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Wound, ostomy and continence care CEO advocates for recognition for nurses with specialized skills, credentials

Cathy Harley adopted a business mindset to advancing nursing practice

By Laura Eggertson
August 8, 2023
Courtesy of Cathy Harley
Cathy Harley is the chief executive officer of Nurses Specialized in Wound, Ostomy & Continence Canada and a strong advocate for nurses to have their specialties and experience recognized and rewarded. “In a lot of provinces, nurses aren’t paid for having additional knowledge and skills,” Harley says. “They are classified and paid as a registered nurse even though they have a specialization.”

Almost 35 years ago, Cathy Harley watched televised coverage of nurse colleagues carrying a coffin to the Ontario legislature during a protest march, alongside banners reading, “Nursing is a dying profession.”

As a clinical care coordinator in the intensive care unit at a large hospital in Mississauga, Ont., at the time, Harley remembers identifying with the protesters.

“Nurses were being stifled. Their abilities weren’t being fully recognized. The investment they put into their education wasn’t being recognized. There were individuals graduating in computer science who were making more than nurses did,” she says.

“I’m looking at all of this, saying ‘There needs to be a change – and change takes time, advocacy, data, and a data model.’ ”

As one nurse working in a critical care hospital setting, Harley felt that steps needed to be taken in order to advance nursing practice. She was convinced the way to change the health-care system was to take a different approach: to adopt a business lens.

Today, Harley is the chief executive officer of Nurses Specialized in Wound, Ostomy & Continence Canada (NSWOCC), an Ottawa-based registered charity with more than 850 members that represents the specialized nurses and promotes high practice standards. In addition, she manages the International Skin Tear Advisory Panel, an official interest group of NSWOCC with over 4,000 members globally.

She’s also a consultant specializing in planning and restructuring for not-for-profit nursing organizations, and has worked with the private sector, through a career in marketing and sales with a global health-care company.

Shifted to business

Getting to this point in her career required Harley to shift gears. She started by leaving direct patient care in her intensive care nursing job to go to work for Convatec, a division of Bristol-Myers Squibb Canada Inc.

After moving quickly from a regional sales representative for wound, ostomy and incontinence supplies to a national position as the skin and wound business unit manager, Harley moved to the U.S. and ultimately became director of global strategic marketing for Convatec’s wound dressing technology core business. With her company’s support, she earned an executive MBA through London Business School and Princeton University’s Leadership Development for Business program.

Harley also acquired specialized credentials in wound management through the University of Toronto’s International Interdisciplinary Wound Management Program. She later completed a certificate in not-for-profit business management from the Telfer School of Business at the University of Ottawa and the Rotman School of Management at the University of Toronto.

At every step of her career, when she felt she needed more specialized training or education, she worked hard, and got it.

Marrying her expertise in skin and wound care and her business education and credentials was critical to providing Harley with the tools she needed to make an impact in specialized nursing care.

Now she uses her standing at health policy tables in Canada and around the world, where she advocates for nurses to have their specialties and experience recognized and rewarded.

“In a lot of provinces, nurses aren’t paid for having additional knowledge and skills,” Harley says. “They are classified and paid as a registered nurse even though they have a specialization.”

Specialized nurses improve care

Many nursing unions don’t have additional categories or pay grades for specialized nurses, she adds.

Although the fight to get nurses better pay based on their experience and credentials is an uphill battle, Harley and the nursing leaders she works with at the Canadian Nurses Association are making headway with the provinces, she says. Presenting the value proposition of specialized nurses is crucial.

“We have research to show that if you have a specialized nurse involved in the wound care team that the cost savings are significant and the clinical outcomes are improved,” she says. “It’s really getting the message across that if you do add specialized nurses into the staff mix, that your clinical and cost outcomes will be improved.”

Throughout her career, Harley has also had opportunities to improve nursing practice by teaching wound care techniques to hospital leaders and health-care professionals around the world. During an initiative to improve foot care for diabetic patients, she toured hospitals in the Middle East to teach surgeons and other health-care professionals about new types of dressings and wound care techniques to reduce infections and avoid amputations.

“It was a very positive experience,” she says.

And in 2011 in Cambodia, Harley and a colleague worked in a hospital and in community settings in Phnom Pen for a month.

Profound learning

As they taught doctors and nurses advanced wound care, they learned how resourceful and resilient those health-care professionals were, caring for devastating injuries with little to no supplies.

One of their patients was a 52-year-old woman who had had battery acid poured over her head. She was being operated on for skin grafts.

“This poor woman — they brought her into the operating room, and we had so little to work with,” Harley remembers. “We had to teach what we could around infection control and other aspects of wound management. It was an experience unlike any I’ve ever had.”

Seeing what other nurses face during situations like that “was so profound,” Harley says. “In Canada, even though there are things that need to be improved, on the whole we have access to things we need when we need them.”

Although she has had to cut back on direct patient care, Harley is encouraged by the work she does to translate knowledge into action, such as helping to launch the first national symposium on wound management. That symposium led to the Canadian Association of Wound Care, now known as Wounds Canada, a non-profit organization devoted to education, research and putting wound care advancements into practice.

Online education offered

She also thoroughly enjoys her involvement in the Wound, Ostomy and Continence Institute, a primarily online initiative that NSWOCC created as an educational program for training specialized wound ostomy and continence nurses, as well as offering a Skin Wellness Associate Nurse Program for practical nurses.

At any one time, there are 150 nurses and paramedics taking the programs and courses, Harley says.

As she juggles her strategic work with health-care organizations, and her education and knowledge translation efforts, Harley safeguards her own health too. An avid cross-country skier and paddler, she enjoys spending time at the cottage with her husband Gordon Faulkner and sees her three grown children whenever she can. She smiles when she says her eldest daughter is a registered nurse specialized in wound, ostomy and continence.

She’s particularly proud of her efforts to help nurses become more confident by increasing their knowledge in wound, ostomy and continence care. Those skills broaden their career horizons and improve patient care, she says.

“This specialized field of nursing has definitely grown and developed over time,” she says.

Many nurses choosing the specialty today do so because in addition to their clinical work, they can become involved in best practice recommendations and guidelines, policy work and research, she adds.

“That’s what appeals to them — moving from a generalist to more advanced specialist care.”

And when they do become advanced specialists, Harley will be in their corner, advocating for the pay raises and recognition she knows they deserve.

Laura Eggertson is a freelance journalist based in Wolfville, N.S.