Editor's Note: In this interview, Erin Testerman-Mitra, BSN, RN, CWOCN discusses ways to help ostomy patients, including pre-operative measures, when convexity is right for the patient, and patient quality of life.

Transcript

Hi, my name is Erin Testerman-Mitra, BSN, RN, CWOCN. I am a certified Wound, Ostomy & Incontinence nurse in New York, New York. I work in the inpatient and outpatient colorectal division. And I love to meet any patient who isn't part of our practice but heard about us and wants some care in the outpatient world or they're coming to us for surgery.

In your experience, what are the essentials of caring for a patient with an ostomy?

So, you want to keep it as simple as possible. You want the patient to be able to do their own self care, and to do that we need to practice. Some essential things are just if you have a patient, you're going to have them bend and twist and stand up and lay down and kind of show you how they get out of bed to show you the kind of creases they're going to have on their body. In cases where they're preoperatively marked, they're really going to have a better, you know, better site.

So, the products you use are going to be like a flat skin barrier, and it works great. Or maybe you do need to use a flat and a ring and that seems to be what the patient needs. More often than not, we need some form of convexity. So the convexity can be firm or soft and that can be from the barrier itself either in a 1 piece or 2 piece style pouching appliance, or you maybe add rings that add convexity or inserts that add a convexity. But it depends really on that, you know, patient's topography and what they look like. Do they have a hernia? There's so many great companies that make all these products.

We had a conversation recently about patients who aren't able to cut their product. Some companies will use multiple technology or you can get a supply company to cut it for the patient once you kind of distinguish what size they are 6 weeks post-surgery. We also have options for, you know, people who have a herniation. They might need something instead of convexity, they might need something that con caves out or, you know, really accommodates the bulging and those products are available and reimbursable.

A lot of times when it comes to picking the best supply for your patient, it's one that their insurance will allow them to have. And really talking to the patient about, like, how to put it on, what's the best way to lift the skin and attach, you know, and letting them know that they can shower and they can go swimming and they can do all these things that they, you know, have an active lifestyle with a proper fitting pouching solution.

When it comes to accessories, a lot of patients really like those accessories. So it may mean to order a belt or kind of a band, but those products kind of give them more security. It's mental, but it's also, like, recent statistics show that they have a better pouching adherence, so less leakage, and they're able to, you know, go surfing or, you know, climb that mountain. And it's something that can seem so simple and so, you know, like underrepresented, but the supplies being used for our patients really do give them the quality of life back.

And the fact that we teach them how to do it themselves and they have that assurance that, you know, they can go anywhere and they travel and they can still, you know, have a pouching system that works for their bodies and sticks well, they deserve that. They deserve that confidence.

So, I really appreciate just the fact that we're able to educate our patients and we have all these supplies available. It's just, you know, getting to know your rep, getting to know the different supply companies and making sure you're getting the patient to do it themselves, because that's what will give them that confidence back and that security.

About the Speaker

Erin Testerman Mitra, RN-BSN, CWOCN started her nursing career at the Burn Center at Johns Hopkins Bayview where she practiced the latest research findings on complex wound treatments for traumatic injury and rare skin infections. She furthered her education as a Certified Wound Ostomy and Continence Nurse and moved to New York City to work with complex surgical wounds and develop an interdisciplinary practice with the inpatient and outpatient Colorectal division at NewYork-Presbyterian/Columbia University Irving Medical Center. She is active in community outreach programs and promotes positive ostomy awareness as an ostomy advocate utilizing social media platforms for international collaboration. Erin is completing her Masters' degree at The Columbia School of Nursing, is a nursing clinical instructor, volunteers with the WOCN National Member Engagement Taskforce and just completed four years of board leadership in Metro NY WOCN Affiliate.