Meeting Mental Health Needs

Meeting Mental Health Needs

In the press of caring for patients, family nurse practitioners (FNPs) must tend to a patients physical well-being and mental health. Caring for a patients mental status can be vital to meeting healthcare needs.meeting-mental-health-needs

As primary care providers, FNPS play a significant role in tending to mental health concerns. The American Association of Nurse Practitioners (AANP) reflected that 88% of the nations NP workforce are certified in an area of primary care, with over 70% delivering primary care services, notes LaMicha M. Hogan, PhD, APRN, FNP-BC, associate dean/department chair for APRN Programs for the Texas Tech University Health Sciences Center School of Nursing-Graduate Program.

In this article, we’ll offer ways to ensure you’re attending to your patient’s mental health needs and touch on how FNP programs should educate students about mental health.

Great Impact

Though stigmatizing societal attitudes regarding mental healthcare have improved, a patients initial encounter with a healthcare provider will likely have the most significant impact on self-perception of a mental health complaint as well as willingness to seek continued treatment, notes Hogan.

Early detection and intervention lead to the best outcomes, in conjunction with a trusting, collaborative rapport between the patient and FNP to reduce stigma present with having a mental health condition, according to Hogan. FNPs must be aware that a patient’s mental health status has a greater impact on chronic physical health conditions if undiagnosed or left untreated, she notes.

Its imperative for FNPs, especially those in primary care settings, to prioritize the screening of conditions such as depression and anxiety, notes Amanda Ringold, DNP, FNP-BC, CRNP, SANE-A, assistant professor at the University of Pittsburgh School of Nursing. “To ensure effective mental health assessments, FNPs must address and overcome organizational barriers, including time constraints, a lack of a universal screening policy, and providers’ feelings of inadequacy in conducting mental health screenings. FNPs are poised to take on leadership roles within clinical settings to address and mitigate these challenges,” she explains.

Screening Strategies

Various strategies exist for dealing with mental health during patient care visits. For instance, 

Ringold notes that not every screening needs to be done face-to-face with the FNP. Instead, screenings can be conducted with pen and paper in the waiting room or via an app before the appointment. She notes that other team members, including nurses or medical assistants, can be trained in administering the screenings.

Lisa Johnson, DrNP, CRNP, ACNP-BC, associate professor and DNP/NP Program Coordinator at Gwynedd Mercy University, agrees that patients can complete questionnaires in the waiting room or before the visit. However, we have to be cautious not to fatigue patients with questionnaires and to ascertain their reading level and primary language prior to requesting a mental health assessment be completed by the patient,” she warns.

According to Ringold, the care setting and patient population should dictate the most appropriate screening tools. The most frequently used tools, she notes, include the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder -7 (GAD-7), and the Alcohol Use Disorders Identification Test (AUDIT). When time is limited, notes Ringold, FNPs can use abbreviated versions of screenings such as the PHQ-2, a two-question alternative to the PHQ-9.

In an interview, Irene W. Bean, DNP, FNP/PMHNP-BC, FAAN, FAANP, FNAP, CEO of Serenity Health Care, P.C., and Tennessee State Rep for AANP, says to pay attention to a patient’s body language once in a patient encounter. Watch for poor eye contact or note whether a patient has been crying.

She says to pay attention to slurred speech and be aware of signs such as a patient who typically speaks loudly suddenly speaking in a whisper or a normally talkative patient now being reserved.

FNP Programs

Johnson says NP educational standards emphasize assessing mental health in varied patient populations. Healthcare providers and institutions of higher education need to focus on the cultural considerations of mental health disorders and further emphasize collaborative communication between primary care and mental health providers, she notes.

Hogan says clinical competencies are best attained via a competency-based educational model throughout the FNP curricula. Specialized courses on mental health, simulation training, interprofessional education, and clinical rotations in primary care settings can develop competence. She says that after graduation, FNPs should maintain continuing education specific to FNP’s scope of practice and evidence-based care for mental health concerns.

Ringold notes a growing trend of students at the University of Pittsburgh School of Nursing opting for dual FNP-PMHNP degrees.

