International Nurses Day is celebrated around the world every year on May 12th, marking the anniversary of Florence Nightingale’s birth, the foundational philosopher of modern nursing. Each year the event highlights the importance of nursing roles and how integral they are within our healthcare today. For ostomates the Stoma Care Nurse is a vital health care professional who guides and supports them through their journey before surgery, throughout their recover phase and living with a stoma.
So let’s talk about what a Stoma Care Nurse does and how they can help you. We have asked one of our Stoma Care Nurse some important questions about her role and her day and this is what she said…
Q. Describe your role as a Stoma Care Nurse?
A. I work as a Community Stoma Care Nurse and visit people in their own homes. Each day is very different to the next. All my patients will have a stoma, whether it is a urostomy, ileostomy or colostomy. They may have had surgery recently or they may be further along their stoma journey and need support. I visit to offer support, advise or guidance with their stoma, their skin or stoma products. A home visit hopefully offers a more relaxed appointment, where the person is in the comfort of their own home, surrounded by personal belongings and loved ones.
Q. What does a typical day look like for you?
A. My day is focused on home visits within a specific location and therefore there is a fair bit of driving involved. Each visit involves a full review of the persons’ stoma, assessing the health of their stoma itself and checking that it is a good colour, is functioning well, that there is a good output. For those who have just had surgery, I would be looking at their sutures to see if they are dissolving nicely, or whether the sutures need to be removed. There may also be any redness, irritation, or rashes to the surrounding skin (peristomal) which might indicate they are having some issues that I would be looking for. I am also there to check and advise on any wound sites too, the patient may have a district nurse involved in their care if they have extensive wounds.
I assess whether the patient is managing their own stoma care or whether a relative or carer is helping and whether they need support. It is also important to ask about any follow up appointments and check they are being seen by the Surgeon following their surgery. I take my time and feel its important to talk things through and check they are coping with everything as there is a lot to take in once you are home.
Not everyone has recently had surgery and those who are further down the line may have been managing well, but then suddenly had a blip and may be experiencing sudden leaks and other issues which I will try and resolve for them.
I also have my phone with me, which will be ringing with patients queries or issues, so I answer those calls at lunchtime and at the end of the day.
Q. What are some common issues or concerns ostomates may seek your assistance with?
A. The most common problems tend to be leaks with a stoma appliance. Leaks can be difficult to manage and can lead to sore skin (peristomal) around the stoma, causing irritation and discomfort. It may even stop the person from wanting to leave their house, as they may worry when the next leak will be. Some ostomates contact me as they are experience pancaking issues or have issues with excessive gas and want to know what to do. Other issues include a parastomal hernia, which may have recently developed or be ongoing, and even a prolapsed stoma.
The person may need advice regarding support garments. Some may find they develop granulomas which start to bleed and feel uncomfortable. At times stomas can also block, and bowels may become obstructed which is another reason patients may contact me for advice as to how to relieve the blockage. Or they may feel constipated, need advice and guidance with laxatives and diet. On the other hand, they may be experiencing diarrhoea and need tips on how to keep hydrated, how to slow down and thicken up their output.
Other issues may involve their stoma products, they may have run out of products, or maybe unclear how to change their product type with their supplier (DAC).
Q. How do you approach consultations with ostomates who are new to stoma care?
A. Depending on the hospital, you may well have met your Stoma Care Nurse before you have your stoma formed and had the chance to build a relationship with them. For those who have emergency surgery, this opportunity will not arise until following your surgery. In some hospital departments the Stoma Care Nurse who visits you after your discharge home maybe the same nurse, alternatively it might be a Community Stoma Care nurse who is linked to your delivery company who you have not met before (this differs from each department/hospital).
It is important to explain to the patient who I am, where I am based and what I can offer. I usually see new stoma patients within two weeks when they’ve been discharged home. For existing ostomates I may discuss the issue with them on the phone and arrange some sample products for them to trial before I can visit them. It is a case of triaging each ostomate and supporting them the best way I can.
Q. How do you collaborate with other healthcare professionals, such as surgeons and GP’s, to ensure comprehensive care for ostomates?
A. We all work together in what is called a multi-disciplinary team (MDT). This team includes all healthcare professionals involved in a particular patients care. I liaise with the hospital Colorectal and Stoma Care Nurse who refer to me in community and provide him/her with an update of their patients’ health. They can liaise with the Surgeon and arrange an appointment if it is deemed necessary and there are any concerns after discharge.
I also send a letter to all patients GP after each visit, so that they are fully informed of their patients progress and what prescriptions of stoma products they will need on a monthly basis. The GP also can refer onto other services such as Counselling, Dieticians, Physiotherapist and back to the Surgeon, if the patient has been discharged.
Q. What are some of the biggest challenges you face as a stoma nurse?
A. The biggest challenge is spending time doing admin, such completing patients notes after every home visit, writing letters to GP’s, arranging prescriptions via the delivery companies, and booking appointments. Another challenge can be the amount of driving. Sometimes the territories in community are large and this requires a lot of mileage. Juggling the home visits and phone calls can also be tricky at times. All of which take you away from your patients, which can be a little frustrating.
Q. What aspects of your job do you find most rewarding?
A. I find there is nothing more rewarding than helping people. As a nurse, watching your patient improve, adapt and start to feel brighter is a great feeling and makes me feel like I’ve done my job well! It gives me great satisfaction knowing I’ve helped someone in their time of need.
