JENNIFER BYRNES - WOUND MANAGEMENT NP

Originally from NSW, Jennifer completed her training before moving to Brisbane to start a career in nursing, at this stage she had no clue to where or who she wanted to be “when she grew up”. Jennifer’s career led her to community nursing where she developed a passion for wound management and in 1999 moved from Brisbane to Darwin to experience an adventure in the amazing Northern Territory, and she was not disappointed.

Tell us how you became a NP

On arriving in Darwin I worked in primary health care for 2 years and relieved in the community wound Clinical Nurse Consultant (CNC) position for 6 months, at the end of this time I decided to move back to the acute care setting, where I worked in the hyperbaric unit which again had a key focus on wound management.

There was an identified gap of service in the hospital of stomal therapy wound management, So I commenced study as a stomal therapy nurse, once qualified I was able to implement the service within Royal Darwin Hospital.

As the role grew it was split into two employing a full time stomal therapy CNC and wound CNC, as time progressed I found limitations for a wound CNC role with diagnostics and streamlining of patient care, with this gap identified I embarked on the path to become a nurse practitioner.

In May 2008 I became the first NP appointed to a position in the NT.

What’s unique about your role in the community?

The uniqueness of the territory makes the clientele and the complexity of cases fascinating and never dull or boring.  The humid tropical environment of the top end of the territory causes a virtual cooking pot of microorganisms, infections can be extensive and fast when they occur.

Working with tropical infections and diseases is a fascinating part of my role as the environment makes some of these infections far more prevalent for example Melioid infection (soil and water borne organisms) that can be fatal to immunocompromised clients.Some complex wounds are common in the NT but only rare in other places in Australia, we have the highest rate of necrotising fasciitis in Australia, and prior to moving to Darwin I had never seen it or heard of it, now it’s a common wound I manage as part of my role as a wound NP.

Due to chronic conditions, (diabetes, renal, liver and cardiac disease) remote locations and patients priorities not always being in alignment with healthcare proprieties its makes for an interesting and challenging work place.  In the Darwin region large unusual and complex wounds are common and provide the utmost challenges in providing care for best outcomes for these patients.  Conflicting priorities can make providing best care challenging e.g patient wants to go fishing in the muddy creek waters but has a large wound on their foot, the priority of fishing is more important than the risk of infection of the wound on the foot.

Remote location access to services means travelling 200km plus each way on a weekly basis to have the wound dressed, as a result planned processes and strategies need to be put into place to achieve the best outcome that is still functional to fit in with the patients lifestyle, wishes and needs.

What is the most rewarding aspect of being a NP?

By working closely with the multidisciplinary team to achieve the best outcomes for the patient. Having the ability to be accepted by your peers and medical colleagues to be able to provide insight, support and guidance in the role of wound management is very rewarding. Providing a seamless service for patients to assist in navigating the complex road of wound healing and achieving the desired result for the patient is the best reward. The amazement and gratitude of a patient when a wound heals makes the effort of case management all worthwhile.

What influenced your decision to become a NP?  Why did you choose your scope of practice?

Whilst working as a wound CNC I identified a disjointed practice in diagnostics and treatment of my patients. i.e GP for bloods and swabs, CNC clinic for wound care, GP to prescribe antibiotics and therapies. I believed if I became a nurse practitioner, I could provide better more extensive streamlined quality service with diagnostic and treatment plans.

A streamlined approach provides patient centred care and reduces impact on the patient with multiple appointments and impact on service provision over multiple sites within the healthcare system.

What are you hoping to achieve in your current role as a NP?

I am hoping to provide leadership, knowledge guidance and support to all the members of the multidisciplinary team, plus the capacity to provide a streamlined service care model for patients with acute and long-term chronic wounds to achieve the best outcomes.

My role is to provide health promotion / hospital avoidance by providing education, support and consultation of patients as a preventative strategy, where clinically safe, from being admitted to hospital and keep patients in their home environment.

What advice do you have for anyone wanting to become a NP?

Don’t be afraid of shooting for the stars, it seems like a big task, but every journey starts with a single step and keep stepping in the right direction you can become a nurse practitioner. Remembering that any high level, clinical role is not without its challenges and critics, it’s a bumpy road but the rewards far outweigh the disappointments you may experience on the way to become an NP. Be sure to Link in with NPs in your area and NPs who are in your chosen field, as we are all passionate individuals and without the passion, we would never have made it this far. It is this passion and leadership that has moved NPs from one to many and will continue to make the NP role grow stronger each day in Australia. Aim high and enjoy the ride.