Wound Care Specialization for the Advanced Practice Clinician

Nursing is a unique and varied field often described as a union between art and science. Nursing appeals to many individuals as a first or second career, and these people see the profession through different lenses. When questioned about why they want to enter the field, many students respond that they “want to help others,” “give back to society,” or “find meaning in my work.”

Many of us can recall our transition from student to entry-level nurse, whether we started on the specialized unit of our dreams or were “strongly” encouraged to start in a general setting. There comes the day when we realize that we have begun to master a clinical knowledge set we once thought impossible. If you are at this crossroads in your career and seek opportunities for increased intellectual challenges, consider a nursing specialty, particularly wound care.

Wound care is a unique territory of practice. Wound care specialization requires additional education, and numerous routes are available. The field allows innumerable opportunities to showcase specialized knowledge, especially through board certification. Furthermore, wound care provides countless occasions for collaboration while allowing a certain degree of autonomy. Best of all, wound care allows for creativity, or the art described earlier. At least a few times a week, when asked about finding solutions to a complex patient problem, the phrase, “desperation is the mother of invention” comes to mind. Solving a long-standing wound problem that has stumped others is particularly rewarding. Moreover, wound care’s direct patient care aspect creates an intimacy among the provider, family, and patient.

As the wound care clinician transitions from novice to expert, becoming an advanced practitioner can be the next logical step. Furthermore, the physician shortage and a lack of wound care education in primary care present an opportunity to expand wound care practice and research for nurse practitioners (NP), physician assistants (PA), and clinical nurse specialists (CNS). While many are familiar with the NP and PA, some may be unaware of the CNS role. This advanced practice registered nurse (APRN) has the knowledge and skillset to positively impact the patient and family, the nurse, and the health care system. CNS core competencies include collaboration, consultation, research, ethical decision-making, expert coaching, systems management, and direct clinical practice. These professionals are adept at providing holistic patient care across the health care continuum and during transitions of care, especially in low-resource settings. Advanced practice degrees provide the practitioner with choices among practice settings. The NP, PA, or CNS can care for inpatients (hospital, skilled nursing, or rehabilitation), those visiting outpatient clinics or offices, and even patients who are at home. One of the most significant impacts the specialist has on the vulnerable wound care patient is during transitions of care, as the patient migrates from one practice setting to another. Holistic patient management and the spirit of collaboration provide a mechanism to ensure safe care transitions for these individuals.

In addition to practice setting versatility and greater autonomy, the advanced practice pathway in wound care presents many professional growth opportunities. For example, becoming a peer reviewer and reviewing literature as it is published keeps the wound practitioner abreast of what is happening in the field. Also, joining wound care societies and attending conferences allows for continuing education and networking, paving the way for partnerships on research and other projects.

Regardless of the chosen route, the PA, NP, or CNS are at the forefront of the rapidly evolving science of wound care. These clinicians are also poised to impact best practices for wound prevention and healing. Quality evidence to support evidence-based practice is lacking in many publications, and most guidelines are built on consensus statements rather than measured and controlled research projects. However, an advanced practice degree provides an opportunity to help drive the science of care and promote high-quality, unbiased research.

If you are interested in advanced practice, finding a mentor can help you transition from a novice to an expert. Mentors can aid with deciding on the appropriate advanced practice role that meets your interests. The mentor can also benefit from this special relationship. Mentors can help ensure the longevity of the practice and pass on valuable knowledge and skills that cannot be gained from a textbook or skills lab. Mentors should push mentees to venture outside their comfort zones. Great mentors can play a significant role in a student’s success during and after schooling. The most important things mentors can provide are support, encouragement, and growth opportunities. As a close friend stated, of all things I can be, I hope to be an asset to my mentor and to develop a lifelong relationship with the individual that will last long after graduation.

Watch a brief video about this topic by Dr Janice Beitz. 

Dr Howell is a wound, ostomy, and continence nurse in Central Valley, CA. Dr Kirkland-Kyhn is the director of wound care, UC Davis Medical Center, Sacramento, CA. The opinions and statements expressed herein are specific to the respective authors and not necessarily those of Wound Management & Prevention or HMP Global. This article was not subject to the Wound Management & Prevention peer-review process.