The purpose of this essay is to reflect on a practical skill that was developed during my recent placement. The skill focuses on the stoma care management as performed on various clients admitted in the ward. Additionally in this essay, ward procedure guidelines governing the skill performance will be discussed in effort to link available ward policies to recent evidence based practice and relevant interpersonal skills required for appropriate skill performance. Lastly, my general attitude and behaviour towards the skill will be addressed and analysed together with identifying the relevancy the skill to clients receiving stoma care. Putting the rationale for my chosen skill into consideration, I happened to attained special interest in previous Gastro intestinal system lectures where stoma care had been discussed theoretically. However, coming into contact with stoma care patients turned the theory into reality thus increasing personal interest. Besides that, stoma care is a rather complicated skill and potential problems of harm to the patient could arise if not well performed (Luscher 2007, p12) .Thus this essay not only aims on giving a reflection on the skill development but also aims to inform practice on appropriate code of conduct nurses should have prior to providing stoma care (NBM, 1998).
Exploring the gastrointestinal disease profiles proves numerous conditions of the bowel and bladder to be affecting people across all ages Burch (2008, p45). These amongst others include; colorectal or bladder cancer, ulcerative colitis, Crohn’s disease, severe faecal or urinary incontinence and trauma (Smeltzer et al 2008,p934). In most cases however, surgical treatment of these conditions may require formation of a stoma (WCET 2010). A stoma is defined as an artificial opening on the abdomen to divert the flow of faeces or urine into an external pouch located outside of the body (Black 2008, p30). However created stomas can either temporary or permanent depending on the patient’s condition (Breckman 2005, p73). Despite the duration of time a client is meant to have a stoma, its creation carries a huge effect on clients’ quality of life (Simmons et al 2009, p70).Looking at reports by WHO, it is estimated that 100,000 people in the UK are living with stomas today (Williams and Ebanks 2003, p90). On the other hand, the Malaysian society of Gastroenterology shows an estimated number of 3000 clients living with stomas today (Arokiasamy 2005, p8). The huge difference in prevalence levels is still vague although some literature blames it on variation in developmental levels. For that reason, a rapid increase is expected Malaysia due to on-going development by 2020 (Handelsman et al 2011, p19).
Looking back at the assessment criteria of this work piece, it is essential to first set out my personal expectations on stoma care stretching back from my first practice session, to my last. This will not only require me to integrate a reflective theory but also provide a clear picture of learning styles used for development. Identifying my learning style for skills as mainly visual I aimed to mainly observe various people train the skill. However, since nursing is a practical hands-on carrier, practitioners need to take up more learning development through physical performance (Moscaritolo 2009, p20). For that reason, my development went as follows. First, I undertook physical performance on dummies in the skills laboratory. This was done a couple of times and with much ease compared to real life hospital situations where patients were involved. Next I observed and assisted clinical instructors, doctors, staff nurses and sometimes patients themselves as they changed stomas occasionally in the hospital setting. This would help me compare who performed the procedure best amongst them all as I aimed to acquire management skills from best expertise (Baxter and Boblin 2008, p347). Analysing the three involved people in stoma care, I noticed...
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