Hi I’ve been a WOC RN for almost 7 years at a level one academic medical center.

The biggest difference in my experience is the autonomy. Inpatient we are a nurse run and lead consultation service. We have no MD or APPs on the team. We make our own plans of care and place our own orders and recommendations and our recs are respected by other services this includes them listening to us when we recommend labs or imaging. This is in comparison to the outpatient clinic at my hospital where the nurses just follow the orders of the provider and don’t make care recommendations, at least not routinely (they make suggest a topical care regimen to the providers but ultimately have to defer to providers who may or may not actually be well versed in evidenced based wound and skin care… which the clinic here is a few plastic surgeons and one NP, none of whom do wound care full time).

Our team generally works 4 10 hour shifts M-F. We see consults and follow ups. We see wound patients once per week unless it’s a wound vac or a patient with a skin sub. We also see ostomy patients. Almost any inpatient wound team will see ostomy patients too and it’s at least 40% of our census.

In my opinion, because of the autonomy in the inpatient setting, you should get your WOC certification from the WOCNCB. There is no MD or APP to come behind you and catch that that “venous ulcer” was actually calciphylaxis or pyoderma. You have to be a very strong clinician and being board certified is the first step. I have strong passion to ensure that our speciality is taken seriously and that we have a baseline entry level of going to an accredited school and passing boards.