Introduction

There are many reasons as to why someone would have to go through an ostomy diversion, such as; inflammatory bowel disease, diverticulitis, and colorectal cancers. The reason for an ostomy diversion can be unique to each person that you come across. Fecal diversions can be one of two things, an ileostomy or colostomy. The purpose of both of these is to divert fecal drainage to the abdominal wall by a stoma (Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022)). There are many focuses of nursing care when caring for a patient with an ostomy, I am going to brief over what I feel are the most important. The care doesn’t start with when the patient has the ostomy, it starts preoperatively, you want to prepare the patient for what is expected and how to handle the situation physically, mentally, emotionally, and in many other ways. Postoperatively, the nursing focus would be things like stoma care, properly cleansing, watching the skin integrity of your patient and doing anything that you can to prevent skin breakdown. 

The purpose of this assignment is to put us soon to be nurses in the patients shoes. It will help us understand how the patient is feeling and why they are feeling that way. Whenever it is possible to be put in the patient’s situation, I think it is a great learning opportunity and will teach you the reasons on why treating them with the best care, compassion, and respect is highly important. This will assist my care of patients with ostomy diversions because I will know what it feels like to live with one. Although it was for a short period of time and some people have them forever, I will at least know the feeling of what it is like to live with something attached to you like that. 

Student Experience

Wearing the ostomy bag for roughly forty-eight hours I experienced some difficulties, much like a patient who lives with one everyday would go through. One of the biggest being skin irritation and breakdown, some solutions that I used were applying an alcohol based content when trying to remove the appliance, washing the area really well and a skin moisturizer after the appliance was removed. Another difficulty that I experienced was a sense of discomfort, I wore more loose clothing so it would not rub as much. While working out the ostomy bag was almost in my way, it was either flapping around or I would feel like I would nudge it and it would want to come off. Some solutions for accommodation with it were taping it down and putting it inside of my shorts. 

My psychological response would probably be the expected response, I felt weird and I didn’t want people to see it or know about it. My body image was definitely disturbed, I tried to wear looser fit clothing and I made sure it was covered at all times. For instance I went to a restaurant with it on, when I got out of the car it was hanging out of my jacket, and it was almost embarrassing and I wanted to make sure it wasn’t showing by the time I went in the restaurant. Other than that I didn’t avoid going places, I mostly just didn’t talk about it or show it. I am sure it takes a patient awhile to get comfortable with something like this in public. I didn’t have too many interactions with others, but if I had to disclose that to a significant other, I think I would start with how many people go through this on an everyday basis and how it is going to affect my life, but I am still the same person with or without it. 

I would imagine it is initially scary and overwhelming, you are looking at a piece of your intestine and your life drastically changes in a short amount of time. There are a lot of things that you have to learn and incorporate into your day for caring for a stoma and everything that comes with it. Besides going through the physical and psychological aspects you have to put that all aside and learn a new way of caring for yourself. This can be stressful to a patient and their family members who may be trying to help. 

Important Nursing Considerations 

An important observation that I made during this assignment is the psychological aspects that a patient going through this may be feeling. After my experience I would say two of the biggest nursing priorities are; how the patient is feeling, and skin integrity. Some interventions that I would take to maintain these priorities would be suggesting therapy to my patient or genuinely asking how this makes the patient feel and how you as the nurse can help. For skin integrity, I would make sure I am cleansing properly and using skin barriers that are aloud, and going the extra mile to avoid skin breakdown. I would modify teaching techniques by telling the patient that they are not alone and there are many others that are going through the same thing as them. This is because it may help the patient to talk to someone who has overcome the fear or shame of having an ostomy diversion and for them to know that it is okay to talk about it and easier to express their feelings rather than keeping them in. Based on this experience, I will employ checking skin integrity and preventing skin breakdown. I only had to wear this ostomy bag for forty-eight hours, and it was itchy and uncomfortable. By the time I took it off, I had two red rings of skin irritation, I couldn’t nearly imagine having to wear it for life. Those who do have to wear it temporarily or for life should have the proper hygiene and care from day one. 

Conclusion

This experience has widened my perspective in different ways. In the future I will provide the best nursing care I can for clients with ostomy diversions, but also with all my other clients/patients. I will try to place myself in their shoes and elaborate on what they are feeling and the reasons that they may be acting in a certain manner. I think that this was a great eye opener and I believe nurses and/or nursing students should be placed in the patients’ perspectives more often. These moments will teach you the importance of nursing and why you should strive to be the best nurse and not the nurse who doesn’t genuinely care about their patients. My advice to future students is to think of this positively and how it can impact the care you will be giving to your patients.