The use of an appliance like an ostomy bag can be very daunting for patients. They may feel embarrassed or uncomfortable with the situation, the appliance, and the ostomy diversion in general. However, the need to use an ostomy bag is very important when the patient has a bowel obstruction or an obstruction in the intestine and has an ostomy diversion. The purpose of an ostomy is to allow the patient to remove waste from their body and relieve built-up pressure from the obstruction. (Hinkle et al., 2022). My perceptions regarding ostomy care before taking part in the ostomy experience were very limited. I did not have a good grasp of what they were and why patients had them. I had seen a few in clinical last semester but never truly created a perception of them because I did not see enough.

The ostomy care assignment was created for students to gain more knowledge and understanding for patients with an ostomy diversion and ostomy care. We learned how to put an ostomy appliance on a patient by putting one on a classmate. We also learned how it felt to have an appliance like this by wearing the bag for 24-48 hours. Through this experience, I believe I gained a better understanding of someone who has had an ostomy diversion. I realized that having to live with this appliance can be very difficult and my respect for individuals with a stoma and ostomy appliance has greatly increased. I want to treat all patients with the best care possible, but I now understand that my care for a patient in this situation will have many layers. I will take the time to clean and apply the skin barrier cream when changing the bag or the appliance. I will also check in with the patient’s feelings towards their appliance and help improve self-image if needed. Overall, I will always try to provide the best care I can to all the patients I treat but through this experience, I believe my specific care for those with an ostomy diversion has improved.

My experience with the ostomy appliance between Thursday, January 27th and Saturday, January 29th was very eye-opening. After it was placed in roughly the middle of my abdomen during lab, I forgot about it for a while. When I got home from lab and went to change out of my scrubs, I realized a lot of the pants I owned were high-rise. This meant the waist of the pant was close to the middle of my abdomen too. Many of the pants, including leggings and jeans, were very uncomfortable to wear. I ended up wearing a pair of sweatpants and finding a few pairs of pants that were not as high of a rise to wear the next couple of days. After this situation, things were going smoothly until roughly 5 pm that night. It never occurred to me that patients with this device may struggle to play sports until I stepped into my locker room to get ready for ice hockey practice. Trying to figure out if the bag should be tucked into my pants or not became very difficult, especially when many of the girls on the team were confused with what I was wearing and looking at me a little differently than normal. I ended up solving this situation by tucking the bag into my pants. This situation brought two things to my attention, the difficulties that surround having to wear an appliance like this and playing a contact sport and the feelings of shame or embarrassment when people saw the bag. I managed to explain to my teammates that the appliance was an ostomy bag, and I was using this experience to better understand someone with an appliance like this. This situation made me very uncomfortable about wearing the bag and very anxious to present the device to others. I felt much better after explaining why I was wearing it but it made me realize how difficult it must be for patients to explain to family and friends why they have this device.

After hockey, my skin was more irritated, and the appliance felt like it needed to be cleaned from all the sweat that I produced on the ice. I cleaned the device and the surrounding skin in the shower and the irritation went down a little. I realized there was a lot of self-care that needed to be done to maintain a healthy site. I pushed myself to check the “stoma” on the site to make sure it looked healthy and to clean the device properly. These small things that patients must do to maintain the health of their skin and overall body may be overlooked by many. However, having to do these small self-care acts are so important for a patient’s ostomy appliance and stoma as well as their overall health. To me, these important but small needs must be very difficult to learn as well as remember to assess. When I care for patients with ostomy bags, I will make sure to help in whatever way I can to teach and help them remember to do these small, important things to maintain their health.

After I took off the ostomy bag on Saturday, I realized many things that I plan to incorporate into my care for others.  I realized that patients’ self-image can become fragmented when they receive a device like an ostomy bag. I realized this when I presented my bag to others and they became very uncomfortable or said, “what is that?!”. I also realized how daily living activities for individuals can become more time-consuming and difficult. I saw this through playing hockey (which is a daily activity for me) and trying to clean my room. While cleaning my room, the bag, which was ¼ full, felt heavier than normal and the adhesive kept pulling away from my body. I realized that as a nurse these difficulties that I faced, were difficulties that many of the patients would/will face when they have an appliance like this. My perception of the need to understand the care I am providing through nursing priorities, assessments, interventions, and education increased. I realized I needed to assess the patient’s site and stoma more thoroughly than I originally thought and provide interventions based on those assessments. I also realized that this device, which I thought was not going to be so bad before I put it on, would be very difficult to get to use both physically and mentally for a patient. Due to this, I knew that patient education was a major priority to provide the best care possible.

This experience was eye-opening, and I recommend every nursing student to take participate in the activity. It truly made me realize the reality of having an ostomy diversion and having to wear a device. My perception for ostomy diversions changed throughout the experience but the major turning point was when I went to hockey practice and discovered the difficulties of wearing the appliance and the viewpoint of others. This experience changed the way I planned to care for clients with ostomy diversions. Now, I plan to create an even more holistic approach for those with appliances. My advice to future students that may partake in this activity or care for someone with an ostomy diversion is to understand that there are so many factors that go into a client’s well-being. Make sure to center your care around the person and understand that ostomy care is important but so is the mental health of that individual. My advice is to always include patient education with every intervention you do. The patient needs to understand why you’re providing the care you are and how they should participate in the care. I truly recommend this experience to every student nurse.

Reference

Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth’s textbook of Medical-Surgical Nursing. Wolters Kluwer Health.