Discovering Wound Care’s Wonders: An RN’s Journey through Cardiology, Oncology, and Beyond

By Sheryl Riley, RN, OCN, CMCN, Clinical Consultant and Patient Advocate, Clarion LLC

I’ve always found it fascinating to learn how my colleagues came to the nursing profession. We each have our own distinctive story. For some, it was a calling; for others, it was an adventure; and some found it a flexible career path.

My journey was also unique; nursing wasn’t always the obvious path. I wasn’t the best student in high school and often doubted my potential. It wasn’t until my junior year that I decided to turn things around. A counselor’s dismissive suggestion that I pursue a secretarial career motivated me to prove my capabilities. Vowing to show her a thing or two, I worked to rise from the bottom 10% of my class to the top.

There were other factors that led me to nursing. My father and several close family members battled with Alpha-1 antitrypsin deficiency and other chronic diseases. I saw nursing as a way to help people I loved and improve their lives.

Those early years weren’t easy. I married far too young (I was only 17), and knowing we needed to support ourselves, I decided to pursue an accelerated Licensed Practical Nurse (LPN) program. I grew up fast, and that 12-month course gave me a solid foundation, instilling discipline and hands-on experience in patient care, medication management, and more. That experience fueled my passion to grow my career.

I remember one case during my training program that profoundly influenced my approach to nursing. A patient with a massive leg wound required meticulous care. Setting up the sterile field without modern kits meant any mistake could lead to contamination and setbacks. I learned the value of preparation, patience, and adaptability. These lessons became the foundation of my nursing philosophy.

Discovering the Intersection of Wound Care and Chronic Illness

After earning my LPN, I pursued an accelerated program to become a Registered Nurse (RN). Despite being told I was “just a B+ student,” I earned dual associate degrees in nursing and liberal arts while achieving top grades.

I was assigned to the cardiac unit at the local hospital where I took my LPN training. Many of our patients had chest wounds, neuropathy, and poor circulation, along with status ulcers in the lower extremities and diabetes. You know, the conditions that can make wound healing so challenging. This experience exposed me to the intersection of chronic disease and wound care. It was also here that I discovered managing chest wounds requires an intricate understanding of nutrition, hydration, and blood sugar control.

I vividly recall a patient who struggled with a non-healing sternal wound. Despite advanced treatments, it wasn’t until we addressed his diet—introducing high-protein supplements and better glucose management—that we saw real progress. Moments like these reinforced my belief in treating the whole patient.

From cardiology, I transitioned to peritoneal dialysis, where I encountered a different set of wound challenges. Catheter-related infections, often fungal in nature, were common. These small openings could quickly escalate into serious wounds and require careful debridement and management.

I’ll never forget one patient with a persistent peritoneal infection. The wound began as a minor irritation around the catheter site but escalated due to poor hygiene and delayed care. Over weeks, I worked with the patient to improve cleaning techniques, monitor signs of infection, and adjust treatments. Witnessing the wound finally heal was deeply satisfying and cemented my commitment to education and prevention.

Next, I found myself caring for cancer and HIV patients, furthering my understanding of the complexities of wound care. Cancer-related wounds often stem from surgical complications or radiation, and many patients face delayed healing due to poor nutrition or inadequate post-hospital care. HIV patients, at that time, didn’t have a lot of chronic wounds, as sadly, many of them passed soon after diagnosis. Still, both populations presented unique challenges and taught me the critical role of multidisciplinary collaboration in addressing wound care needs.

But it was my experience with my mother that most influenced my growing appreciation for wound care. She had COPD, AFib and used a walker. One day, while trying to corral a runaway cat, she fell and suffered a severe wide and deep 14-inch gash on her leg.

In those early days, I would visit and change her bandages three times a day. Even with her poor circulation and oxygen levels that rarely reached 90, we managed her wound at home with the help of a great caregiver and visits to a wound care center to confirm my treatment. By focusing on nutrition, keeping the wound clean, using Tubigrip compression socks, and pure olive oil massages to the affected area, we avoided hospitalization and healed her wound in about three and a half months.

A Shift to Home Care

When I transitioned to care management at a national home infusion therapy provider, wound care took on even more dimensions for me. I worked with patients nationwide, often in rural, farming, or underserved areas. The wounds I encountered ranged from diabetic ulcers to bed sores, each aggravated by the challenges of delivering care in nonclinical settings. Many patients lived in poverty, lacked access to nutritious food, or faced barriers to basic hygiene. Nutrition became a focal point for me. I’d walk into a patient’s home and immediately assess their pantry. What they ate—or didn’t eat—was often the root cause of their inability to heal.