Scope of Practice

While FNPs can treat mental health conditions such as basic anxiety and depression, they need to be mindful of their states scope of practice, says Bean. For patients with conditions such as bipolar disorder or schizophrenia, you may be stepping outside your practice scope and may need to refer the patient to a specialist, Bean says

One thing that I would stress, and I stress to my students, is that you want to protect your license. You want to ensure the patient is safe while protecting your license,” Bean says.

Calling on Compassion

When you realize your patient is anxious, depressed, or dealing with a mental health issue, What you don’t want to do is rush that patient from that conversation,” says Bean. You’re going to miss a lot of things when you rush patients who have a mental health crisis through your clinic,” Bean says. 

You have to have compassion for patients dealing with a crisis. Their crisis may not be something you feel is a crisis, but to them, its everything. You cant discount their feelings, and you cant discount what youre seeing in that patient.”

Is the FNP Program Right for You?

Is the FNP Program Right for You?

The family nurse practitioner (FNP) credential is a popular choice for nurses considering the right academic path to becoming nurse

While nurses can choose a route that addresses more specific populations, such as a pediatric NP, a psychiatric NP, or an adult-gerontology NP, the FNP offers an opportunity to treat patients across the lifespan—from infants to centenarians.

In fact, according to the American Association of Nurse Practitioners (AANP), 70 percent of nurse practitioners are FNPs.

The appeal of the FNP is rooted in both the patient care opportunities and the professional autonomy the FNP offers. “The premise behind the FNP is to provide holistic care for all individuals,” says Julia M. Steed, PhD, APRN, FNP-BC, CTTS, academic director of the Family Nurse Practitioner Specialty and assistant professor at Vanderbilt University School of Nursing. She says that FNPs focus on an approach that emphasizes health prevention and promotion appropriate for different lifestyles and cultures. It’s an approach that’s useful in many healthcare settings.

Nurses choose a path for many reasons, often based on a mix of personal and occupational experiences, says Tearsanee Carlisle Davis, DNP, FNP-BC, PMHNP-BC, FAANP, the director of Clinical Programs and Strategy at the University of Mississippi Medical Center (UMMC) Center for Telehealth and an associate professor at UMMC. “Originally, I entered a nurse educator program because of my love for teaching,” Davis says. “However, after the first day, I knew I loved patient care more. I switched programs and became an FNP. One of the main reasons for my choice was my hometown and the needs of the people there. I knew that nurse practitioners were the answer, and I was excited to become a part of something that could change people’s health.”

Jo Loomis, DNP, FNP-C, CHSE, CLC, ANLC, NCMP, CNL, associate professor in the School of Nursing and Health Professions at the University of San Francisco, realized that her original midwifery plan would better serve her if she could do what she found was pulling at her—being able to care for the whole family. Nursing students, she says, can keep an open mind as they are moving through clinical settings that will include other NP areas, such as pediatrics or women’s health, and can pay special attention to the especially appealing areas—or notice if they all are.

Loomis says that as an FNP, a nurse can have a broad scope of everything that may contribute to a patient’s health. They focus on the tenets of health promotion, risk aversion, and disease prevention. “They take it all into consideration,” Loomis says, including that other factors might influence a care plan or other people involved. She says the role consists of listening to the patient’s health concerns and what is happening in their lives.

The FNP is an excellent choice for many nurses, but not all. If nurses are trying to decide the best credential, Davis says to remember what is truly important. “I believe [nurses] should answer their ‘why’ for advancing their education first,” she says. They will be more successful if they can prioritize what makes them tick. “I believe that by knowing their reason for choosing a path, they will understand the responsibility that comes with it,” she says. The FNP, says Steed, includes a little bit of everything, which gives an FNP the ability to adapt to different patients and settings. Steed has used her FNP as a practicing nurse in areas ranging from chiropractic to urgent care to weight loss.

Finding the right academic program to earn an FNP is essential to a nurse’s success. Many factors influence the decision, and each nurse will have different priorities. The final decision includes determining what will work for course delivery (online or on campus), cost, location, and the length of the program. However, while the school’s reputation and the strength of the faculty are top-of-the-list fundamentals, a flexible approach will be helpful. Automatically thinking the shortest program is the best can be detrimental. “It takes time to learn the role and become fully equipped as an NP,” says Loomis.

