Another theme suggested the need for not only
patients to be supported but family and friends too.
Therefore, to ensure adequate support is provided
throughout the surgical process, the educational
learning package could include a gender specific
checklist to address patients concerns including
pregnancy and erectile dysfunction. However, the
LGBT foundation (2017) suggest that for this to be
effective, transgender patients should be able to
express their concerns considering not only their birth
sex but the gender they identify as too. Additional to
this, a separate checklist could be devised specifically
for relatives and peers. The content for this tool
would be slightly different focusing on how much
understanding of a stoma the friend or relative has,
identifying signs of infection and providing the nurse
to discuss these areas if necessary. Krouse et al
(2016) found that not addressing concerns before
discharge often affects how relatives and friends
care for their loved ones as they commonly feel
unconfident and unsure. If these negative feelings of
uncertainty continued, a flowchart should be available
in the educational learning package which highlights
additional support patients, spouses or peers could
access including charities and helplines.
To aid adult nurses in improving their knowledge and
confidence around stoma management, a section
of the learning resource would include current
information regarding topics to inform patients
pre and post-operatively such as reintroducing
exercise into their daily routine, painkiller addition
and symptom management to name a few. For
nurses to provide this information to patients allows
them to know what to expect during recovery and
if complications do arise, this information would
hopefully help patients know how to cope with these
situations. It is also important for nurses to discuss
other aspects of stoma management following
discharge such as traveling as this can often be
problematic for patients. The educational learning
package could include points that nurses should
discuss with patients such as what to eat or avoid
before travelling as well as a checklist regarding what
essentials need to be packed. To ensure healthcare
professionals are consistently learning, McGeever
18
(2013) emphasises the importance of current
information so the educational package should be
regularly updated.
Lastly, it would be useful if the educational learning
resource could include a timeline for patients that
gave an overview of their pre and post-operative
journey. Having the chance for nurses to discuss what
happens in theatre, what skills will be covered with
nurses post-operatively such as changing the stoma
pouch a would hopefully make the surgical journey
less overwhelming.
Conclusion
To conclude, it is apparent from the various studies
and experience in the local NHS trust, patients often
face challenges when adapting to their newly formed
ostomy. This process is often not helped by adult
nurses who feel unconfident and unable to provide
thorough advice regarding stoma management. It is
essential that these issues in practice are overcome
to ensure that patients receive well supported,
effective care that meets their mental and physical
needs. Additionally, nurses education needs to
be addressed to ensure their confidence around
ostomy care improves. The introduction of an
educational learning package would hopefully provide
healthcare professionals with current, evidence based
information that can be transferred patients to allow
them to make informed decisions regarding their
treatment. This information alongside useful tools
that could be accessed if the learning package were
to be implemented into clinical practice would also
hopefully reduce patients’ risk of becoming anxious or
depressed following surgery. These resources could
also be extended to benefit patients’ relatives and
friends too, preparing them to deliver effective care.
Therefore, it is essential for nurses and patients to
build rapport during this surgical process, working
together to personalise care and improve healthcare
professionals future practice.