A first experience of as a nursing student.

I encountered my first stoma as a nursing student and the incident is seared into my memory. It was in the first semester of my medical–surgical nursing course. The patient was a middle-aged man three or four days post-op after a colon resection. I was very nervous, but figured my instructor would know what to do. My stomach dropped when she confessed that she was not all that familiar with stoma care but was confident we’d figure it out with some help from the staff.

Fortunately, the head nurse of the surgical ward (I’m dating myself: yes, it was a ward and yes, her title was head nurse, not nurse manager or patient care coordinator) was very experienced with new ostomy care. She helped both of us gather the correct supplies and briefed us on what to assess and do. We were able to competently change dressings, change the ostomy appliance, and make the patient comfortable. However, I don’t think I encountered another patient with an ostomy until a few years later. By then my knowledge had faded. I had to seek a refresher.

Stoma assessment and common complications.

Photo by Amelie-Benoist / BSIP / Alamy.

I am very pleased that Susan Shelton (immediate past-president of the World Council of Enterostomal Therapists, which collaborates with us on AJN’s Wound Wise column) authored our July CE article, “Stoma and Periostomal Skin Care: A Review.” The article is offered as a brief overview of stoma assessment and common complications.

While consultation with a qualified wound, ostomy, and continence (WOC) nurse would be the best case scenario for nurses new to ostomy care, not all hospitals or agencies employ WOC nurses, and their time may be limited. It’s important that all nurses have at least enough knowledge to assess and manage basic problems. Most nurses don’t have much experience with stoma care and may be unsure of what to do. As a result, notes Shelton:

” . . . lack of knowledge can contribute to the nurse’s stress and may cause the patient and family members to lose confidence in the nurse.”

‘No one knows’: Patient perspectives.

We hope you find this article helpful. Accompanying this article is one we selected from our archives, “No One Knows I Have a Colostomy” (free until June 30). Published in 1951, the author, not a nurse, writes about her experience with a colostomy and her wish for more support in dealing with it.

And for a more recent patient perspective, read this powerful and vivid blog post we published several years ago by a young mother with Crohn’s disease who had her colon removed and had to learn to adapt to a future as an ostomate.