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  • Writer's pictureNSWOCC

Calling on New Brunswick to change the way it handles specialized wound, ostomy and continence care

Updated: Jun 8, 2023

CBC News New Brunswick Interview with Catherine Harley, NSWOCC Chief Executive Officer

On May, June 5, 2023, Catherine Harley, NSWOCC Chief Executive Officer, was interviewed on Shift - NB with Vanessa Vander Valk, a CBC News New Brunswick Program. Cathy spoke about the New Brunswick Wound, Ostomy and Continence Summit, calling on the Province to change the way it handles specialized care.


On Thursday, June 1st, 2023, from 8:00am to 1:00pm ADT Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC), in partnership with Ostomy Canada Society, hosted the New Brunswick Wound, Ostomy, and Continence Summit to discuss issues and provide solutions to wound, ostomy, and continence within the provincial health care system. Held at the Fredericton Convention Centre, 670 Queen Street, Fredericton, NB, the nearly 100 attendees included patients, health care administration, government and academic decision makers, industry partners, senior nurses from the community and continuing care as well as Nurses Specialized in Wound, Ostomy, and Continence (NSWOCs).

A nurse shares concerns about the state of specialized wound, ostomy and continence care in the Province of New Brunswick during the group discussion portion of the Summit.

This important summit helped move discussions forward on how to improve health outcomes, how to gain access to specialized nursing care and positively impact the lives of people living with wound, ostomy, and continence in the Province of New Brunswick.


The Summit’s main objectives were to:

  1. ​Update decision makers on best practices in wound, ostomy, and continence within New Brunswick.

  2. Evaluate patients’ experience living with an ostomy in New Brunswick versus other provinces.

  3. Determine the economic burden for people living with an ostomy through the review of the ostomy impact study.

  4. Provide information on the value of a wound, ostomy, and continence tri-specialty to support patient-centred improvements.

  5. Engage and strengthen the approach of wound, ostomy, and continence care through health care teams in New Brunswick.


Listen to the interview


Read the transcript

Vanessa Vander Valk 00:00

A national charity is calling on the province to change the way it handles specialized care, Nurses Specialized in Wound, Ostomy and Continence Canada or NSWOCC held a summit in the province last week they met with health care administrators, nursing managers and representatives from the province to talk about the gaps and what can be done to improve patient care and clinical outcomes. Cathy Harley is a registered nurse and CEO of NSWOCC. We reached her back in Ottawa.


Cathy Harley 00:41

Good afternoon, Vanessa.


Vanessa Vander Valk 00:45

Cathy, I suspect a lot of people don't realize that nurses do require this specialized training if they are involved in caring for wounds, ostomy bags or continence care. Why is that important?


Cathy Harley 00:59

Across Canada, most nursing programs, maybe touch on the topic of wound, ostomy, or continence, but they don't give in-depth training and in order to deliver wound ostomy and continence safely and effectively, it's very important to have identified competencies, which are the knowledge skills, abilities and behaviours that which contribute to the individual nurse being able to deliver safe and effective care.


Vanessa Vander Valk 01:30

What kind of a difference does it make for a patient?


Cathy Harley 01:34

It makes a tremendous difference. We know through research that when a nurse specialized in wound ostomy and continence is involved that the patient outcomes are greater. If it's a wound and then healing time will be shorter. If they have an ostomy, they have a reduction in complications such as whether or not their skin breaks down . They also contribute to cost savings across wound, ostomy, and continence.

Catherine Harley, NSWOCC Chief Executive Officer, describes the challenges in accessing better specialized wound, ostomy and continence care in New Brunswick.

Vanessa Vander Valk 02:08

If we take someone who is living with an ostomy, for example, what kind of risks do they face if they aren't able to access specialized care?


Cathy Harley 02:16

If they're not able to access specialized care, first of all they could encounter a lot of stress and anxiety because if for instance, if a pouch or appliance is not staying on appropriately and it keeps falling off, it can cause a lot of anxiety because of course there's nothing there to catch the effluent that is coming out of the body. If it's not fitting securely in place, it could cause a breakdown of skin around the stoma which is the opening that's on the abdomen and ends up very painful and uncomfortable. And it also can impact the overall quality of life because it could prevent them from going to their job or being able to socialize or even come in contact with other family members because there could be a lot of embarrassment.


