Master of Science in Community Health Specializing in Wound Prevention and Care Program.

“During this time, I had the good fortune to connect with 2 fantastic community-based enterostomal therapy nurses — Cheryl Thompson, BScN, RN, ET, and Loretta Micelotta, BScN, RN, ET,” Corey says. “Over several years, I was able to learn from them and gain insight into the enterostomal therapy nurse role. Using the knowledge and experience I acquired, I moved into a new role in my current organization at the Royal Victoria Regional Health Centre (RVH) as a Wound/Ostomy Clinical Nurse Specialist.”

With several certifications under his belt, Corey wanted to further explore the WOC realm. He enrolled in the Canadian Association for Enterostomal Therapy (CAET) Enterostomal Therapy Nurse Education Program, which helped him better understand the link between each component of WOC care and its impact on skin. He continued to follow the WOC career path, earning certification as an enterostomal therapy nurse from the Canadian Nurses Association. Now, as a seasoned WOC veteran, Corey is enrolled in the CAET LEADs program and serves on the Registered Nurses Association of Ontario Best Practice Guideline Development Panel for Ostomy Care and Management and the CAET Executive Board of Directors as the Treasurer and advocate for Enterostomal Therapy Nurses.

When he is not sharing WOC knowledge with patients and peers, Corey is advocating for the field. “I lead and participate in organizational wound- and ostomy-related research, working with other members of an interprofessional team to advance the practice of RVH and the field of wound and ostomy management,” he says. “I also lead wound and ostomy program development, such as the implementation of the wound- and ostomy-related Registered Nurses Association of Ontario Best Practice Guidelines throughout our facility. I also develop wound- and ostomy-related organizational policies and procedures and participate on my organization’s Nurse Advisory Council and the Product Evaluation and Standardization Committee to help ensure staff and patients have the most appropriate resources available to them and to the guidelines and policies to support their use.”

Getting the WOC message across is not always easy. “I find the most difficult aspect of my position is communicating the importance of evidence-based, patient-centered, best practice WOC care to clinicians who have competing priorities and many areas of care to focus on,” Corey says. “Whenever I have a chance, I try to work one-on-one with staff to demonstrate the importance of focusing on a patient’s skin. Reaching out to our clinicians both as a group and as individuals and reminding them on a daily basis how their care affects their patients’ skin motivates them to spend time on prevention to save themselves the time involved in managing a wound, should one develop.”

Corey recognizes how the smallest, simplest things can have the greatest impact. “When I am able to make a suggestion that prevents a wound from occurring or worsening, or decrease the chronic pain someone feels in his lower legs due to venous insufficiency by suggesting compression, I am rewarded by knowing I have made a difference, no matter how small, to improve that patient’s life,” Corey says. “The realization that a recommendation for an easy change in a patient’s routine could have profound effects on their quality of life, self-confidence, and comfort is part of what makes this specialty so rewarding.”

Corey continues to emphasize the significance of the WOC field. “Many aspects of wound healing, ostomy management, and continence care are unexplored,” Corey says. “They require inquisitive minds to consider new treatments, think outside the box, and advance the evidence-based literature of this specialty’s knowledge base. This specialty has excellent rewards in the ability to use your knowledge, skills, and judgment to make profound impacts on your patients’ lives. It provides an opportunity to lead in many aspects of health care from research to education to bedside care and to grow as an individual and clinician.”

Leading the way within the WOC realm is an integral part of Corey’s scope of practice.