Steed also recommends that nurses look into the student support available. Supports include all the assistance a grad student needs, including library help, career coaching, and even grad services counseling. Assessing what kind of research the schools faculty members are working on and possibly reaching out to them individually also offers insight into what opportunities will be available as an FNP student.

Davis, who has used her FNP in settings as diverse as private practice, community health, emergency medicine, and academia, recommends putting in some work before making a decision. “I think they should study it and talk with others who have been successful on the journey,” she says.

This crucial role allows nurses to make meaningful and measurable changes for families in their communities. In practice settings, the FNP, with a broad understanding of all ages and health conditions, is an expert in triaging what is within their scope to treat and what might need additional expertise or specialists.

Once nurses are in practice as FNPs, they are often rewarded with seeing the change that comes from their work. “For me, it was the satisfaction of knowing I was meeting a real need in the community. Nurses are often the ones who connect with the patients and family. As an NP, I felt better prepared to educate and provide care. My FNP experience opened many doors for me, many of which I could have never imagined,” Davis adds.

How Do I Choose an FNP Program?

How Do I Choose an FNP Program?

So, youve decided its time to further your education? Or maybe you havent decided yet because you are unsure what to do. So many questions are swimming through your mind: Are all FNP programs the same? How much will it cost? Can I still work as an RN while I’m in school? How will I know which program is right for me? Well, never fear; you may find the answers you need

Are All FNP Programs the Same?

The short answer is no, and that can be a good thing. All accredited FNP programs in the United States must follow the standards of their accrediting bodies, both for nursing and their university at large, governmental regulations, licensure standards, and other guidelines. However, the standards can be arranged in several different ways. This allows nursing colleges to offer programs that fit various student needs.

The FNP curriculum is typically offered in three different formats: online, traditional face-to-face, or a hybrid of online and traditional. Online programs have made educational experiences more accessible to students who would not otherwise have the opportunity to further their education or who prefer the flexibility of online learning. When considering online learning, ask whether the classes are presented in synchronous, asynchronous, or a combination of formats.

Synchronous delivery typically means having online classes with a live instructor at specific times, discussions with other students, and opportunities to ask questions and receive feedback. Asynchronous classes usually consist of recorded content, allowing students to access their learning experiences at any time of the day or night, with scheduled opportunities to interact with instructors. Combination formats are just that, a combination of the two.

Traditional programs provide face-to-face learning with an experienced instructor, and hybrid programs offer a taste of both in-person and online learning. So, determining which of the program types is right for you may take some self-evaluation. Some students need the structure of being required to show up in person at a specific date and time, and some are more self-regulated. Neither is right, and neither is wrong. Just make sure to think it through to set yourself up for success.

Another similarity between FNP programs is the requirement for hands-on patient care in clinical settings with properly vetted preceptors. Make sure to inquire about preceptor policies when considering a program. Some programs arrange clinical experiences for their students. However, the vast majority of programs require students to arrange their own clinical experiences. So, the time to start networking with FNPs in your area is now. Most programs allow students to learn from physicians for some required hours.

However, the majority of hours should be spent learning from an experienced nurse practitioner. Because the FNP scope of practice encompasses patients across the lifespan, students will likely be required to have preceptors in differing specialties: pediatrics, womens health, primary care, and urgent care. Many programs also allow preceptorships within sub-specialties such as aesthetics, dermatology, podiatry, cardiology, urology, etc. Think outside the box. It never hurts to ask whether your favorite practitioner could be approved for a clinical experience.

A couple of words to the wise concerning preceptorships:

  • Some preceptors require payment for their services, and some do not. Some colleges allow paid preceptors, and some do not. Make sure to ask about this before you enroll in a class that requires a preceptor.
  • Contact your states Board of Nursing (BON) to ensure they allow clinical experiences while you learn from another location. The college you apply to should provide this information, but it always helps to check it out yourself.

How Much Will an FNP Program Cost?

According to, the range for graduate credit hours is approximately $500 to $2000. Required credits usually range from 46 to 54, but there are variations. So, look at the program curriculum and do the math. Also, dont forget to ask about fees, books, supplies, etc., and start thinking about scholarships, grants, and financial aid now.

