Modern day medicine has allowed the creation of artificial elimination pathways in patients that have gastrointestinal tract (GI) complications. An ostomy is a diversion of the GI tract towards the outside of the body that does not enter the colon and rectum. Most artificial ostomies are in the abdominal area. Therefore, waste is moving directly from the intestines to the outside of the abdomen. The patient will no longer be able to control the amount of waste that comes out from this area due to smooth muscle contractions, so they will need a container that can capture the waste as it comes out. An ostomy bag is responsible for holding the waste that comes out of a stoma (the area of smooth muscle that meets the outside of the body).  Ostomy bag care and proper usage is crucial to ensure that the patient is relieving themselves of waste without the complications of perfusion issues or possible infection.

The assignment for this lab course is to wear an ostomy bag for up to 24-48 hours, after learning the proper care methods, and how to change the bag. This activity is meant to give student nurses an insight as to how lifestyle changes can occur when patients need an ostomy placement. This project will help nursing students express empathy towards our patients when we provide care for them. In specific, this opportunity will allow us to experience life through their perspective. In this activity, I was required to fit an ostomy bag to a drawn-on stoma. This portion of the activity was easy because we were provided with tools that were designated towards measuring stomas. Then, I released the adhesive backing to the bag and placed it carefully over the stoma. The final step of the in-lab portion was to fill the bag with beans representing waste.

Living with an ostomy bag had its pros and cons. For example, the instructions to fit an ostomy bag to the body were simple. Patients can fit these on at home for their own convenience. Another benefit that I noticed was that I rarely realized that the bag was attached to my body. There were many times that I hadn’t noticed that I had a bag on my abdomen until it was pressing up against a table or if I looked in a mirror. It is important for patients to feel comfortable with their ostomy bags, so that they can continue with their everyday lives without becoming distracted.

There were also other aspects of the bag that were not so favorable. For example, it took up a lot of space on the body and puffed outward. I felt too embarrassed to wear any tight-fitting clothing or shirts that potentially showed my abdomen. I did not want other people to see the bag, so I always wore baggy clothing. Even with the baggy clothing, the ostomy bag still poked out, and made my body appear as though it had gained a few pounds. I felt self-conscious about my body appearance during the entire course of this activity. I could assume that people who live with these bags for their entire life must deal with these conflicts as well. Nobody else had noticed the ostomy bag unless I directly showed them. I personally feel that if I were to be intimate with a partner, the ostomy bag would make those interactions uncomfortable. It’s unappealing both visually and physically, so owning an ostomy bag with a sexual partner could create conflicts within intimate interactions.  

 Another example was that the adhesive to the bag had only lasted for five hours. I truly attempted to wear my bag for the whole course of the activity, but I physically could not because ostomy bag physically could not stick onto my stomach after working for a few hours. I was not doing any strenuous activity, so I do not believe that it could have lost its adhesive capabilities from moisture. If this occurred to a person who requires an ostomy bag, waste would not be properly handled, and that person might be embarrassed by the situation. Not only that, but they would risk infection if the stoma were exposed to the environment.

I can see how managing an ostomy bag might be difficult for those who need them. It felt unfamiliar to see a newly made stoma along my abdomen. Sometimes patients have a difficult time coping with having a stoma because they feel that they have lost a part of themselves. I completely understand this process and could imagine myself experiencing those same emotions if I were in their shoes. I could only imagine that it would be difficult for that person to have a difficult time being able to look at the stoma for quite some time after the procedure.

In the future, I will want to ensure that the ostomy bag is up to date, so that there is no further risk that it could fall off within a short amount of time. I will also make sure that I individualize my care plan to fit the holistic being of my future patients. Having an ostomy bag is not only a physical change but can also be an emotional challenge for patients. I would like to include this information in my patient education. I would go into depths on how their procedure can influence all domains of the body. I would then provide them with information regarding what to expect, and what resources they have for support. This will allow the patient to feel prepared for their procedure and provide them with a form of patient lead care. Therefore, it is important to include your patient in their line of care, and only move forward with the care plan when they are comfortable.

Overall, this experience really helped me use the nursing skills associated with empathy. This will allow me to individualize care in the future and prevent desensitization to patient needs in my future career. It is important for nursing students to engage in activities like this one to get a feel of how holistic health is a real need in healthcare, and we should use this experience as an example of this nursing practice moving forward. Therefore, this activity was an inspiration for me in advancing my skill set for my future career.

                                                      References

Hinkle, J.L. & Cheever, K.H. (2014). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13th ed. Philadelphia, PA: Wolters Kluwer/ Lippincott, Williams and Wilkins.