How My Role As A Community Stoma Care Nurse Has Changed During The COVID-19 Pandemic
The Year of the Nurse! When this special year started, we had no idea what this would mean and how things would change beyond what we could have ever imagined.
Nurses all over the world have been tested and challenged. Roles have been adapted to suit the current situation, and stoma care has been no exception.
With that in mind, I thought it may be of interest to share how my role as Community Stoma Care Nurse has been adapted, and what this has involved.
Community care for stoma patients is usually carried out in the home or in a clinic setting – however due to the Government guidance surrounding COVID-19, it hasn’t been possible to fully sustain this. As of mid-March, all our community clinics were cancelled, and home visits were done only if essential. As a service however, we still wanted to provide the same standard of care and commitment to our patients that we have always given. So, in order to do this we have set-up virtual reviews with our patients, and I have been involved in carrying these out.
The reviews consist of phoning patients that we had already planned to see in clinic or for a routine home visit. This includes their second or third post-op visit (the first is still done face to face), which means these new stoma patients are still well supported.
Patients have been receptive and understanding of the new system, right from the start.
Because many of our patients are in the vulnerable category due to their age/diagnosis/treatment, the majority were pleased that we weren’t coming to their home and risking exposing them to any infection, and a lot were and are self-isolating. I soon realised therefore, that not only was there a need for stoma support, but also for company as for some patients, we were now the only people they were in regular contact with.
In such a time of fear and uncertainty, a chat has become an important part of caring for that patient. It has been interesting to hear what some have been doing, and to hear their thoughts and views of these strange times.
To carry out my work as a Stoma Care Nurse I may need to see the stoma itself rather than just discuss it on the phone, so in those cases I have been offering video calls to patients.
Understandably, not all want to, or have the facility to do so, in which case I suggest they can send me a photo next time they change their bag - I then phone them back to discuss and give advice about what I see.
It’s best to arrange these calls for when patients will have their stoma pouches off – during a change perhaps, and that they have our skin health tool to hand so we can best discuss the condition of their peristomal skin (the skin around your stoma). We have had some fun and games, I’ve seen a lot of ceilings and floors! Partners have been very patient and great in helping too, and mostly people are very good at knowing where to place their device so I can adequately see the stoma.
Stomas have been measured, skin health has been checked, pouches have been looked at, and the use of washers and flange extenders have been demonstrated from my end.
This has been essential for empowering patients to manage their stomas and attaining a good quality of life, but I have also found it important as I’m speaking to a lot of patients I have never met before, so it’s nice to put a face to a voice - and likewise for the patient I suppose!
After each review, I always ensure our contact details are given, whether that be our office or my email and we arrange a time for our next review if necessary. So far, most issues have been resolved over the phone, and home visits has been avoided. At times, I have done a weekly call to check if skin is improving and if leaks are resolved. But overall, we continue to follow the same pathway for reviews for the first year of a patient’s stoma journey.
As a service we have faced challenges never seen before and I am proud to work with a team of nurses who have met them with such skill and courage, as they continue to give excellent face to face stoma care in the hospital setting and where there is an essential community need.
In conjunction with this, I hope that the virtual reviews have helped support that care and ensured we have met the challenges we have faced. We have successfully adapted our roles, whilst still offering our patients the best possible care. We are asked in The Year of the Nurse if there is ‘one way you’ve made a difference’ - I hope by adapting my role, I have done just that!
My final thought… video calling is great and I’m so pleased we have it, especially in these difficult times. Some patients have asked though, if this is the way things will go in the future – I have no idea, but one thing I have realised over the last few months, is that as a nurse, human touch and face to face contact is still so important. So, whilst we will utilise the technology we are so lucky to have, I am still looking forward to the day when we can all actually see each other again!
“I am proud to work with a team of nurses who have met the challenge of COVID-19 with such skill and courage.” – Sophie Page