GOING INTO HOSPITAL
WHAT TO EXPECTGoing into hospital can be unsettling for most people and for some it can be quite terrifying. We hope this short guide will settle at least some of your anxieties and equip you (albeit only slightly) for the experience.
Going for testsWhen going to the hospital for tests you may be required to attend as a day patient or even as an out patient depending on the level of tests to be undertaken.
You can find out more about the tests that may be done by jumping to TESTS
DIAGNOSIS
This will largely depend on the tests that have been undertaken and the interpretation of the results by the relevant specialists.
Either your GP or the hospital will contact you as soon as the results are known. Your GP may want to see you to discuss the implications. A date to attend the hospital will be given to you and you will then be put in touch with the STOMA CARE NURSE.
THE STOMA CARE NURSE Changes within the NHS structure have lead to the introduction of "hospital groups". This means that instead of all the hospitals within a region being responsible for all conditions, each hospital within the group will specialise in certain aspects of care e.g. heart, paediatric or cancer etc.
The centralising of skills creates "centres of excellence", which it is believed will be able to provide a better service to the customer. In reality it often means that the customer will be required to travel or become an in patient at a hospital which is far from being the most convenient to themselves or their family.
There are approximately 400 centres in the UK offering specialisation in bowel surgery. Each of these centres has at least one clinical nurse on staff specialising in stoma care who will provide practical advice and sometimes home visits after the surgery is complete.
These nurses rarely have other responsibilities and are able to devote their entire day to caring for and advising patients, within their region, who have been through the experience of stoma surgery.
click here for a SPECIAL WARNING otherwise ignore and continue.
I am sure you will have many questions needing answers as to how the surgery will affect various aspects of your life. Diet, travel, sport and sex are some of the most common place. It worth making a list of your concerns and talking them over with your stoma care nurse at your pre-operative visit. Remember, never be embarrassed to ask no matter what the subject matter. If it is important to you, then it must be discussed, and your nurse has been specially trained to help work through any worries you might have.
In many cases the nurse is able to find someone who has already had the same surgery as you and can get them to come and talk to you about their own experiences. YOU MAY HAVE TO REQUEST THIS!
The fact is, that no matter how well informed your nurse may be, knowing about it isn't the same as living with an "altered body image" and contact with existing ostomists through the self help groups can be invaluable. For more information on such groups, check our SUPPORT GROUPS list.
WHAT IS A STOMA? The term stoma is derived from Latin meaning mouth or opening.
This is the point where your bowel contents will be discharged into a bag that you will be wearing once you return from the operating theatre.
The stoma is intestine that is brought to the skin surface and then turned back on itself (like the top of a farmers wellington boot). Like all body parts, every stoma shape and size is different. It might be large or small, flat or proud, oval, round or apparently mis-shapen so do not worry if it doesn't look quite like the pictures you see here.
As intestine has no sensory nerve endings you will feel no pain within the stoma itself, though the opening to the abdomen may well give some pain initially (hardly a surprise considering the skin has been cut open during the operation).
You will notice a significant difference between the varying type of stoma operation. This is due to the nature of the waste that will pass out of the stoma.
As these next pictures show, the type of appliance used to deal with the waste varies accordingly.
The colostomy pouch will collect solid waste (not unlike a normal bowel motion) and is removed and discarded totally.
The ileostomy pouch collects a more liquid form of motion and as such can be drained when full to preserve the skin from the constant removal of adhesive endured by the colostomist.
The urostomy pouch is dealing with urine and is predictably the trickiest pouch of all to seal to the skin successfully. This does not mean however, that it can't be done. Although it may take longer to find the correct combination of pouch and skin care products to suit you. Once mastered a good drainage tap will allow the longest use of any stoma pouch resting the skin for longer in between pouch changes.
SPECIAL WARNING During the last 8-10 years there has been a frightening rise in the number of product manufacturers and distributors who "sponsor" stoma care nurses.
What this means in practice is that (usually without the nurses involvement) a restrictive deal is agreed between the 'sponsor' and the Hospital Trust so that a sum of money (never publicly disclosed) is paid to the hospital in exchange for near exclusive use of that companies products and/or supply service.
We have been alerted to a number of unhappy situations where patients have felt pressured by their nurse into using a product or service that is not their preference. Even where no actual 'sales targets' exist, the nurse often feels morally obliged to promote the sponsoring company, to the exclusion of others, in order to justify his/her cost to that company. Where a nurse proves to be unprofitable there is always a risk that the sponsor will withdraw funding and nurses have lost their jobs when too few 'products' have been promoted to their patients!
With almost 400 UK posts now sponsored at hospital and/or community level it is unlikely that you will be able to avoid the pressure to use a particular company. YOU DO NOT HAVE TO DO SO!
You DO have the right to see and select other products from other manufacturers!
There are eight major product manufacturers in the UK and countless supply companies to which you should be given access. If you feel that you have only been offered a limited range of products and only one supply company the chances are your nurse is sponsored. A fact that will undoubtedly be kept from you.
Despite defensive protests from both the sponsoring companies and the hospitals in league with them that there is nothing wrong with these arrangements, neither are prepared to advertise the fact that the specialist nurse is no longer employed by the NHS, nor give the financial details to any enquirer!
Every patient has a right to make choices about products and who they will use to dispense their prescription, sponsorship deals try to deny these rights. If you feel that you have been denied access to other products and would like to see what else is available, Rapidcare offer a totally independent sample service.
Rapidcare are opposed to deals that fly in the face of the patients charter and have fought long and hard to overturn the authority that allows them to continue. As yet we have been unsuccessful.
To see the relevant pages click here PATIENTS CHARTER.
To return to the text click here RETURN.
