What Is An Ostomy?
An Ostomy is a surgical procedure creating an opening from the bowel or ureters to the abdomen, resulting in a stoma, for the purpose of eliminating waste (stool/urine).
The digestive tract is a hollow tube which stretches from the mouth to the anus and is lined with mucous membrane. As food travels through the system, enzymes are added which break down the food into a form that can be absorbed and used by our bodies. It is important to remember that digestion and absorption of nutrients takes place in the small bowel. Therefore, if there is a need for the removal of the large bowel because of disease, the normal digestive process is minimally unchanged. The main function of the colon is to extract fluid and salt from the stool and act as a storage organ.
Ostomies are created to overcome problems with the bowel or bladder which are caused by injury, disease or congenital defect. All ostomies allow for the discharge of normal waste through a surgically-created opening (stoma) in the abdomen. Most ostomates wear a pouch to cover the stoma and to collect body waste, but a few have some control over discharge of waste and do not need an appliance.
What Is Enterostomal Therapy?
Enterostomal therapy is a comparatively new specialty in the field of professional nursing. The first Enterostomal Therapy (ET), Norma Gill-Thompson (deceased 1998) came on the scene in the very early sixties under the tutelage of Dr. Rupert Turnbull from the Cleveland Clinic. Canada’s first ET is Bertha Okun of Montreal who has just recently retired. Both Norma and Bertha were ostomates before being trained as ETs.
ET Nurses give preoperative and postoperative counseling to patients who must have ostomy surgery. The duties include marking the stoma site on the abdomen prior to surgery and assisting the patient with post-surgery rehabilitation. This entails education on the daily management of the ostomy, and adjustments to diet, exercise and as well as to social and marital relations. ET nurses are responsible for helping patients to cope with fear and frustration and for the involvement of the family in the rehabilitation program.
ET nurses contribute special nursing skills and understanding in the promotion of better patient care by education health-care personnel, both in the hospital and the community. Also, they are involved in the special care of draining wounds, fistulas, and decubitus ulcers. ET nurses are obliged to attend and participate in seminars and workshops, to keep themselves up-to-date on new techniques and information, and to carry out research which will result in optimal care for the ostomate.
Approximately 70,000 patients undergo some form of ostomy surgery each year in the United States and Canada. Most, if not all, are aided by an ET.