Stoma Nurses; What makes them so important?

A couple weeks ago I got the chance to interview my  stoma nurse about her job role; this is Q & A with Nicola Jennings: Stoma Care Nurse at Good Hope Hospital in the Heart of England NHS Trust.

1. What is a stoma nurse?

The title for the role at the hospital I work is ‘Colorectal Specialist Nurse’, this incorporates stoma care. They are specialist’s registered nurses wo have gained additional specialist knowledge and experience in caring for people with colorectal cancer, IBD and other disorders of the bowel requiring surgery.

The Role:

• We provide patient support at diagnosis and throughout the surgical and oncological management of colorectal cancer. Where appropriate, to community nurses or other agencies for patients diagnosed with colorectal cancer.
• Assist patients and those close to them to prepare for and adapt to life with a stoma through assessment, physical and psychological preparation, appliance selection, practical stoma teaching and provision of on-going stoma related support.
• Pre-operative preparation and practical stoma training, where appropriate.
• Specialist education, advice and appliances for the management of enterocutaneous fistulae.
• Assessment of preparation of patients with IBD going for surgery and stoma formation.
• Nurse led Colorectal clinics – all sites.
• Assessment and management of bowel function disorders.

2. What background do you have in your field? Why did you become a stoma nurse?

I qualified as a nurse in 1996, I spent two years working surgical nurse and then 16 years working in endoscopy. I started my role as a colorectal nurse in 2016; I’ve always been interested in the bowel and disorders of the bowel.

3. What types of patients do you have? We know it’s not just from IBD related surgery.

• Colorectal Cancer
• Diverticular Disease
• Inflammatory Bowel Disease – Ulcerative Colitis and Crohn’s Disease
• Sigmoid Volvulus / Intussuseptions
• Faecal Incontinence – trauma / paralysis
• Trauma
• Infection – Necrotising Fasciitis / Funieres Gangrene

4. Do you receive referrals for care to older ostomates?

Yes, patients are welcome to contact us at any time for review, new and old.

5. How do you gain the help of a stoma nurse? Who decides which patients get access?

All patients having bowel surgery for any condition at the hospital that I work at have access to a colorectal nurse specialist and are given contact details on discharge. Those having a stoma will be seen afterwards in stoma clinic.

6. What questions arise the most often?

What can and what can’t I eat? Can I sleep on myside? What about bathing and showering? Can I swim?

7. What is the most challenging / frustrating aspect about your job?

Not enough time to do some aspects of the role. We would like to offer survivorship clinics for cancer patients, hold open days for stoma patients, but don’t have the man power currently.

8. What do you feel patients aren’t very good at or struggle with when it comes to stoma care?

Initially the smell, some patients struggle with. They find it hard getting over a major operation and learning a new skill – how to manage a new stoma. Some don’t seek help, they battle on when they are having problems.

9. What is a typical day like for a stoma nurse?

No two days are the same!

• Start of the day we always have handover, there are three members of the team at the hospital I work at. This is when we divide the patient’s up that we will see that day.
• If there are any patient’s coming in for elective colorectal surgery, we see them in the morning for site for possible stoma formation, if there is a chance they could have a stoma.
• We then head to the wards to see and review the in patients, this includes stoma teaching. We are often running between the ward and clinic where we see patients with new diagnosis of colorectal cancer, or IBD patients heading for surgery.
• We can be contacted to see emergency patients; this is unpredictable, to discuss stoma formation and site for potential stoma formation.
• We see patients in stoma clinic for follow up review of their stoma and organise stoma supplies for them by completing a prescription. We also sign post patients giving them information on support wear and benefits they are entitled to.
• Throughout the day we check on phone messages and act on them as necessary, these can be a variety of issues; such as stoma problems, chasing appointments, running low on stock and requesting a review.

10. Which part of your role do you feel the most passionate about?

It can be a challenging role but also very satisfying. I enjoy getting to know the patients, building up relationships; its professionally fulfilling when you see patients are their worse and when they come back to clinic how well they look and know that you have been part of that. Being able to help someone at one of the most difficult times of their lives.

11. Do you see stoma care evolving in the future?

Maybe within stoma products themselves? It’s good to see some of the charities such as Purple Wings promoting stoma’s as acceptable.