Please consider your time cost as well. Colleges and universities must calculate in-class time, expected out-of-class work time, clinical time, lab time, etc. So, think of solutions ahead of time for things like childcare, vacations, practice, and life in general. While graduate school is temporary, it will likely mean change for the whole family. So, make sure to talk it through with all of those important people in your life. After all, people can do just about anything for a while, as my Nana always told me.

Can I Still Work as an RN While Im in School?

Most people do work while in graduate school. However, this may factor into your decision about the type of program you want to attend. An asynchronous program may work better if your practice site requirements conflict with traditional or synchronous course requirements. Or your practice site may be willing to accommodate the changes you need. It never hurts to ask. Just remember, a practice site is a great place to make contacts for clinical preceptors.

How Will I Know Which Program is Right for Me?

Consider the things above and talk to people that you trust. Ask them to tell you about their experiences. Then, consider what they say with your perspective in mind. Ask good questions and do your homework in examining available programs. You must consider your learning style, non-negotiable responsibilities, resources, and your familys willingness to be flexible for a little while. When considering a program, you need to know about the format, the colleges accreditation status, the programs success in licensure pass rates and graduate placements, the length of the program, the cost in money and time, the programs preceptor requirements, and whether your BON allows learning from the colleges state. Then, choose wisely and GO FOR IT!

The Road to Becoming an FNP

The Road to Becoming an FNP

Nurse practitioners (NPs) are essential healthcare providers who are excellent, skilled clinical resources for newborns and elderly patients. While there are many available NP career choices, the family nurse practitioner (FNP) is a trendy option among nurses seeking to become primary care providers with the authority to diagnose illnesses, order diagnostic tests, prescribe medications, and manage the care of patients across the lifespan.Interested in becoming an FNP? Learn about the process and requirements for nurses to embark on this fulfilling career

If youre a nurse who wants to become a family nurse practitioner, what does that avenue look like, and what hoops do you need to jump through to achieve your goal? And if youre not a nurse, what additional work must be done to get there? Lets examine the landmarks along the way to becoming an FNP.

Why Become an FNP?

Becoming an FNP has pros and cons, so considering the many possibilities available in advanced practice nursing, its prudent to do your due diligence.


Earning power: According to the U.S. Bureau of Labor Statistics (BLS), nurse practitioners, nurse midwives (CNMs), and nurse anesthetists (CRNAs) earned a median annual salary of $125,900 in 2022, with a mean hourly wage of $60.53. While the much higher salaries of CRNAs may admittedly skew the numbers higher, there’s no arguing that NPs are doing well for themselves.

Job growth: As another incentive for those considering the NP path, the BLS projects 38% job growth for NPs through 2032. When weighed against projected job growth of 6% for RNs and 3% for MDs, the attractiveness of a career as an NP can appear exceptionally bright.

Full practice authority: The state practice environment for NPs is improving slowly. The American Association of Nurse Practitioners (AANP) reports that in the states where full practice authority has been granted, state practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.”


Future license portability: At some point in the future, the APRN Compact will become a reality like it is for millions of registered nurses. However, more states still need to sign on to begin implementing even a fraction of a potential compact.

Stress and burnout: Recent statistics show a high level of burnout, depression, and anxiety among NPs, primarily due to workplace stress, overwork, perceptions of lack of respect from colleagues and patients, and insufficient salaries.

The 15-minute visit: Since most FNPs work in a clinic or office setting, the now common 15-minute office visit can starkly contrast with the relational aspects of bedside nursing that many nurses enjoy as RNs.

The FNP Career Pathway

For Non-nurses:

For non-nurses wanting to secure their future by becoming a family nurse practitioner, the first step is to become an RN through an associate degree in nursing (ADN) program or a bachelor of science in nursing (BSN) program.

Alternatively, a non-nurse can also pursue a direct-entry MSN program, an accelerated path where the student simultaneously earns a BSN and an MSN. Specific direct-entry programs bypass the BSN entirely. Most of these programs will require the completion of prerequisites that will likely include some combination of anatomy and physiology, biology, chemistry, nutrition, sociology, psychology, statistics, and microbiology.

For Registered Nurses:

Registered nurses with an ADN who want to pursue a career as an FNP will want to complete an RN-to-BSN bridge program and then apply to an MSN program with an FNP track. Registered nurses can also consider an RN-to-MSN program, which allows students to take core BSN courses while completing their MSN.

