An ostomy is used for several different diagnoses including diverticulitis, the later stages of colorectal cancer, or irritable bowel syndrome (Cheever et al., 2021, p. 1319).  The ostomy directs feces through a stoma into a small appliance attached to the patient’s abdomen instead of being expelled through the colon (Cheever et al., 2021, p. 1318).  This procedure can be temporary or permanent and requires diligent routine care to prevent infection (Cheever et al., 2021, p. 1320).  Due to the significance of this procedure and the change it has on a person’s daily life, the healthcare team must address both the physical and psychological effects to ensure they are meeting all the patient’s care needs (Cheever et al, p. 1319-1320). 

       When we were told that we would be wearing an ostomy bag for 48 hours as a part of our skills lab experience, I was not sure what to expect.  I had no prior experience caring for a person with an ostomy bag, nor did I know anyone with an ostomy.  However, I knew this would be an invaluable learning experience that I could carry forward through my nursing career, even though I was aware that I could never replicate the experiences and emotions a person with a real ostomy may have.

       When I applied the ostomy bag on my lower abdomen with the bean mixture inside to represent stool, I could not help but notice the smell of the beans initially, and the feeling of the device dangling from my stomach.  It felt very obtrusive as though everyone must be staring at this bag hanging off me.  I thought of wearing longer shirts so the device would not be as visible, and I realized how difficult it would be to change one’s wardrobe just to hide the device.   

       As I walked back from the skills lab to my car and the device flapped against me as I walked.  I thought, “maybe I won’t notice this after a while.”  The feeling of the device against me did go away after a couple of hours…until I tried to crawl into my 2 ½ year-olds fort on the floor.  Crouching down, I felt the bag dangling, and I worried he would try to grab or pull at it, I instinctively held it down and gingerly crawled into his fort.  This was ultimately the most defining, and most difficult moment I imagined for patients with ostomy bags; even when the feeling of the device against you does subside, it can hinder spontaneous moments, such as romping around with one’s kids.  I continued to be reminded of the device when taking a shower, putting on clothes, or simply looking down.  It was also somewhat itchy at different points, and I could imagine that if this was not fitted properly, it would become increasingly uncomfortable.  It was heartening that my spouse nor my kids noticed the bag hanging from under my shirt and I had to tell my husband about the bag before he ever noticed; this reminded me that although it was very apparent to me, to most people, it was not as noticeable.

      This ostomy experience was a significant reminder not only about patient education on how to keep maintain the stoma’s viability, but to also talk about the emotions related to this life-changing procedure (Cheever et al., 2021, p. 1319).  As a nursing student, it is easy to hyper-focus on patient education pertaining to cleaning the stoma and changing the appliance to prevent infection.  However, I must not forget the importance of the patient’s psychosocial and psychological needs (Cheever et al., 2021, p. 1319).  If the patient cannot look at their ostomy appliance, then they may not want to go to work, or see loved ones, let alone be willing to comply with a cleaning regimen on a regular basis; these are aspects that the healthcare team needs to address prior to discharge (Cheever et al., 2021, p. 1319).  My approach to patient education has changed in that I would first address their emotional response to the ostomy, and then proceed with cleaning the stoma, appliance changes, and signs and symptoms of infections (Cheever et al., 2021, p. 1319).  I would also look to see if there are any support groups for those who have ostomies and connect my patient with them (Cheever et al., 2021, p. 1319).  If a support group does not exist, I would advocate for starting one to help alleviate any feelings of isolation my patient may have (Cheever et al., 2021, p. 1319). 

        This experience was incredibly valuable, and I have a deepened respect and empathy for those patients who have ostomies.  While I did get more use to wearing the ostomy bag during day-to-day activities, it did take some time.  It made me realize how this small device can have a significant influence on a person’s life, and how important it is as a nurse to emphasize to patients that they will still be able to do the things they enjoy with some modifications.  I was also reminded how I must determine patient readiness prior to offering any education since the patient may not be in a place where they will receive the education well, which could lead to medical complications (Cheever et al., 2021, p. 1319).  This experience has strengthened my understanding of how the healthcare team must see patients as multi-faceted people and consider all aspects of who they are and how an ostomy may affect their daily lives in order to provide the best patient-centered care.   

Cheever, K. H.K.H.J.L.O. (2021). Lippincott CoursePoint Enhanced for Brunner & Suddarth’s

Textbook of Medical-Surgical Nursing (15th Edition). Wolters Kluwer

Health. https://coursepoint.vitalsource.com/books/9781975186722