One case that stands out involved a patient in New York City who relied on food from her local bodega. Her diet, high in sodium and low in nutrients, contributed to poor wound healing and other health complications. By collaborating with a social worker, we arranged for grocery deliveries of healthier options.

In rural areas, I encountered patients living in extreme poverty, often in homes with limited access to running water or refrigeration. I recall visiting a patient with a chronic leg ulcer in a remote Texas farmhouse. She lacked basic supplies; her only food source was a local convenience store. There, too, we coordinated with community resources and provided wound care kits, fresh groceries, and education.

Meaningful interventions like these underscored the critical role of social drivers in wound care. They also highlighted that advocacy is often as important as clinical care when it comes to today’s patients.

What Providers Often Miss

In my 40-plus years as a nurse, I’ve seen a lot; the good, the bad, and frankly the embarrassing when it comes to how we providers can sometimes treat patients. One thing that continuously surprises me is that providers often overlook the importance of nutrition, hydration, and overall wellness. Many providers not schooled in wound care focus solely on the external—dressings and medications—without considering the patient’s internal health. Wounds heal from the inside out. Without proper nutrition and hydration, even the most advanced treatments will fail.

That’s why it amazes me that there isn’t more understanding of how vital wound care is across the continuum. It shocked me to learn that the healthcare industry spends more on conditions like Lyme disease than on wound care, despite the latter’s widespread impact and cost.

There’s also a gap in interdisciplinary collaboration. Too often, wound care falls through the cracks because providers operate in silos. Plus, as we move toward telehealth and doctor visits of 10 to 15 minutes, there’s even less opportunity for hands-on care, meaning providers may miss early-stage and even worsening wounds.

Another challenge is the limited access to specialized wound care centers, particularly in rural or underserved areas. While these centers have grown in number over the past decade, they remain out of reach for many patients. New technological advances like mobile wound care platforms and remote connections to Centers of Excellence are starting to address these barriers. However, more systemic changes, including better funding, education, and policy support, are still needed.

Understanding the Often-Missed Aspects of Wound Care

My ongoing experience in discovering how crucial wound care is to heal a wide range of conditions has led me to pursue advanced certifications in wound care. I love mentoring other nurses and physicians and especially want to encourage all providers to embrace a more holistic approach to wound care.

As a healthcare provider, it’s crucial to see beyond the surface of wound care. It’s not just about treating the wound but understanding the underlying reasons why the wound occurred in the first place and what factors might impede healing. Here are some key points often missed.

1. Holistic Patient Assessment: Providers must assess the entire patient, not just the wound. Why did the patient develop this wound? For instance, surgical wounds are often straightforward, but a heel wound in a non-diabetic patient requires deeper investigation. What medical conditions or lifestyle factors contributed to this wound? Understanding the patient’s health and conditions can significantly impact healing.
2. Individualized Treatment Plans: There’s no one-size-fits-all in wound care. Just as physical therapy has moved away from generic exercise lists, wound care must be personalized. Each patient’s wound needs specific care based on its origin, the patient’s health status, and other unique factors. Individualization is key to effective treatment and faster healing.
3. Whole-Body Approach: Healing a wound isn’t just about treating the local area. Providers need to consider the patient’s overall health and how it affects wound healing. Nutrition, comorbidities, and systemic issues all play a role. By improving the patient’s overall health, we can enhance the wound-healing process.
4. Education and Support: There’s always a temptation to let ill loved ones, especially the elderly, eat and do whatever they want. I strive to remind people: would you rather have your loved one healthy or risk them dying with a steak in their mouth? Patients need to be as healthy as possible to heal wounds, and that requires education and support, so they understand its value to healing.

Becoming Wound Care Influencers

To spotlight the crucial role of wound care among providers, researchers, pharma, and payers, we need a multifaceted approach. While some conditions have high-profile celebrities to fundraise and spotlight the disease, wound care does not. You won’t find an A- or even B-list celebrity talking about their painful, oozing wound. That means it’s up to us as providers to become the influencers for the profession.

This begins with awareness and telling compelling stories. One critical message is the importance of personalized care. Each patient’s wound and treatment plan must be tailored to their needs. This approach will drive better outcomes and innovation in wound care practices. Education and supporting caregivers are also crucial. We can’t send patients home with a wound the size of a tennis ball (which, yes, I’ve seen) and expect families to handle it. They need lots of support and care coordination.

Although I’m new to wound care compared to many, I have quickly grown to love this specialty, the patients, and the people. By focusing on what matters, we can change the landscape of wound care, making it more effective, personalized, and collaborative across the healthcare spectrum.