Vanessa Vander Valk 03:17

How many nurses are there in New Brunswick who are trained in this specialty and we're generally do they practice?


Cathy Harley 03:24

In New Brunswick, for the two health regions – in Vitalité, which services one third of the Province, there are 7 full time nurses and 2 part time nurses who specialize in wound ostomy and continence that are working predominantly in hospitals. Whereas in Horizon, which services two thirds of the Province, there are only 4 full time NSWOCs, 2 part time, and 2 casual NSWOC positions mostly within the hospital setting. Unfortunately, we don't have any NSWOCs in New Brunswick who are working in long term care where there is a fairly high incidence of prevalence of skin issues and there could be ostomy and there definitely are continence related issues. And in the home care program, they really don't have formal NSWOC positions and so even though in the hospital you have NSWOCs, there aren't enough for the patient population. We are missing NSWOCs when the patient flows through the continuum of care from hospital to community.


Vanessa Vander Valk

Let me ask you, Cathy, what does happen when someone is sent home now from a hospital with say a wound that will require some care going forward?


Cathy Harley 04:47

If the patient is on home care, they would have a home care nurse come into the patient's home who may or may not have specialized education and wound, ostomy and continence. It would depend on the nurse that was assigned to the patient case. Many times patients are discharged into the community and they don't get the follow up that they need and then they'll end up either getting an infection or having other complications and will end up coming back to the hospital and could even be readmitted to the hospital.


Vanessa Vander Valk 05:25

What are you asking the province to change that when it comes to the way that it deals with wound ostomy and continence care?


Cathy Harley 05:33

Well, there are several things that we've identified that needs to change. First of all, you need more specialized nurses, not just in hospital but going over the continuum of care to home care and long-term care. So that's a transition for the patient is seamless moving from hospital to community. It's really by having more specialized nurses that you're going to get the optimal clinical outcomes and we know that they will save money to the overall health care system because they're doing more thorough assessments, selecting appropriate products and technologies, and monitoring the patient as they move through the system. Secondly, we need to make sure that we have the right number of NSWOCs and SWANs per patient population in each area. Because even though we do have an NSWOCs in the Province of New Brunswick, in most areas there are discrepancies and even in the hospital, the position is underserved for the number of patients that they're seeing. We also need to look at a well thought out and sustainable plan for ostomy reimbursement. Right now in the province it is very different call for people to get reimbursed ostomy appliances unless they have private health insurance, or they have social worker intervention and to access some seniors insurance, but we know through an ostomy impact study that was done that most patients are paying well over $1,000 to $2,200 out of pocket and some people just can't afford it. They get to the situation where do they put food on the table or do they pay for their ostomy supplies and being able to eliminate from your body or go to the bathroom is a basic human right.

Joined by fellow panel members, Dr. Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), FCAN describes the Ostomy Impact Study, which highlights the economic burden faced by people living with an Ostomy in Canada.

Vanessa Vander Valk 07:29

What are you doing at this point to ensure that these changes that you're asking for do take place or that there are steps made in that direction?


Cathy Harley 07:39

One of the things that we put together for the Province of New Brunswick is an educational strategy. And part of that educational strategy is to provide 30 seats to our foundational wound management program which is under our practice enrichment series, which we will give fairly to long term care, home care, and hospitals in order to help improve the foundational knowledge in wound care as a start. Since we made that announcement, we've had several emails with candidates for the seats and we will continue to follow up on all 30 seats are filled. We also provided information on the other educational programs that are available to nurses and are working with one nurse to help her secure funding to be able to go through the program and become specialized.

 

About the Wound Management Course offered by the Wound, Ostomy and Continence Institute

The Wound Management Course is a six-week, paced, online course that's accredited by the Canadian Nurses Association (CNA). The learning outcomes of the course are to:

  • Increase your knowledge related to evidence-based wound care

  • Improve your ability to advocate for patients with wound related issues

  • Enhance your ability to collaborate with wound care specialists

Course registrants also get access to virtual mentorship and knowledge consolidation opportunities with our team of CNA certified Nurses Specialized in Wound, Ostomy, and Continence (NSWOCs).


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