Nurses get under their patients’ skin – in a good way



Tracy Swift wound, ostomy, continence nurse

Certified wound, ostomy, continence nurses like Tracy Swift are experts at treating or preventing skin issues that can put patients at risk.

By Maureen Gilmer, Riley Children’s Health senior writer,

Tracy Swift thought she’d be at Riley Hospital for Children maybe a year before moving on. Thirty-eight years later, she’s still here and doesn’t regret it for a minute.

She had worked with adults as a nursing student and expected to continue with that population after graduation, but after a clinical rotation at Riley, she accepted an offer to work in its toddler unit.

“That was before we had the cancer center or the heart center, so we had age-based units,” she explained. “I took care of toddlers for nine years, then transitioned to the infant unit.”

That’s where the former bedside nurse first began learning more about wound care and skin care, thanks to educational sessions provided monthly over at IU Health Methodist Hospital.

It sparked a passion in Swift, which was reinforced when she moved to 9E in 2011, caring for surgery and trauma patients.

“I really like wound care. I’ve taken care of patients with ostomies and G-tubes for 30-plus years, so in 2016, when an opportunity came along to be a wound and ostomy nurse, I transitioned to this position.”

Ostomy surgery is a life-saving procedure that diverts bodily waste through a surgically created stoma on the abdomen into a pouch. An ostomy can be necessary due to birth defects, cancer, inflammatory bowel disease, incontinence and other medical conditions or trauma.

Caring for the skin around ostomies, wounds, pressure injuries and related conditions is a specialized skill. That’s why Riley has three certified nurses dedicated to this area on the inpatient side, as well as two who work on the outpatient side.

Technically, they are called Wound, Ostomy, Continence (WOC) nurses, and this week is set aside to recognize them and the contributions they make to keeping patients safe from harm.

Swift’s WOC colleagues are Lydia Council and Cara Flanigan (inpatient), along with Lisa Kirk and Tim Luttrell (ambulatory).

These nurses are clinical experts in the prevention and treatment of any skin issues, explained Kristin Miller, director of nursing practice for Riley Children’s Health.

As the largest organ in the body, when the skin is not healthy, it can lead to other issues such as dehydration, infections and sensation issues, Miller said.

On the inpatient side, WOC nurses round on high-risk patients in every unit, including the Maternity Tower, where they treat moms and babies. They also do a lot of educating to help bedside nurses understand best practices to prevent and/or treat skin injuries.

“Their role is incredibly important to keep our patients safe and ensure that we are providing quality nursing care,” Miller said, adding that in 2023, Riley Children’s Health decreased hospital-acquired pressure injuries (a type of skin injury) by 53.5%.

“There is no doubt in my mind that our Wound, Ostomy, Continence Nurse team played a large role in this improvement,” Miller said.

Swift, who is certified as a pediatric nurse as well as a WOC nurse, said she loves the challenge of the job.

“It keeps me on my toes,” she said. “There’s always something new to learn, and we have a great network of peers across the country.”

Swift serves on the board of directors for the Midwest Region of the national Wound, Ostomy and Continence Nurses Society. While she sees several patients each day, she also leads a skin champion group that seeks representation from every unit, meeting quarterly for training and information-sharing.

In addition, the small team does extensive teaching with families to ensure that they are prepared with the knowledge, skills and supplies they need when they go home.

Tracy Swift wound, ostomy, continence nurse

Swift and her husband, Rick, have three sons, two grandsons and a granddaughter on the way. She indulges her creative side outside of work by designing her own greeting cards.

While her career plan might not have included nearly four decades at Riley, she wouldn’t change a thing, she said.

“I would do it all over again. Clearly, pediatrics is where I belonged.”

Photos submitted and by Mike Dickbernd, IU Health visual journalist,