Stoma care during a hospital admission | by Rachel

Needing to go to hospital with a stoma can be a very daunting experience, especially if you haven’t had to go post-surgery. Whether it is stoma related or not, we need to think about more things than a patient without a stoma. Here are a few things I use and have learnt in recently months:

Being prepared

We all know how important it is to have stoma care kits for different scenarios such as in the car, in your bag, and in your home, but do you have one ready to go for an emergency hospital trip? In all fairness, the one you have in your car or a spare for other uses will suffice in an emergency, but if you or the person you care for is prone to needing medical intervention, it wouldn’t hurt to have a bag ready. Make sure with your extra bags of supplies that you do stock rotation just as you would when you get a delivery. In the warmer months especially when kept in the car, the integrity of the products can change above certain temperatures. Make sure to check the labels. You may have your bases cut already, however you may find if you have a gastro bug that your stoma shrinks in size. For this reason, be sure to have some that are not cut as well.

Nappy hack

Yes you are reading that correctly, a nappy hack! When I had become poorly with little notice and my output rocketed on the school run a few months back, I could feel my stoma bag become itchy and I knew the pressure underneath my jeans with the sudden huge volume had caused a leak. Being in the car driving I couldn’t do anything about it apart from grab a nappy and think to wrap it open, around my waist covering the bag as much as possible. This acted as the perfect plaster to absorb the leaking until I could get home and sorted. Of course if you don’t have a baby, you won’t have nappies spare in the car, but if you know someone that does it’s definitely worth asking to use in case of emergencies. If you are going to the hospital in the car whether you have to drive yourself or have a lift, this hack can save a lot of mess.

Admission

If you are admitted, be sure to let hospital staff know you have a stoma, which type it is, and if you need supplies. Triage staff need to know you are at high risk of dehydration if high output is the problem. Be warned that stoma nurses do not typically work outside standard working hours of 9-5. You may struggle outside of this if you need to see one. Some wards have keys to stoma supplies which could be locked outside of the stoma nurses working hours should you need them. You may be lucky and have nurses on shift that are familiar with stomas, and find some supplies elsewhere. Failing that, ask a loved one to bring some to you. If hospital staff are able to get supplies for you, don’t expect for them to have the exact ones you use. Make sure to tell them if you use convex or non convex, and soft or hard. You may have some staff not too experienced with stoma care, and it might take some explaining so be patient with them, and they will help you the best they can.

High output hack

If you have very high output, your normal stoma bag may not have the capacity to allow for this. You may need to change the size completely due to the volumes per output, and you may find with an ileostomy, if the consistency is water, it is causing leaks that you wouldn’t necessarily have. Changing your stoma bag to one with a tap on the end is worth its weight in gold. Typically these bags are used for urostomy patients. Nursing staff can provide you with a catheter bag to attach to the end, meaning the output can drain away without putting pressure on the base of your stoma bag which could cause leaks. During a recent hospital stay for my eldest who was losing litres of output a day, this hack changed him from having three bag leaks the first night, to none the rest of the stay. The collecting of stool in the catheter bag will also help nursing staff empty and monitor the output easier if they are doing a fluid balance. It also makes for a much messier job of emptying.

Finally, be your own advocate

Being in hospital is awful enough, but when you have a stoma to contend with, it can feel very difficult to stay positive and not get down about it. High output, especially when it is at its worst, can feel relentless and never ending. Medical staff are there to help you, and if you feel you are not being heard or the treatment plan is not working, make sure to speak up for yourself and be your own advocate. If this is difficult for you, have family or friends support you when you talk and write it down so you are prepared with what you want to say.

Rach
@gutsy.mum