Potential MSN and FNP students should know there is a strong movement afoot to make the Doctorate of Nursing Practice (DNP) degree the entry-level requirement for becoming a nurse practitioner. While a goal of 2025 has been set, this change has yet to be codified as an absolute requirement, but the day for such a requirement is fast approaching.

The FNP Certification Exam

No matter what type of program is pursued to become a family nurse practitioner, graduates must apply for the 150-question FNP certification exam administered under the auspices of the American Academy of Nurse Practitioners Certification Board (AANPCB). Clinical domains covered by the exam include:

  • Newborn
  • Infant
  • Toddler
  • Child
  • Adolescent
  • Young Adult
  • Middle Adult
  • Older Adult

Students can expect to be tested regarding aspects of assessment, diagnosis, planning, and evaluation of patients across the lifespan in areas of knowledge that include:

  • Health assessment
  • Pathophysiology
  • Therapeutics
  • Evidence-Informed Practice

The Life of the FNP

Licensed and certified family nurse practitioners can work in a wide variety of settings, including but not limited to:

  • Physician practices
  • NP-run clinics and practices
  • Private practice
  • Community health centers
  • School-based health clinics
  • Urgent care centers
  • University and college health centers
  • Occupational health clinics
  • Acute care hospitals (e.g., emergency department)
  • Skilled nursing and long-term care facilities
  • Hospices
  • Retail clinics (e.g., in pharmacies)
  • Correctional facilities
  • Holistic health clinics and practices
  • Pain clinics
  • Insurance companies
  • Dialysis centers
  • Clinical research facilities
  • Substance abuse treatment programs and facilities

FNPs can earn additional postgraduate certifications in areas like psychiatric/mental health. APRNs can also become eligible for leadership positions in many clinical settings.

While those considering FNP certification may be worried about the limits of the increasingly common 15-minute patient visit, FNPs can find plenty of practice areas with other types of structures for patient interaction.

With predictions for astronomical job growth and opportunity in the years to come, family nurse practitioners will undoubtedly be in great demand nationwide. Pursuing the career path of the FNP is not for everyone, but the plethora of potential opportunities will attract students from all walks of life far into the foreseeable future.

Embracing Cultural Competence and Cultural Safety

Embracing Cultural Competence and Cultural Safety

Cultural competence and cultural safety are crucial to delivering effective care. They are also key to creating working environments where everyone feels valued and able to function at the highest level. If we invest time and energy in understanding and implementing these concepts, the dividends can be invaluable, both individually and collectively.embracing-cultural-competence-and-cultural-safety

Defining Cultural Competence and Cultural Safety

Dr. Raj Sundar is a physician, community organizer, and the Healthcare for Humans podcast host. As a healthcare leader, Dr. Sundar uses various platforms to bring a human scale to care delivery. In his view, the importance of cultural competence and safety cannot be overstated.

“Understanding cultural competence and safety is crucial when working with diverse cultures,” Dr. Sundar shares. “However, the definitions of cultural competence have evolved from diverse perspectives. One definition that’s commonly used is the following: having the capacity to function effectively within the context of diverse cultural beliefs, behaviors, and needs, as highlighted by the CLAS Standards (culturally and linguistically appropriate services).”

 He continues, “On the other hand, cultural safety goes beyond individual competency, focusing on creating environments where everyone feels safe and respected, particularly addressing historical and structural causes of inequity. It builds upon cultural humility, which involves recognizing personal biases while understanding and respecting others’ perspectives.”

 Where Does Cultural Competence Fall Short? 

However well-meaning cultural competence initiatives can be, they don’t always hit the mark. Dr. Sundar explains, “Competence-focused approaches can sometimes overlook individual differences, leading to stereotyping and neglecting unique experiences.” He continues, “Additionally, while cultural competence training is valuable, it often emphasizes surface-level cultural differences, neglecting deeper issues such as systemic biases and power dynamics.”

Sundar uses his cultural background and experience to illustrate how cultural competence can fall short. “My identity as an Indian-American from North Carolina who likes lacrosse, sweet tea, and country music illustrates the complexity [of individual experience] beyond cultural identity. Individual differences always matter, but my history and values are deeply connected to my Indian ancestry.”

