Overcome Burnout by Becoming A Wound Care Specialist
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By Claire Nana, LMFT
Burnout In Healthcare
Healthcare offers many opportunities to truly improve the lives of people affected by injuries, disease, and wounds.
Yet the pressure of lack of time, work days that seem to never end, a pace that can’t be maintained, and the emotional drain of life and death situations can take a tremendous toll on healthcare professionals.
Often the result of this is burnout. According to the Agency for Healthcare Research and Quality (AHRQ), burnout is “a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment.”
In recent years, the rate of burnout among physicians and other clinicians has been rising dramatically. One AHRQ-funded project, the Minimizing Error, Maximizing Outcome (MEMO) Study found that more than half of primary care physicians report feeling stressed because of time pressures and other work conditions.
While the causes of burnout can be broad, the AHRQ identifies five major contributors. These include family responsibilities, time pressure, electronic health records, chaotic work environment, and low control of pace.
Importantly, the AHRQ also notes that burnout can significantly impair many aspects of patient care. Burned-out doctors are more likely to leave practice.
They can experience depersonalization, which can lead to poor interactions with patients. Furthermore, burned-out physicians can suffer from impaired attention, memory, and executive function.
Studies such as the one described above have led to questions about the ways in which physician burnout can be addressed. In this article, we will explore how achieving a wound care specialty can help physicians and other clinicians overcome burnout.
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What is the Wound Care Specialty?
The wound care specialty begins with a wound care fellowship, where physicians practice with senior wound care specialists with various technical backgrounds, implementing an interdisciplinary approach to healing wounds.
For nurses, a wound care specialty involves completion of an accredited educational program that addresses topics such as acute and chronic wounds, atypical wounds, F686 regulatory requirements, geriatric skin conditions, infection control, management and treatment of vascular ulcers, nutrition, support surfaces, wound care treatment options, wound healing, and wound rounds and assessment as well as prevention of re-hospitalization.
How Does Working In A Wound Care Specialty Combat Burnout?
Physicians and nurses who specialize in wound care don’t only develop lasting relationships with their patients, they also gain the opportunity to pursue an alternative career in medicine that allows schedule flexibility and longitudinal care.
A wound care specialty also offers reliability, competitive pay, and work-life balance that leads to greater personal and clinical satisfaction.
Further, continuity of care during the healing process has been shown to improve patient outcomes and increase patient satisfaction.
US News reports that more than 20 percent of residents of Maine and Florida are 65 years of age or older. By 2050, more than 1 in 5 people in the United States will be over the age of 65. The aging baby boomer population ranks the US among the top quarter of oldest countries.
The country is only getting older, and along with aging comes many health concerns – one of which is chronic wounds. The National Institutes of Health (NIH) describes chronic wounds as a “silent epidemic.”
At present, it is estimated that 1 to 2 percent of the population of wealthy countries will experience a chronic wound during their lifetime.
Chronic wounds come with many complications. The NIH report notes that some of these include infection such as cellulitis and infective venous eczema, gangrene, hemorrhage, and lower-extremity amputations.
Moreover, chronic wounds often result in a sort of vicious cycle, where outcomes worsen, and the risk of disability increases significantly.
Chronic wounds also have a low rate of healing, which has a significant impact on the health and quality of life of patients and their families. Pain, loss of function and mobility, financial concerns, social isolation, prolonged hospital stays, and other associated comorbidities are just a few of the related concerns.
The NIH suggests that chronic wounds impose “significant and often underappreciated burden to the individual, the healthcare system, and the society as a whole.”
Chronic wounds affect 6.5 million patients in the United States and cost more than $25 billion each year.
Solving A Problem
While the normal wound healing process is well understood, there are many complex components to effective chronic wound care. For one, the molecular mechanisms behind healing are not completely clear and much of the understanding we do have comes from animal models.
Healing mechanisms are species-specific and also depend on different physiological processes, which means more study is needed to effectively treat chronic wounds in humans.
Unlike wounds undergoing normal healing, chronic wounds often do not follow this recognized process, commonly remaining in the inflammation phase.
Chronic wounds represent a societal problem that requires physicians, nurses, and other clinicians with the skills and expertise to effectively treat them.
Using Unique Skills
Effective wound care consists of many unique steps. First, the wound must be properly cleaned, often using a saline solution. Following this, debridement of the wound involves the removal of dead or inflamed tissue, using an instrument such as a curette, scalpel, or tweezer.
Debridement can also be achieved through using a high-pressure water jet, or a certain species of maggots (fly larvae) that are specially bred for medical purposes to remove dead tissue and fluid from the wound.
Once the wound has been cleaned and debrided, it is covered with a dressing, such as film, gauze, hydrogel, hydrocolloid gel, or material containing silver or alginates.
The purpose of a dressing is to remove excess fluid from the wound and protect it from infection. Some dressings also contain growth factors, which are meant to help the healing process.
Wound Care Techniques
Within these steps are many unique skills required to treat chronic wounds. Here are just a few:
Hyperbaric Oxygen Therapy
In hyperbaric oxygen therapy, the aim is to increase the oxygen concentration and blood supply to the wound. In this treatment, the person with the wound goes into a special chamber to breathe in oxygen under high pressure.
Ultrasound therapy involves treating chronic wounds using sound waves, which make the tissue warmer and potentially help the wound heal faster.
Vacuum-Assisted Closure Therapy
Vacuum-assisted closure therapy (VAC therapy) involves covering the wound with an airtight dressing that is connected to a pump by a thin tube.
The pump continuously sucks fluid out of the wound, creating negative pressure across the surface of the wound. The purpose of this is to increase the flow of blood to the wound and also keep the wound moist which improves the healing process.
When a wound is so large that it cannot close on its own, skin grafts are considered as a treatment option. Here, skin is taken from another part of the body – usually the thigh – and transplanted onto the wound.
Painful chronic wounds can be a burden in daily life and also prevent patients from getting a good night’s sleep, and healing effectively.
Managing pain involves using drugs acetaminophen (paracetamol) or ibuprofen, as well as wound dressings that contain ibuprofen.
Burnout is a critical concern in healthcare that can lead to increased turnover, poorer quality of care, and ultimately worse patient outcomes.
Through becoming a wound care specialist, physicians and nurses can begin to overcome burnout through learning a specialty that fills a market need, solves a problem, and utilizes unique skills.