JSTA December 2010 - Australian Association of Stomal Therapy ...

Print Post Approved PP 642521/00041 

ISSN 1030 5823 

The Journal of 

Stomal Therapy Australia 

V O L U M E 3 0 N U M B E R 4 D E c E M B E R 2 0 1 0 

Case studies: Hollister Adapt Barrier Seals 

(7805) used in conjunction with negative 

pressure therapy dressing to maintain 

moisture control in complex wounds 

Reflective essays 

Iran, an experience 

Stomal Therapy Nurses of Newcastle 

give Birth OR 

Articles printed in the Journal Stomal 

Therapy Australia: index 2008-2010

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aaStN Code of Ethics 

The Journal of 

Stomal Therapy Australia 

Volume 30 Number 4 – december 2010 

ISSN 1030-5823 

Copyright © 2009 by the 

Australian Association of Stomal Therapy Nurses Inc. ABN 16072891322 

• The stomal therapy nurse must at all times maintain the 

highest standards of nursing care and professional conduct. 

• The stomal therapy nurse will provide needed services to 

persons irrespective of their race, colour, creed, sex, sexual 

preference, age and political or social status. 

• The stomal therapy nurse must respect the beliefs, values 

and customs of the individual and maintain his/her right to 

privacy by maintaining confidentiality, sharing with others 

only information relevant to that person’s care. 

• The stomal therapy nurse will not participate in unethical 

practice. 

• The stomal therapy nurse must maintain competency by 

keeping abreast of new developments in the theory and 

practice of stoma care and related fields. 

• The stomal therapy nurse will participate actively in 

professional, inter-professional and community endeavours in 

order to meet the highest professional standards. 

• No full member shall be in the employ of a company or selfemployed 

in the manufacture or sale of products, prostheses 

or pharmaceuticals where it could be perceived that the use 

or selling of products prostheses or pharmaceuticals could 

disadvantage or contradict the personal preference of clients 

or be construed to result in unethical conflict of interest. 

Published four times a year by 

a division of Cambridge Media 

10 Walters drive, osborne Park Wa 6017 

Web www.cambridgemedia.com.au 

Copy Editor Rachel Hoare 

Graphic designer Sarah Horton 

advertising enquiries to 

Simon Henriques, Cambridge Publishing 

Tel (08) 6314 5222 Fax (08) 6312 5299 

Email simonh@cambridgemedia.com.au 

disclaimer The opinions expressed in the Journal of Stomal Therapy Australia 

are those of the authors and not necessarily those of the Australian 

Association of Stomal Therapy Nurses Inc., the editor or the editorial 

board. 

contents 

President’s report 3 

Editorial 4 

Articles 

Case studies: Hollister Adapt Barrier Seals 

(7805) used in conjunction with negative 

pressure therapy dressing to maintain 

moisture control in complex wounds 6 

Reflective essay: Stomal therapy nurse: 

a year in the making 14 

Reflective essay 17 

Reflective essay 22 

Iran, an experience 27 

Stomal Therapy Nurses of Newcastle 

give Birth OR 31 

Conference report 32 

WCET report 32 

ACSA report 33 

State reports 34 

Articles printed in the Journal Stomal 

Therapy Australia: index 2008-2010 38 

Editorial Board 

lorrie Gray RN MSc(Ed) BSoc SC STN 

WA Branch STNEP Coordinator 

Keryln Carville RN PhD STN (Cred) 

Silver Chain Nursing Association 

Julia Kittscha RN STN BHSc 

Wollongong Hospital, NSW 

Julia thompson RN PhD STN 

St Vincent’s Private Hospital, Sydney 

Journal of Stomal therapy australia – Volume 30 Number 4 1

directory 

ExECutiVE CoMMittEE 

President Sharmaine Peterson 

St Andrew’s Hospital 

350 South Terrace, Adelaide, SA 5000 

Tel (08) 8408 2164 (w) 

