The Ostomy Files: Who Are You?

Ostomy Wound Management is pleased to announce the return of The Ostomy Files, now sponsored by Coloplast Corp. This series of occasional articles features no-nonsense tips and insights for providing compassionate, high-quality management of the patient with an ostomy.

     As an ostomy clinician, you serve numerous purposes and play vital roles.

     You are a clinical specialist. Not long ago, some patients had two choices: ostomy surgery or death. Surgery came with postoperative complications, long hospital stays, and no one to help patients manage. Even for a long while after 1958, when the first Enterostomal Therapist was trained at the Cleveland Clinic, patients faced extended postoperative hospital time and no reliable resources other than others who survived similar ordeals. Until the late 1950s/early 1960s, ostomy supplies were manufactured by a limited number of companies and usually comprised heavy, rigid, reusable products. As additional manufacturers joined the ostomy industry, more advanced, disposable products and improved pouching systems became available to address most of the needs of an individual living with an ostomy. Yet despite the evolution of ostomy surgery and management, no one seemed to embrace the science, technology, and humanity of ostomy care quite like the ostomy/ET nurse specialist. You are the person with the knowledge and expertise to be relied on to “mark” patients for surgery. You have the answers to questions about the surgery (anesthesia, catheters) and physical and anatomical changes (sexuality, diet), as well as how to manage the ostomy.

     You are counsel and champion. You provide short- and long-term survival advice. You address the psychological problems that can stymie a person’s ability to perform self-care. Even though the demand for ostomy specialists far exceeds supply (eg, there are only approximately 4,000 WOC nurses in the US) — especially when you consider these specialists also treat wounds and incontinence — you deal with important particulars, such as product choice. For example, you address the issue of 7-day wear time for pouches (as suggested by manufacturers) when clinicians and patients question their techniques if they achieve “only” a 2- or 3-day wear time. You know that when so many options available, human private elimination should not be subject to mandates and you help patients accept that although a product can be used for up to 7 days without losing effectiveness, body function and lifestyle are individual considerations that affect product “life”.

     You are a financial advisor. You are mindful of the patient’s economic status and strive to disallow income concerns from determining ostomy management system choice. When quality of life is at issue, a more costly product or one with a shorter wear time should not be dismissed. Medicare has cooperated somewhat, increasing product reimbursement options. You guide choice based on the patient’s needs and care abilities, not just on price.

     You are an educator. This is, perhaps, your most important moniker. Education should begin before surgery and continue through hospital discharge to the time when the individual is comfortable and confident with self-care. You are the filter in this era of easily accessible, but often contradictory and confusing information. You reinforce and clarify the great quantity of information patients are provided in the hospital — when the ostomy is new, unfamiliar, and daunting, they may not retain much of what they initially are told. As a clinician with working knowledge of state-of-the-art care and modern products, you are an asset to your healthcare organization — a proactive resource and teacher for non-specialized staff who probably, in the long-term, will assume many patient care duties. You can help establish standards of care and protocols, teach staff, evaluate ostomy products, and determine cost-effective ostomy management that matches your organization’s patient population.

     Consider your significance. Despite the evolution in surgical techniques for creating stomas and the ostomy products used to manage them, this healthcare sector still falls prey to inadequate, inconsistent care and teaching or little-to-no access to specialized ostomy care practitioners. Through the upcoming months, The Ostomy Files will address common concerns and areas for improvement to make you a better ostomy clinician and your patients the benefactors of your expanded knowledge. I am proud to know you.

     Our gratitude to Gwen Turnbull, former author of The Ostomy Files. The information for this inaugural column was culled from her previously published articles. New and old columns are available at www.o-wm.com.

The Ostomy Files is made possible through the support of Coloplast Corp, Minneapolis, MN. The opinions and statements of the clinicians providing The Ostomy Files are specific to the respective authors and are not necessarily those of Coloplast Corp., OWM, or HMP Communications.

This article was not subject to the Ostomy Wound Management peer-review process.