Bridging the theory/practice gap.

I read with interest Susanne Trim's article "Subspecialisation--is it good for nursing?" in last month's issue (p23). I also support the article by co-editor Anne Manchester "Certificate programme values nurses in practice" in last September's issue (p21) and Jane Hardcastte's article in November (p18-19)--"Education for registered nurses--Does one size fit all?"

For over two years, I have been acting wound care specialist nurse at Wairau Hospital awaiting the outcome of the political debate with the Nelson Marlborough District Health Board over my job title. Before taking this position, I ran a busy, sole-charge rural nursing practice, held an Accident Compensation Corporation contract and gained vast experience in wound care for acute and chronic wounds.

With my clinical nurse leader's support to up skill for my specialist role, I chose the Graduate Certificate in Wound Management at Christchurch Polytechnic Institute of Technology. This course gave me experience in academic writing and clinical training, and has brought safe and best practice to my workplace. While doing the course I met nurses who had done master's papers but who found the certificate courses gave them the clinical skills they needed in their specialty fields. The theory and practice gap was illustrated to me recently when I observed the inappropriate wound care practice demonstrated by a visiting master's-educated, wound nurse who writes for a wound care journal (not New Zealand).

I completed the graduate certificate in wound management in two years, though it can be done over six years part-time. I loved the learning, the courses that were pitched at the right level, supportive and motivated tutors, and branching out of one's comfort zone with assignments. The course gave me the confidence with evidence-based research to make changes in the selection of wound care products, particularly by introducing hydrofibre dressings. Our wound care referrals in community health services have increased by eight percent and our visits decreased by nine percent. The district nurses are excited by these statistics and improved healing outcomes for patients.

I run weekly complex/chronic wound clinics parallel to the vascular surgeon's clinic at the surgical outpatients department. The clinic is extremely busy, with referrals from surgeons, wards, district nurses, GPs, rest-homes and podiatrists. The flow-on effect from the assessment and treatment plans is another tool for raising awareness of best practice in the wider community.

I hope my specialist role will be properly recognised as it provides a valuable resource for hospital and community.

Susie Wendelborn, RN, GradCert (Wound Management), Picton