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The best job in nursing - one woman's account of stomal therapy nursing

Photo: Carolyn Atkin
The best job in nursing, is how Carolyn Atkin describes her position as a Stomal Therapy Nurse.

“Every day is different and, despite the best of intentions, often does not go to plan but that is half of the fun!” says Ms Atkin.

“A typical day usually involves anything from seeing patients on the ward who have had a new stoma created and teaching them how to manage this, to reviewing a wound and providing strategies to support ward staff to manage this. 

“Other aspects of a ‘typical day’ may include answering telephone queries from patients at home, or telephone follow ups of patients who have recently been discharged.

“Patients may be seen in outpatients for education and stoma marking before surgery or after surgery for follow up or because an issue has come up with their stoma management.”
Stomal therapy nurses (STN) are registered nurses who have undertaken further education, enabling them to provide expert advice to patients, carers and other healthcare professionals on all aspects of stoma and fistula management.

A stoma is a surgically created opening on the body allowing for the passage of waste.

Many stomal therapy nurses are also able to provide wound management and/or continence clinical consultancy services. They also contribute to the development and delivery of specialty related education programs, as well as participating in research.

“A stomal therapy nurse is a vital member of the healthcare team for any person living with a stoma,” says Ms Atkins.

“People who have a stoma have unique physical and psychological needs, particularly when a stoma is first created. 

“Given the depth of knowledge and expertise, a stomal therapy nurse facilitates the patient with a stoma toward independence with their stoma and support them with any issues that arise during treatment and throughout the life of the patient.

“They are also an important resource for other healthcare professionals, providing expert clinical advice relating to stoma, fistula and wound management.”

Working across all areas of healthcare – inpatient, outpatient and the community – Stomal Therapy Nurses’ duties may range from some or all of the following:
  • Preoperative education and counseling for patients undergoing surgery that may involve the formation of a stoma,
  • Determining the best position for the stoma prior to surgery,
  • Postoperative education and support for patients and carers to promote independence in stoma care,
  • Ongoing support in outpatient clinics/community for people living with a stoma e.g. support for travel, parastomal hernia prevention and management,
  • Consultation service for management of fistula and/or wounds,
  • Liaising with community healthcare providers to ensure continued support,
  • Education – consumers, patients and other health professionals.

Due to the advanced and specialised nature of the role, a Stomal Therapy Nurse must have a minimum of two years postgraduate experience and undertake a Graduate Certificate of Stomal Therapy Nursing or a Graduate Diploma in Wound Ostomy and Continence Practice.

Many stomal therapy nurses also undertake further postgraduate studies in wound or continence management, progressing their careers to become nurse practitioners.

“Choosing a nursing specialty is one of the most important decisions nurses can make in their career,” says Ms Atkins.

“I suggest talking to a stomal therapy nurse you know, maybe working with that person for the day if you have the opportunity to do so. 

“This can always give you a great insight into the day to day life of a stomal therapy nurse.”

While it does incorporate direct patient care, Ms Atkins says the stomal therapy nurse role differs from that of a general nurse due to its consultancy focus, and the degree of autonomy and working across the hospital.

“It incorporates some of the managerial and educational aspects of nursing as well as having clinical care and service development components,” she says.

“The personality traits needed to make a good stomal therapy nurse are empathy, excellent communication skills and as a well-developed emotional IQ to guide practice. 

“A stomal therapy nurse needs to be organized but flexible and have the ability to adapt to change.”

Working with clinicians across all areas of healthcare, a stomal therapy nurse needs the ability to be able to function within a team, but also independently, as well as a commitment to ongoing professional development within the specialty. 

“Keeping up to date with such things as new products, surgical techniques and wound management developments.”

Ms Atkins says almost all of her career highlights involve patients.

“Helping people gain independence with stoma management and ‘get on with living’, whether that is simply helping them changing stoma products to give more security against leaks, teaching them stomal, or simply helping to dispel any myths or preconceived ideas about living with a stoma.

“(Another highlight was) sitting beside a patient in her late 30’s at her request to provide support as she explained to the surgeon that she had decided she did not want any further surgical intervention.

“Afterwards she told me that she wouldn’t have been strong enough to have that conversation with the surgeon without my support.”

Ms Atkins says being a Stomal Therapy Nurse enables you to follow your patients throughout their health continuum, providing support and care as their lives change.

“As well as the patients, you get to work with a team of dedicated health professionals who are all committed to providing the best care possible.”

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.