Our team did need to revise our topic and question slightly. Our topic involves mental health and psychological affects after an amputation. We ended up getting rid of the time component as it wasn’t necessary and thinking more about what specific negative psychological effects we could look into such as anxiety, anger, hostility, and the tendency towards social isolation. It was a bit challenging to revise our PICOT question at first, but I feel that we were able to make some good improvements. A success we experienced was finding three good articles for our paper. We looked into a lot of articles regarding amputation and decided ours should be focused more on traumatic amputations versus planned amputations. I think focusing on traumatic amputations will make it easier to explore negative psychological effects. Our process of finding the articles worked well as we each picked a few we though would work, and then went through the articles together to pick the most relevant ones.
Month: February 2022
The purpose of an ostomy diversion is to divert fecal drainage through the abdominal wall by means of a stoma (Hinkle et al., 2022). The ostomy appliance is placed over the stoma and is sealed to the skin. The appliance consists of a bag, and an adhesive portion that is cut to fit around the stoma. Ostomy diversions are often indicated in patients with diverticulitis, ulcerative colitis, irritable bowel disease, and colorectal cancer (Hinkle et al., 2022). Before wearing the ostomy, the nursing care, I perceived was mainly about preventing skin breakdown around the stoma and keeping it clean. Another element of nursing care that I focused on prior to wearing the ostomy appliance was emptying the bag when it got to be about 1/3 of the way full. The purpose of this assignment was to put myself in the shoes of an ostomy patient and gain insight into what challenges they face, and how they go about caring for their ostomy appliance throughout the day. I think this experience will help me improve my care of clients with ostomy diversions because I was able to gain a new understanding of what it is like to wear an ostomy appliance and the challenges that come with that.
Physically, I did experience a few difficulties with the ostomy appliance. I did not experience much gas collection, or device malfunction. I did have some trouble finding clothing to accommodate the ostomy appliance and figuring out how I could adjust the appliance, so it didn’t feel like it was moving around all day. What worked best for me was to partially tuck the appliance into the waistband of my pants and wear a baggy shirt or sweater. This was most comfortable for me, and I felt I could move around easiest this way. Another difficulty I faced was skin irritation. I have sensitive skin, so I was expecting to see some skin irritation after removing the ostomy appliance. Throughout the two days of wearing the ostomy appliance the adhesive part felt itchy and when I removed it there was some redness and irritation, which went away in a few days after using moisturizer.
One instance where I felt some anxiety wearing the ostomy appliance was when I went to spin class. I felt worried that the appliance was very visible, or that it would somehow open, and I also kept feeling that I needed to adjust the appliance. I did not withdraw from social activities, but while I was out with my friends I would often think about the appliance or readjust it. Both of my roommates were also wearing the ostomy appliance, so I did not feel any different at home, and it was helpful to all be doing it at the same time.
I think it would be difficult both physically and mentally to have to perform ostomy self-care at first as it is a big life change. Personally, I would feel some repulsion when first looking at the stoma and emptying the pouch. Taking on another aspect of taking care of your own health is also challenging, so I would expect there to be an adjustment period before getting into a solid routine of ostomy care.
One important observation I made during wearing the ostomy appliance was that there is a big psychological impact along with the physical aspect. My perceptions did change a bit regarding helping patients care for the ostomy appliance. I would still focus my care on helping the patient be able to successfully change their ostomy bag and keep it clean, but I would try to spend an equal amount of time on assessing how they are doing mentally and helping them to effectively cope with this new device. I would focus my client teaching and education on finding ways to care for their appliance that make them the most comfortable, such as suggesting certain clothes to wear, and bringing supplies with them in case they need to empty the bag when they are not in their house.
This activity changed my perspective on the effects caring for an ostomy appliance can have on a patient, as I did not really think about the psychological impact this could have prior to doing this activity. In the future when I am caring for clients with ostomy diversions, I will be more mindful about what they could be going through and try to cater my care to that. This was a good learning experience for me as I learned a lot more about the care of an ostomy appliance and how to help the patient in a better way. My advice to future students would be to go into this activity with an open mind and to think about ways to help make this time of transition easier for the patient.
I think that this team project will be accomplished through setting out clear goals and ideas to keep us on track. Our communication plan involves splitting up the work evenly and keeping a google doc of all our ideas and notes that we can put towards our project. We have been using this to help decide on our topic for our final paper. We can hold ourselves accountable by setting clear due dates for when we need to get a section of the project done and reminding each other about what work we need to complete. Our plan for conflict management involves being open with each other if we feel someone is not doing enough work and making checklists for each of us to stick to, although I do not think we will face any barriers during this project. One benefit to completing this project as a team is that we can bounce ideas off each other and learn how to collaborate while doing research. This will be helpful in future nursing practice as healthcare workers of different professions often come together to work with each other on research and finding the best way to provide quality patient care.
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