A study published by the National Library of Medicine adds to this idea.

“A plethora of training is designed to expose providers to different cultures and expand their understanding of the beliefs, values, and behavior, thus achieving competence. Although this intention is commendable, training providers to become competent in various cultures presents the risk of stereotyping, stigmatizing, and othering patients and can foster implicit racist attitudes and behaviors.

“Further, by disregarding intersectionality, cultural competence training tends to undermine provider recognition that patients inhabit multiple social statuses that potentially shape their beliefs, values, and behavior.”

Parallel Concepts

When it comes to other concepts that parallel cultural competence, Sundar adds that two other terms to be familiar with are cultural humility and responsiveness.” He describes them thus: “Cultural humility is an attitude or mindset characterized by an ongoing willingness to engage in self-reflection, self-critique, and lifelong learning about one’s own cultural biases and the cultural backgrounds of others. It emphasizes recognizing the limitations of one’s perspective and being open to learning from diverse experiences and perspectives.”

He states, “Cultural responsiveness involves recognizing, respecting, and integrating individuals’ cultural backgrounds, values, and beliefs into designing and delivering services and interventions. It goes beyond cultural competence by emphasizing the importance of engaging with communities, co-creating solutions, and adapting practices to meet diverse populations’ specific needs and preferences.”

Strategies and Tools for Increasing Cultural Competence

There are many strategies and tools for increasing cultural competence. Dr. Sundar shares, “While insufficient, cultural awareness training can be essential opportunities to connect with peers to reflect on conflicts, tension, or care pathways that can be improved.” His examples include asking questions like:

  • Why does our Russian community have the lowest mammogram rate?
  • When a Jehovah’s Witness refuses blood in a life-threatening situation, are we all aware of what to do and have the support we need?
  • When families come together to care for an individual, can we navigate that context in our highly individualistic environment?

Sundar adds, “It’s often essential to have cultural liaisons, which allows for collaboration with community leaders and organizations serving diverse populations.” This strategy can provide insights into cultural norms and various practices and behaviors that community members engage in when seeking healthcare.”

As a community organizer, Sundar has other recommendations. “Building relationships with your community is helpful. Part of my podcasting journey with Healthcare for Humans is building relationships with local immigrant and refugee communities, amplifying their voices, and caring for them in the way they want in the context of their history and structural inequities.”

Patients’ perspectives must also be taken into consideration. “It can be beneficial to actively seek patient input about cultural preferences, needs, and concerns,” Sundar advises. “Take time to listen attentively and respectfully to patients’ perspectives and incorporate their feedback into your approach to care. Ask, ‘How can I be a better advocate and caregiver for your community?’”

Dr. Sundar reminds us that we must also reflect on our cultural biases, assumptions, and privileges. “If we consider how these factors influence our interactions with patients and colleagues from diverse backgrounds, that self-awareness is a step toward becoming a more culturally aware healthcare professional.”

A Learning Process

In the end, Dr. Sundar has specific recommendations for nurses.

Nurses should recognize cultural awareness as a continual learning process rather than a static achievement. For example, it’s been a journey for me to realize how to incorporate the values of the Native Hawaiians and Pacific Islander community in my care. I have had to be intentional about how I say hello and talk about suffering to meet the community where they are. It takes time and building relationships to realize this.”

Dr. Sundar believes that achieving health equity requires ongoing self-reflection and that we remain open to diverse perspectives.

“Health equity is the idea that everyone should have the same opportunities to be as healthy as possible, regardless of their circumstances, and we must be committed to it. Doing this work isn’t always easy, but it’s worth the effort and will always be needed in our diverse world.”

WOC Nurses Week Highlights Specialty

WOC Nurses Week Highlights Specialty

Wound, Ostomy, and Continence (WOC) Nurse Week runs from April 14-20 and brings attention to this nursing specialty and the expertise WOC nurses bring to patient care. logo saying WOC Nurses Rock for WOC nurses week

As a member of the Wound, Ostomy, and Continence Nurses Society™ (WOCN®) for 31 years and now its president, Vicky Pontieri-Lewis, MS, RN, ACNS-BC-CWOCN, says the field is exciting and ever changing. This kind of dynamic professional learning environment brings a career satisfaction that keeps her advocating for nurses in the specialty while also appreciating the continual work they must do to stay current of WOC developments.

