Ostomy Reflection
Bowel Diversion/Ostomy Reflection Assignment Introduction:
An ostomy appliance is used to collect bodily waste such as stool from a patient’s intestines. The ostomy appliance is placed around a stoma, which is an opening in the intestines where the waste can exit the body (Hinkle et al., 2022). Many adjustments need to be made by the patient to properly care for an ostomy appliance. These include both physical and psychological adjustments. I perceived nursing care to include patient education about the appliance and the stoma, psychological challenges, and good hygiene practices before this assignment. After wearing an ostomy appliance for 48 hours, there were many challenges that I didn’t foresee or fully understand before. I believe that the purpose of this assignment was to give us as nursing students the most realistic experience of having an ostomy appliance as possible. This way, we will be able to have more empathy for our patients and their various challenges in the future. After wearing the appliance, I feel that my patient education will be more accurate and compassionate than it would have been before.
Student Experience:
When the ostomy appliance was first applied and throughout the duration of this assignment there were many physical challenges I didn’t foresee. One challenge for me in particular was that the ostomy appliance began to itch my skin the longer I wore it. This became a nuisance to me as time went on, and I wanted to just rip the appliance off because of how much it itched. I also became uncomfortable with how warm the ostomy bag become. When I exercised in the gym it made the skin around the appliance sweaty, and when I slept at night it was uncomfortably warm against my stomach.
Psychologically this assignment was especially difficult for me because my Nana went through this same experience. My Nana had a large bowel resection and needed a permanent ostomy appliance afterwards. It was a very difficult adjustment for her, and she hated having to wear it. My nana passed away this fall, but her strength through many different surgeries, and remission three times from breast cancer has always inspired me greatly. She was the strongest person I’ve ever known, so this assignment wasn’t just for me, it was also for her. I felt uncomfortable wearing the ostomy appliance in public, especially when I wore tight fitting clothing to the gym. I imagine this is probably how my Nana also felt, and I now have a new appreciation for what she went through.
I think it would be very difficult for me to clean and look at a stoma each day. A stoma is an intense adjustment for a patient because a part of your body that is supposed to be inside is suddenly on the outside. Disturbed body image is a common nursing diagnosis for patients with an ostomy appliance, which may prevent proper care of the appliance and stoma. It is my job as the nurse to assess a patient’s readiness to care for their own appliance, and if they don’t feel ready it’s also my job to help them break down any barriers keeping them from caring for their stoma or ostomy appliance.
Important Nursing Considerations:
After wearing the ostomy device for 48hrs I would adjust my care plan as a nurse. I would adjust my patient education by discussing with the patient what their concerns are about the appliance. I would make this a priority because ultimately the patient will be the one caring for their stoma and appliance each day when they are no long in the hospital. I would also make sure to educate the patient’s family on what their family member may be struggling with such as disturbed body image. Lastly, I would make sure to thoroughly assess the patient’s skin around the stoma and ostomy appliance site. Since the appliance is always resting on the same part of the skin, the patient is at a high risk for impaired skin integrity.
Conclusions:
I’m glad I got to opportunity to participate in this assignment, because it gave me the closest experience, I could have without actually having an ostomy appliance. I only had to wear my ostomy appliance for two days, so I can’t imagine having to wear it every single day. I would have to adjust how I dressed, adjust my mindset, and adjust certain parts of my lifestyle. This experience gave me more empathy for my patients because I was only able to experience a fraction of the discomfort and irritation that a patient with an ostomy appliance would feel on a day-to-day basis. My advice for future students would be to fulfill this assignment to the fullest and pay attention to your day-to-day routine. This is what I did, and small things that would typically be a breeze for me such as showering, putting on clothes, and working out were significantly more difficult, and took extra time and precautions. This experience has already helped me communicate with patients I have had in clinical and be a better and more understanding nursing student.
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