Emma is a Stoma Clinical Nurse Specialist (SCN) at Basingstoke and North Hampshire Hospital and works closely with Pelican.
How does Pelican help you and your colleagues?
With the multi-disciplinary team (MDT) meetings being held in Pelican’s purpose built room, I have exposure to the charities work, keeping me up to date with the latest developments in the innovative research that Pelican supports. I can attend and participate in educational courses that benefit my development as a SCN, which in turn aids the care that I can deliver to my patients. I am also part of Pelican’s faculty and this enables me to explore the care that I provide for patients and this ensures that I keep the service we offer up to date and relevant.
What attracted you to the role of being a SCN and what are the rewards of your job?
I enjoy problem solving and will quite often have to deal with complications with the stoma*, which are impacting quality of life and wellbeing; I feel a real sense of achievement when I can resolve them, enabling the patient to overcome the issue and return to their daily routine. It’s a real privilege being a stoma care nurse; I am involved with the patients at their most vulnerable time, when quite often their world has stopped. They are frequently quite frightened or scared and I follow them through each stage of their treatment, supporting them and their family to manage the best that they can. My job gives me the opportunity to work closely alongside each patient and it is very humbling to know that I have been part of their journey to help towards restoring their quality of life.
*A stoma is an opening that is made on the wall of the abdomen, which allows food waste to pass out of the body to be collected into an external pouch. There are different types of stoma dependant on the treatment each patient undergoes and it may be temporary or permanent.
What does ‘a day in the life of a stoma nurse’ involve?
My day can be quite busy and diverse. It varies from looking at all stages of the patient pathway, from in patients and regular follow ups with patients who have been discharged from hospital, to complex stoma and fistula management and counselling patients who have been told that they need surgery resulting in a stoma. I also see patients with long-term complex issues for example; high stoma output and then I liaise with members of the MDT to formulate a management plan to enable the patient to be cared for in primary care within the community. I also support hospital staff with the management of stoma care with teaching and guidance, so that if a patient with a stoma is admitted to hospital, their needs are met.
What is your role within the MDT and why is it important that a SCN is included?
For each MDT clinicians will meet to have a collaborative discussion about our patients and the joint input will influence the decision making process. As a SCN my main focus is based on the patient’s ability to cope with the type of stoma that may be required. This will be influenced by the patients’ lifestyle, dexterity and the stomas effect on their activities of daily living and quality of life; also with the consideration of stoma reversal and long-term bowel function.
How do patients react when they need a stoma?
When we are dealing with patients on a cancer pathway it can be quite upsetting for the patient to be informed that they will need a stoma. This is often because they have limited insight into stoma care and have heard or looked at negative information, often on the internet or social media. As SCN’s we have a lot of clear information about stomas from our industry partners and charities such as the Pelican Cancer Foundation, which assists us in giving details in a manageable and appropriate way. We also sign post patients to stoma support groups where they are able to gather more information and have the opportunity to meet and talk to other stoma patients. As a SCN I can’t alleviate everyone’s fears and anxieties, however just by talking through aspects of stoma care, showing them stoma pouches, the products and how they work, for example, filters so that they know that they won’t smell, can commonly alleviate some of the initial anxieties that the patients will have. We will also discuss their lifestyle and how a stoma will fit in with their everyday life – that they will still be able to work, enjoy leisure activities such as swimming and go about their normal day – with very little limitation and concern about the stoma being noticeable or problematic. My role is based on building a strong and trusting rapport with each patient so that I can knowledgeably inform them about all of the options, which helps them to make an informed decision about their care.