Weekend Doctor: Ostomy care
By Pamela Kathrens, RN, BSN, Wound and Ostomy Nurse Blanchard Valley Hospital
An ostomy is a surgically created opening in the abdomen for the discharge of body waste. The United Ostomy Association of America (UOAA) notes the term “stoma” is used interchangeably, which refers to the actual end of the ureter, small or large bowel that can be seen protruding through the abdominal wall.
An ostomy could include a colostomy (connecting the colon to the outside of the body), ileostomy (connecting the small intestine) or a urostomy (a general term for a surgical procedure that diverts urine away from a diseased or defective bladder).
A person could have either a temporary or a permanent stoma, depending on the disease that led to needing it. For example, colorectal cancer might lead to a permanent ostomy while perforated diverticulitis might lead to a temporary one. Sometimes a stoma is needed for trauma or injury. Young or older individuals might be affected because of illness or a disease process. Even babies can be born without the normal anatomy to require a stoma. It is a tremendous adjustment, both emotionally and physically.
When possible, patient and family teaching on ostomy and stoma management begins before surgery, with education kits provided by the surgeon’s office through the American College of Surgeons to assist in preparing for the best outcomes and recovery. A major role of an ostomy nurse is to provide proper education about your stoma, along with teaching independence, confidence and rehabilitation. The ostomy nurse will provide education on stoma care, body image, lifestyle changes, application of the pouch appliance, etc. The patient also receives tools to assist in learning at the bedside, such as sample pouch appliances, measuring guides to measure their stoma and a book to assist in their knowledge of created stomas. They are given tablets to use at the bedside to assist with videos and other ostomy stories of success and “how to” videos to change their pouch appliance and more. This information continues throughout their recovery on an inpatient basis and continuity of care outpatient.
Immediately upon entering the hospital for this procedure, your nurse will begin planning for your discharge and establish goals for rehabilitation. The nurse will complete an assessment of your financial, technical and emotional needs, along with community and home resources. They will also coordinate with social workers and the stoma nurse to ensure a positive outcome.
The local Ostomy Support Group was organized in 2017. This support group offers representatives from ostomy brands such as Coloplast, Hollister and Convatec to go over new products, speakers from local surgeons on reversals/creation of stoma placement and representatives from 50 North showing relaxation techniques.
Through this support group, patients build self-esteem, confidence and the security of knowing they are not alone on this new journey. Each person brings new techniques and tools to assist those having issues. After receiving education, reassurance and guidance from an ostomy nurse, patients can be assured that they can return to a normal life. Patients often benefit from talking to others that can relate. For more information about and/or to connect with the local Ostomy Support Group, please call 419-423-5154.