Enterostomal Therapy - An Overview

Introduction:

An enterostomal therapy nurse is a registered nurse (RN) with specific training in managing ostomies, including ileostomies, colostomies, and urostomies. These nurses are occasionally referred to as stoma nurses, particularly in Europe. In addition, enterostomal therapy nurses provide care for wounds and incontinence.

What Is Enterostomal Therapy?

Treatment offers care for those with ostomies, such as colostomies or urostomies. An expert who has received training in enterostomal therapy, or ET nursing, can assist a child in using and caring for an ostomy. This nurse may provide in-hospital treatment for a child or visit the house as a home health aide to assist with the child's ostomy care. Patients receiving enterostomal therapy are given specialist care for conditions such as:

• Stomas: During ostomy surgery, the doctor creates a stoma in the patient's body to let excrement or pee out. Extra care must be taken around the opening of the abdominal wall to prevent infection or other consequences.

• Complex Wounds: Bedsores, also known as pressure ulcers, develop when the skin's surface is compressed by weight, preventing blood flow to the affected area. Elderly people and bedridden individuals who are unable to shift positions frequently develop pressure ulcers.

• Incontinence: Patients experiencing incontinence may experience skin irritation from urine and feces. If not treated, skin irritation can result in more serious wounds and consequences.

Enterostomal therapy-focused nurses are valuable healthcare team members in office, hospital, and home environments.

What Are the Side Effects?

Numerous hazards and difficulties can arise from having an ostomy, particularly in children. Among them are, for example:

• Personal Cleanliness: It is important to clean the child's ostomy site thoroughly to avoid infection, irritation, unpleasant odor, and undue discomfort. Keeping a child's ostomy clean may be difficult, or one may worry about cleaning it better. If a child has a urostomy or colostomy, an ET nurse may assist in keeping the ostomy clean and hygienic and teach them how to change the ostomy bag. Additionally, the equipment, including the bag, can be modified to make it more comfortable for the youngster.

• Emotional Problems: Anyone dealing with an ostomy may find it embarrassing or challenging, but kids may be particularly affected. Because they feel ashamed or concerned about spills, kids with ostomies may not want to hang out with their peers. Depression and other mood disorders may result from this. An ET nurse can teach any kid how to take care of the ostomy in a way that will reduce accidents and help a child feel less embarrassed, even though it cannot make a child feel better on their own.

To What Extent Are ET Nurses Trained?

Every task performed by ET nurses is highly specialized and necessitates a specific level of training. In addition to their license as registered nurses, ET nurses will hold a bachelor's degree. After that, a nurse needs to finish either a Wound, Ostomy, and Continence Nursing Education Program or 50 hours of experience. An additional certification exam administered by the Wound, Ostomy, and Continence Nursing Board (WOCN) must be passed by the nurse.

What Are the Advantages?

Enterostomal therapy provides care, support, and training for a child's ostomy, which benefits both the parents and the child. A triage nurse can assist by:

• Improving the usability of a child's ostomy.

• Lowering the dangers of a colostomy or urostomy on one's health.

• Teaching the functions of the ostomy to a child.

• Training children to use, clean, change, and maintain the ostomy will reduce the likelihood of mishaps or adverse effects.

How Can Patients Get Ready?

Making an appointment with the ET nurse and knowing what to anticipate during their visit will help the child prepare for enterostomal treatment. If the child has a new ostomy, one may wonder how to keep it clean and pleasant when the nurse is not around.

One should write down all the questions they would like to ask the ET nurse and discuss them with her until they feel they understand everything. They have a right to know everything about the medical care the child is receiving. If there are any questions the ET nurse cannot address, they should make an appointment for the child's physician to follow up.

What Is the Job of an ET Nurse?

Patients may receive care from an ET nurse before, during, and following ostomy surgery. An ET nurse may be a patient's first and main point of contact for information on their ileostomy, colostomy, urostomy, and stoma.

• Before Surgery: If ostomy surgery is not performed urgently, an ET nurse may assist a patient with stoma insertion during the initial appointment. An ET nurse can also help a patient choose the best location for a stoma, such as away from the waist so that clothing does not obstruct stoma outflow by considering lifestyle and clothing.

• Following Surgery: An ET nurse can help in various ways once a patient returns home. Changing an ostomy appliance needs practice and patience. The patient can learn how to change their ostomy equipment at home with the help of an ET nurse, who can also help with the initial few changes. An enterostomal therapy nurse can guide the most effective way to address an issue, such as leaking, and assist in troubleshooting it by recommending a specific method or specialized appliance.

Enterostomal therapy nurses frequently work with patients for an extended time, particularly when the patient needs continuous assistance in changing their appliance (patients who are elderly, crippled, or have limited vision). Especially after surgery, ET nurses frequently visit patients in their homes to assist with common concerns, including pain from the procedure and the adjustment to living with a new stoma. As surgical team members, ostomy nurses may assist with the actual surgery.

What Is the Adverse Reaction of Enterostomal Treatment?

Adverse Reactions to Enterostomal Treatment: Ostomies are safe and effective when properly maintained and used. Nonetheless, one should be informed that there might be some adverse consequences. Consult the ET nurse or child's physician if one observes any of the following:

1. High temperature.

2. The odor persisted for more than a week.

3. Persistent irritation in the area surrounding the stoma.

4. Vomiting, queasy feeling, or stomach ache.

5. Absence of bowel motions.

Certain symptoms may indicate a more serious issue. If one observes that the child has any of the following, then one should take the child to the emergency room:

1. Black or bloody bowel motions.

2. Bleeding persistently in the ostomy.

3. Extreme weakness.

4. Intense stomach ache.

Conclusion:

Nurses who specialize in enterostomal therapy (ET) care for patients who have chronic wounds such as pressure ulcers and vascular ulcers, fecal and urine incontinence, and draining wounds and fistulas. There is much that ET nurses can contribute to the care of cancer patients. Incontinence, radiation therapy, immobility, and flaky skin can all cause skin breakdown, which ET nurses can advise on how to prevent and manage. Additionally, they can help with the cost-effective care of draining wounds and fistulas and correcting or containing fecal or urine incontinence.