First, I would like to thank the readers for taking the time to review the topics I have presented regarding the world of wound care.
If you read my blog, you are likely seeking some insight or clinical perspectives that may help you in managing patients with chronic wounds from a variety of etiologies.
This month, I would like to turn the tables and gain some knowledge from you, my respected colleagues, on your approach to things, specifically how you have attained your level of expertise.
I would also like to dedicate this month’s blog to anyone on the receiving end of wound care turf jobs. If you do not know what I am referring to, please consider the following scenario.
A nursing facility directs a patient with a deteriorating heel ulcer to you for a consult. In reviewing the patient’s history and the ulcer, you find an outside provider has performed serial debridement of an ischemic limb at bedside. In reality, this provider has no surgical training, no board certification and no hospital privileges. He or she comes to the facility every one to two weeks to perform debridement on the patients with wounds.
If you think this scenario is far-fetched, think again.
Wound care is an evolving multidisciplinary specialty with the podiatric profession at the forefront of its development. The past 15 to 20 years have been a remarkable and dynamic time in which breakthroughs in research and product development have positively impacted both providers and patients alike.
Persistent inconsistencies in the delivery of care have been a personal concern during this timeframe. I have dubbed this a widespread phenomenon of anecdotal chaos that continually undermines all emerging positives.
One of the issues wound care faces is the lack of standardization regarding educational level within the specialty. Part of the problem may stem from deciding who the providers are within the specialty. Are they surgeons in the twilight of their career who may be less likely to adopt new standards of care? Is it a nurse working for a home health agency that, over time, become the de facto wound expert within an agency, a designation based solely on the number of years of service?
It has been my observation that a number of providers who fall into the two examples mentioned also look to claim a level of expertise based on his or her total years in medicine, not necessarily in time dedicated to wound care. This phenomenon is certainly not limited to older surgeons and nurses.
As a result, many providers feel justified in portraying themselves as experts in wound care. They may stand behind their certifications, which they may have achieved through two-day courses or by joining an organization that included a designation implying competency in wound care as part of the benefit of paying dues.
I must disclose that I have served as a member on the Board of Directors of the American Board of Wound Management for the past several years. I have held the Certified Wound Specialist (CWS) designation for nearly 12 years.
That said, there is no shortcut when it comes to attaining a level of expertise, no matter what the discipline or craft. Years of study and an application of knowledge in the clinical setting are the ways to develop competency.
Showing your level of expertise by way of a valid credentialing board is one important way to raise the bar and to ultimately improve the quality of care that our patients need and deserve.
Where do you stand on this issue?
• Do you think certification in wound care is necessary?
• Do you see any problems with those who portray themselves to be proficient in any area, let alone wound care, based on a shortcut to certification?
• Do you think there is a lack of clarity regarding where to obtain certification (i.e., which is the best certification to attain) in wound care?
Before I conclude, I would again like to assert the important place in wound care that our colleagues hold. Do not take this lightly. Please continue to raise the bar for yourself and your patients.