An ostomy bag is an appliance that is used when there is a needed change in the way urine and stool are excreted from the body. In order to correctly use an ostomy bag the patient will have to go through an ostomy surgery to create a stoma. A stoma is an artificial opening of the intestine to the outside of the abdominal cavity. This allows for the excretion of waste products to bypass the malfunctioning intestinal tract. A patient can have a temporary or permanent ostomy depending on their diagnosis. Prior to the surgery, the nurse is taking care of the patient and preps them for the procedure. The nurse may make sure the patient is NPO and provide pain management in the meantime. Other than medical management, the nurse should also begin to think about the patient’s mental and emotional status since they are about to undergo a major lifestyle change. For 48 hours, I was given the chance to wear and care for my own ostomy bag. The purpose of this experience was to give us a better understanding of the impact this appliance has on a patient’s life. I believe that this assignment will help me become the best nurse I can be for patients with an ostomy bag by getting the first experience with device placement and maintenance.

As I began my day with my new ostomy bag, I noticed right away that my first issue was going to be with my clothing. I was wearing high-waisted jeans and a cropped sweatshirt. I usually don’t have to think twice about this outfit but as I allowed a peer to draw on my stoma I noticed that I had to unzip my pants to allow for correct placement. This challenge only got worse as I began to place my ostomy bag onto my abdomen. I noticed that I had to then place my bag into my jeans in order to zip them back up. This was a very uncomfortable experience as I had to sit for the rest of my school day with my ostomy bag in my high-waisted jeans. As I sat in class, I began to wonder ‘if I had a stoma would I feel comfortable with my jeans pressing on it?’ It was interesting to see how even the little things like my wardrobe would affect my experience. A different physical experience I had, happened during the removal of the bag. As I pulled the adhesive dressing off of my skin I noticed that my skin was very irritated. Underneath my skin was very red and sensitive to the touch with various small bumps. This may have been a sign of hypersensitivity that I did not know I was experiencing. My immediate thought after, was how actual patients are unable to take a break from the bag and would’ve had to place another adhesive dressing onto the irritated skin. These are just some of the physical challenges that a patient with an ostomy bag may go through in their day-to-day lives. 

Another concern I noticed was about what outsiders would think of me. I found myself becoming hyperaware of my physical appearance because of the ostomy bag that was sticking out of the top of my pants. Constantly thinking about my looks and worrying about what other people may think of me is exhausting. This really made me think about how patients with real ostomy bags may feel the same way. I also became anxious about the contents inside the bag and worried about if it smelled or would accidentally leak. These are some serious concerns to have with an ostomy bag. It made me think about how a patient with a new ostomy may have unique stressors and mental health issues because of it. I feel a patient with a new ostomy and stoma may be in shock and grossed out by the looks of this opening from the intestine. A patient may need someone from their support system to help them with the care of this new device for the first few months while they adjust to their new normal. 

All in all, I believe this experience, though a difficult one, was very beneficial in developing a new perspective on patients with ostomies. My beliefs have changed as a nurse having to care for these types of patients. I hope to prioritize more of the needs of Maslow’s hierarchy. A patient that has to live with one of these devices may struggle with esteem, love, belonging,  and self-actualization. These are very important pieces of a patient’s overall well-being. In my future endeavors as a nurse, I hope to not only care for the medical components of an ostomy but also look at the bigger picture and how it may affect a person’s life. If I have any advice for the future students of this class it is to wear low-rise jeans, leggings, or sweatpants to this class despite the dress code. This will help you feel more comfortable for the rest of the day. I would definitely recommend this experience to any nurse because it can give us a better understanding of what it may be like for the patient thus providing the best care possible for them.

Since completing my medication reconciliation on my patient, I noticed that my biggest concern was with the patient’s lack of knowledge. She did not quite understand the potential complications that could come with taking these medications together. My patient had a difficult time understanding what to do in the case of an emergency and how to see the warning signs before it happens. The patient did understand what amlodipine and loratadine were for and how they could help. She did not know what the gabapentin and the haloperidol were for. It is important for the patient to know the purpose of each medication to be an advocate for their own health. She did not have multiple medications that did the same thing, but she had a few medications that had side effects that were similar to the purpose of her other meds. Amlodipine is to decrease blood pressure and haloperidol has a side effect of hypotension. These together may cause very dangerous outcomes such as the increased risk of falls, stroke, and organ failure. The patient did not know of this potential risk factor and was made aware when we conversed. I believe this conversation really helped my patient feel more comfortable and confident with her medication list.