Pontieri-Lewis shared some of her thoughts with Minority Nurse about the career path and the excitement of being in the broader field of WOC nursing.

How did your career as a WOC nurse begin and evolve?
After graduating from nursing school in 1983, I had the opportunity to work on a surgical unit with patients who underwent cardiac surgery in addition to patients who also had abdominal surgery, with an ostomy. The unit had an Enterostomal Therapy (ET) nurse, now called a Wound, Ostomy, and Continence nurse, who consulted primarily to patients with an ostomy. I noticed when the charge nurse was making daily patient care assignments, none of my colleagues wanted to care for the patients with ostomies. So, I always volunteered to have the ostomy patients within my assignment.

I worked with the ET nurse at the time to ensure in her absence that I would provide the ostomy patients with the right education. Later that year, my grandmother who lived in a very small remote town in the mountains, was diagnosed with colon cancer. She underwent surgery and as a result had a colostomy. I went to visit her and was appalled by the lack of access she had to any type of ostomy pouching system. At one point she was using a plastic bag! I tried my best to get her access to what we used in the United States so she could have some quality of life.

When I returned, the ET nurse at the hospital announced that she would be leaving. After the experience with my grandmother, I knew I wanted to pursue the role of an ET nurse. I went to my administrator to inquire if the hospital could assist with the finances to attend ET school. After I wrote a proposal for financial funding, the hospital agreed to send me to ET school for 6 weeks, and in return I signed a contract that I would stay at the hospital for one year after becoming certified.

Thirty-eight years later I was still at the same facility, and it became a major academic university trauma medical center. I developed the full scope of the WOC nurse role at the facility and then the advanced practice role. I had no idea at the time how the roles would expand to consulting so many patients with ostomies, wounds of all types, and continence needs. Going to ET school was the best path I took in my nursing career. I have dedicated most of my nursing career to being a WOC nurse, and I absolutely love what I do!!

What attracted you to this specialty?
As I shared above, I have a “love” for caring for patients with an ostomy. My grandmother was my inspiration and I always have the memory of her on my shoulder when caring for patients with an ostomy. Caring for patients with different types of wounds was ever-evolving as new technologies and products were being developed. It was almost like baby boomers, but “wound care boomers.” Each time I attended a conference there was something new and exciting being presented.

As the role of the WOC Nurse continued to grow and develop in healthcare systems, so did the WOCN®, the largest and most recognized professional nursing community dedicated to advancing the practice and delivery of expert healthcare to individuals with wound, ostomy, and continence care needs. The WOC nurse conferences began to include more evidenced-based lectures and presentations, more research was being done, and notably­, products were being developed across the specialty.

What would inspire nursing students to consider this specialty as a career path?
Nursing students across the country would be inspired to pursue a career path to be a WOC nurse by simply talking to and spending time with a WOC nurse. Nursing students today are thirsty for knowledge on how to manage wounds and skin integrity, and to educate patients with an ostomy.

Spending a day or two with a WOC nurse can provide a realistic insight into the scope of the role. Nursing students will undoubtedly be dazzled by the wealth of knowledge and expertise that WOC nurses possess, and the extent of how that knowledge and expertise contributes directly to patient care and quality outcomes. The role of the WOC nurse can be in an inpatient or outpatient setting, allowing one to work independently, and be innovative in the care delivered. Overall, the impact of the role is inspiring and rewarding and it can be a lifelong career filled with continuous learning and professional development.

What might surprise people about your role, all you do, and your connections with your patients?
The role of the WOC nurse is very rewarding. WOC nurses can work with all members of the healthcare team to improve the outcomes of patients. Since the scope of practice is very specialized, WOC nurses are viewed as the experts and are consistently relied on not only by the healthcare team, but by patients as well.

I had the opportunity to form an in-depth connection with patients from providing support and guidance, to sometimes just lending an ear to listen to their concerns and healthcare needs. Overall, the in-depth connection, the breadth of education that is provided, and the ongoing support is the most satisfying—especially when you can see the impact that you have had on someone’s life.