Ingenuity: out of necessity
For referencing Prentice J. Ingenuity: out of necessity. WCET® Journal 2023;43(3):7.
Historically, the universe is awash with examples of ingenuity; whether it be the capacity of animals to evolve and develop techniques to survive as their environment has changed or those that have emanated from human effort when faced with a dilemma. Helmstetter in terms of modern culture describes ingenuity as “...the creation of a solution to a dilemma or problem …and demonstrating novel or unusual approaches to achieve a solution”1. Resourcefulness, cleverness, inventiveness and originality are also other characteristics associated with ingenuity.
Ingenuity borne out of necessity is a common construct of articles within this issue of the WCET® Journal. Singh et al describe how during the COVID-19 pandemic they used video teleconferencing technology to overcome the barriers of distance, time zones and limited clinical sites to collaborate with the Wound Ostomy and Continence Nurses (WOCN) Society USA to develop and provide the first accredited international advanced wound, ostomy and continence education program to nurses in Vietnam and other Asian countries. The program, which was hosted via the Ho Chi Minh University School of Nursing and the University Medical Center, had 23 nurses who graduated in the specialty of wound, ostomy and continence nursing.
The difficulty in identifying skin changes that may lead to the development of a pressure injury in people with a darker pigment to their skin has long been acknowledged. In discussing the salient issues pertaining to skin assessment and identification of changes within the skin of patients with dark skin tones, Black et al refer to the emerging use of clinical visual detection technologies such as subepidermal moisture (SEM) assessment technology and long wave infrared technology (LWIT) as promising clinical technologies for early identification of skin changes before they are visible to the naked eye. Earlier detection and confirmation of subepidermal skin changes, it is proposed, will assist with avoidance of pressure injury development through earlier implementation of pressure injury preventative strategies and /or reduce the incidence of latent presentations with associated more extensive tissue damage in people with darker pigmented skin.
Karadağx et al, within their poignant case study, tell of the ingenuity of a 54-year-old Turkish shepherd, who because of cost constraints, washed and re-used his colostomy irrigation equipment for over 13 years. The circumstances leading to this unusual situation are explained, as are the secondary unintended cost savings achieved. Fundamentally, however, the authors explain the need to review health insurance and reimbursement process for ostomy equipment in Turkey so that people with ostomies are not disadvantaged and can safely use ostomy appliances as per manufacturers’ instructions.
In many low-income resource poor countries, local and readily available low-cost remedies for treating and healing wounds are out of necessity often the first choice of dressing. Coffee powder is one such resource. Coffee powder, which reportedly has antioxidant, antimicrobial and anti-inflammatory effects, has been used as a traditional method for treating wounds, particularly in Indonesia, for many years. Haesler reviews the current evidence on the use of topical coffee powder for facilitating wound healing in a variety of wound types. Which species of coffee bean, the process of applying coffee powder as a topical dressing and how coffee powder interacts with the wound bed are identified.
Ingenuity and adaptability are synonymous with wound, ostomy and continence nursing as we strive to provide best practice clinical care to achieve the best possible clinical outcomes with the resources available to us in the context of the person, their personal preferences, their medical conditions or clinical circumstances and their living environment.
Thank you all for continuing to use your passion, expertise and empathy to rise to these challenges with your ingenuity.
Best wishes to you all, Jenny.
PhD BN RN STN FAWMA
- Helmstetter M. A Story Of Human Ingenuity Crossing Decades. Michael Helmstetter https://www.forbes.com/sites/michaelhelmstetter/2021/07/06/a-story-of-human-ingenuity-crossing-decades/?sh=129f92403596