Making good on promises
When Jan Harrison's husband fell ill over a decade ago and his surgery went awry leaving him with serious complications, Harrison struck a deal with the Lord.
"He had an ostomy and through that whole process, he got abscesses and wounds," Harrison said. "He had to undergo 12 surgeries in two years."
Harrison, previously a trauma and emergency room nurse, was her husband's caretaker, and that meant paying strict attention when the wound care nurses explained to her how to dress his wounds for optimal results.
Having experienced some the worst case scenarios with her own husband, those wound care nurses encouraged Harrison to consider doing the additional schooling necessary to become a certified wound nurse.
"So I made a pact with God. I said if he let my husband live, I'd stay in Northeast Nebraska to do wound care and ostomy care. So I'm in Northeast Nebraska."
And while some may think it's a waste to see such a specialized practice run in Northeast Nebraska, Harrison feels very strongly about it.
"I have no desire to go to a big hospital. They have people there, avenues they can go to. The little hospitals and rural clinics don't have access to this around here."
Harrison went on to explain that the doctors around here have to know so much about so many things because of the fact that they are a general practitioner, she said it really shows why it's so important for her to practice in the area.
"Only someone who is trained knows all the different dressings. The doctors here know the basics with wet to dry dressings, so I'm here to help the physicians."
Schooling for her certification to be a wound ostomy continence nurse would normally take an additional three semesters, but because of the number of patients she was seeing with diabetic foot ulcers, Harrison decided to add a certification in foot and nail care which took another semester of schooling.
She completed it mostly online, but did drive up to St. Paul, Minn. for the immersion part of the program as well as making a trip to Wisconsin to finish the foot and nail certification.
Harrison practices out of Providence Medical Center for half the week and spends the remainder in another hospital or traveling a one hundred mile radius.
Harrison makes the decisions about how to best treat a wound, and three nurses at PMC, who have taken the wound treatment associate class which allows them to assist with Harrison's wound care patients, follow those instructions and call if someone new comes in the door while she's traveling.
And her travels aren't just around Nebraska.
Because of her extensive knowledge and first hand experiences and continuing education requirements, Harrison visits wound care conferences each year.
Those conferences, which could be a mini vacation for some, are hard work for Harrison. Not only is she sitting in on educational sessions to keep her certification valid, she's working too.
Harrison is asked regularly to test dressing products for numerous companies. She doesn't say yes to just everyone, but if she does and she likes the product, she gives presentations every five minutes for hours a day during those conferences.
"You have to present to everyone walking by in five minute intervals. I get asked all the time to do trials," Harrison said. "
While Harrison is required to keep up 30 hours of continuing education every two years for her RN degree, she is also required to keep up 80 hours of continuing education every five years for her additional certifications. And that's not 80 hours total, it's 80 hours for wound care, 80 hours for ostomy care, 80 hours for continence and 80 hours for foot and nail care.
But those 80 hours each aren't just classroom hours, they also have to include studies or projects like product testing.
The only way to achieve those intense requirements is to attend the conference she most recently attended in Salt Lake City.
"It offers such an array of options," Harrison said of the conference. "I do as much as I can with that one."
She attended a second conference in San Diego that is geared toward nurses who do what she does but more so for physicians who want to learn more about wound care and what products are out there.
Harrison said there are thousands of different types of dressings, but that this year was a big year with many advancements made.
While a basic wet-to-dry dressing will work for some, the more advanced wound care dressings available often do a better job with less pain for the patient and save time for the nurses administering the dressings.
"There is a company that makes one dressing. There are different versions of it -- with a border or plastic backing or without those things, but the dressing stays the same," Harrison said. "Then there are companies that make 50 different dressings that I think 'how can you know that it's working?' It's nice to have the company that puts all their time into that one dressing and they know it works."
She develops a personal relationship with each of her patients, which is why it's so important to her to advocate for the quality products and continue learning and studying to find the next step in better wound care.
Her work is demanding but worth it, she said. And though her husband worried he'd pass away before her schooling was finished and she wouldn't continue, it was all unnecessary.
"He's going strong. He's retired now from teaching and doing very well."
And 13 years later, Harrison is fulfilling her end of the deal by offering wound-ostomy-continence care in Northeast Nebraska.