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Patient education is imperative for stoma patients. The nurse must be able to educate the patient, so they can handle the stoma themselves upon discharge and should be able to answer any questions the patient may have regarding stoma care. Usually, training in stoma care would be done before the surgery so the patient is competent and can be discharged sooner. The patient should be shown first how to change the bag and then when they feel confident, should attempt it themselves. The patient should know the importance of cleaning the area, – so as to “promote cleanliness and prevent skin excoriation” – drying the area, so the bag will stick easier and measuring the stoma carefully, so that there is a border of 2-3mm to prevent skin damage caused by the effluent (Dougherty, Lister and West-Oram, 2015). The nurse should educate the patient on the different types of bags available. For an ileostomy, as aforementioned, initially the ideal bag would be a clear drainable bag, as stools would be loose. Identifying possible complications of the stoma and the appropriate actions to take with these if they were to arise are also things the patient must know (Burch, 2008). Another thing the patient should be educated on is their diet. What a person does and doesn’t eat can be significant when caring for an ileostomy, as what you eat has an effect on your stool. Patients should try eating a range of foods to see what foods work for them and what foods don’t. With an ileostomy, the anal sphincter is no longer functioning so therefore foods such as beans and pulses that produce flatulence should be avoided and foods that reduce wind, like yoghurt and buttermilk should be recommended (Dougherty, Lister and West-Oram, 2015). With some patients, it may be a good idea to educate the family as well, depending on the patient’s age and cognitive status. Therefore, the family should be offered the opportunity to watch the nurse care for the stoma, and should also be given booklets, DVDs and names of websites that can further help them in learning about caring for an ileostomy.
Family and friends will be very important for the patient during this time as they will need all the support they can get. Stomas tend to have a negative impact on the quality of life of the person who has it and can have an effect on the person’s body image, sexual relationships, mental health and social life. Rozmovits and Ziebland (2004) conducted a study to see how having an ileostomy affects people’s lives, with many saying they feel it has had a negative impact on their social lives. One woman says how she doesn’t want to eat out in case she is questioned on why she is avoiding certain foods, and another mentions that he does not like to leave the house at all as he feels he needs to be near a toilet at all times. Patients who have undergone the formation of an ileostomy may also suffer from body image issues and would be embarrassed of their bag, which can result in decreased libido. In some patients, as the stoma is a new orifice, they may take it as a sexual connotation – if the stoma is protruding, a woman may think it resembles a penis, or in men, they find their stomas have female characteristics such as bleeding – like menstruation (Myers, 1996). The nurse should attempt to promote sexuality among stomas patients. It is important as a nurse to not only support the patient’s physical needs, but also their psychological ones. In giving the patient the correct education and information about caring for the stoma, the patient will be able to cope better with it – they will know the right foods to eat and the correct bags for them that would be less likely to leak and to produce a bad odour. The nurse must carefully monitor the patient and identify any behaviour that could suggest that the patient is struggling or could be having mental health issues due to the stoma. It is important for the nurse to understand the appropriate support involving a person with a newly formed ileostomy as lacking such understanding can result in missed opportunities if they don’t offer “emotional, physical, and social encouragement” (Morris and Leach, 2017).

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