My Scope of Practice: Once and Always a Nurse

‘Tis not enough to help the feeble up, but to support them after. — William Shakespeare

  At 7 years old, Debra (Debbie) Siddi, now RN, CWON, knew she wanted to be a nurse. She charted her course through life accordingly. She didn’t wait until she graduated high school — during her junior and senior years, she attended the New York State’s Board of Cooperative Educational Services Licensed Practical Nurse program, graduating with an LPN degree in 1973. After high school, she attended Mount Saint Mary College (Newburgh, NY); in 1977, she earned her Bachelor of Science in Nursing, as well as her Registered Nurse (RN) license.   Debbie worked full-time at the Nyack Hospital (Nyack, NY) from 1977 to 1979, at which time she became a community health nurse at Nyack Hospital Home Health Agency. In 1982, she became the nurse coordinator for the hospice-based Coordinated Approach to Resources and Extended Services (CARES) program. A hospital-based ET nurse asked if she would be interested in becoming an ET nurse for the home care department; in 1984, Debbie attended a Wound Ostomy Continence Nurse (WOCN) Educational Program at Memorial Sloan-Kettering and went on to obtain CWOCN certification 1985. She served as Clinical Nurse Supervisor at Nyack Hospital from 1985 through 2002.

   Ready to dedicate more time to wound care, Debbie transitioned into the role of coordinator for the Nyack Hospital’s Wound Care Center. She worked on a per-diem basis at Nyack Home Care Agency from 2000 to 2002 and joined Good Samaritan Hospital, Suffern, NY as a wound specialist RN, where she has continued to work with home care professionals managing patients with wound, ostomy, and continence issues.

  In order to help young wound care nurses, Debbie became a preceptor for the Wicks Education Associates, Inc (Mechanicsburg, PA) and LaSalle University’s (Philadelphia, PA) Wound, Ostomy, and Continence Nursing Education Program. Debbie also is involved in a new home care staff orientation program that takes nursing students out on home visits. Working with patients outside of the hospital setting is one of the most rewarding aspects of her career. “I enjoy making home visits and interacting with the patients and their significant others,” Debbie says. “The home environment is where day-to-day living occurs, which can vary greatly from patient to patient. My goal is to help patients maximize their independence via self-care and adjust to life post-hospital.” Debbie hopes that bringing nursing students along will show them the impact they can have on patients.

  Debbie is thankful that working in home care has allowed her to be there for patients as they run into a problem for the first time. “You never know what is going to happen along the journey,” she says. “I have had quite a few experiences where being in the right place at the right time enabled me to help people get through a trying time.” Although working in home care provides Debbie greater access to her patients and their daily lives, she cannot be with them at all times. That is why teaching self-care is important, so the patient knows what to do when an unexpected circumstance arises.

  Some things Debbie cannot teach her patients, such as the healing power of talking with one’s peers. After all the basics are taught, Debbie guides patients to work out residual concerns through ostomy support groups. In 1985, Debra became involved with the Rockland County (New York) Ostomy Support Group, which was hosted by the Rockland County American Cancer Society. Although the group is no longer active, Debbie says it was one particularly rewarding aspect of her role as a CWOCN. “They were a great group of people who were interested in learning and helping other ostomates cope with living with an ostomy,” she says. Debbie is working on restoring the group and is currently available to ostomates in need of support or guidance through the United Ostomy Association of America website’s contact page (www.uoaa.org). Debbie also has been the President of the Wound Ostomy Continence Nurse Garden State Affiliate from 2008 to the present time. She takes great pride in being a leader of the WOCN affiliate.

  What Debbie likes best about support groups is that participants realize just how normal they still are. “If you walked into an ostomy support group meeting by mistake, you would not know you were among ostomates unless you heard what was being said,” she says. “You may work side-by-side with an ostomate and never know it.” Working with patients, whether in a clinic, at their home, or in a support group, and helping them reach a point where they feel normal again, is what helps define Debbie’s scope of practice.

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