Email sharmainep@bigpond.com 

V/President Helma riddell 

GSAHS, PO Box 159 

Wagga Wagga, NSW 2650 

Tel (02) 6938 6487 

Mobile 0427 460 024 

Email hermanna.riddell@gsahs.health.nsw.gov.au 

treasurer Vanessa rhodes 

Royal Hobart Hospital 

48 Liverpool Street, Hobart, TAS 7000 

Tel (03) 6222 8283 

Mobile 0409 807 827 

Email joco7595@bigpond.net.au 

Secretary Margaret Fraser 

3/70-74 Brunswick Road, Brunswick, VIC 3056 

Tel (03) 03 9388 0791 

Mob 0410 417 287 

Email margaretfraser5@bigpond.com 

Membership robyn Simcock 

Coordinator PO Box 153, Floreat, WA 6014 

Mob 0417 627 970 

Email rmsimcock@bigpond.com 

Editor theresa Winston 

Fraser Coast Health Service, Hervey Bay Hospital, 

PO Box 592, Hervey Bay, QLD 4655 

Tel 0438 738 074 (w) 

Email theresawinston@gmail.com 

Committee Sue delanty 

Launceston General Hospital 

Charles Street, Launceston, TAS 7250 

Tel (03) 6348 7832 (w) 

Mob 0417 395 536 

Email sue.delanty@dhhs.tas.gov.au 

debra d’Silva 


6 Sundercombe Street, Osborne Park, WA 6017 

Tel (08) 9242 0242 

Mobile 0410 222 048 

Email debiedsilva@hotmail.com 

Genevieve Cahir 

Northern Hospital, 185 Cooper Street 

Epping, VIC 3076 

Tel (03) 8405 8597 

Mobile 0417 385 533 

Email gencahir@internode.on.net 

Education Fiona Bolton 

Subcommittee 64 Carlisle Street, Ethelton, SA 5015 

Mob 0418 266 680 

Email fionabolton65@optusnet.com.au 

WCEt id Brenda Sando 

46 Lugano St, Riverhills 4074 

Tel (07) 3376 5409 

Email: bsando46@bigpond.com 

CPd & Sue delanty 

Credentialling Launceston General Hospital 

officer Charles Street, Launceston, TAS 7250 

Email sue.delanty@dhhs.tas.gov.au 

2 Journal of Stomal therapy australia – Volume 30 Number 4 

Website Karen McNamara 

Coordinator Acute Home Care Service 

Joondalup Health Campus, 

Shenton Ave, Joondalup, WA 6027 

Tel (08) 94009297 (w) 

Mob 0431 603 230 

Email mcnamarak@ramsayhealth.com.au 

Public officer Carol Stott 

Stomal Therapy Department 

Dickinson 2 North, Prince of Wales Hospital 

Barker St, Randwick, NSW 2031 

Tel (02) 9382 3869 

Email carol.stott@sesiah.health.nsw.gov.au 

SPaP liaison diana Hayes 

CNC/Stomal Therapy, Western Hospital 

Gordon Street, Footscray, VIC 3011 

Tel: (03) 8345 6553 

Mobile: 0428 441 793 

Email diana.hayes@wh.org.au 

aaStN StatE rEPrESENtatiVES 

aCt Kellie Burke 

CNC Stomal Therapy 

The Canberra Hospital, PO Box 11, Woden, ACT 2606 

Tel (02) 6244 2222 page 50959 

Fax (02) 6205 2829 

Email kellie.burke@act.gov.au 

NSW Jenny rex 

CNC 

Royal Prince Alfred Hospital 

Missenden Road, Camperdown, NSW 2050 

Tel (02) 9515 8990 

Email jenny.rex@email.cs.nsw.gov.au 

Nt Jennifer Byrnes 

Royal Darwin Hospital, Rocklands Drive, Tiwi, NT 0810 

Tel (08) 8922 8888 

Email Jennifer.byrnes@nt.gov.au 

Qld Helleen Purdy 

St Andrew’s War Memorial Hospital 

457 Wickham Terrace, Brisbane, QLD 4001 

Tel (07) 3834 4589 

Fax (07) 3834 4373 

Email Helleen.Purdy@uchealth.com.au 

Sa lynda Staruchowicz 

Stomal Therapy Department, 

Royal Adelaide Hospital 

North Terrace, Adelaide, SA 5000 

Tel (08) 8222 4000 pager 1224 

Tel (08) 8222 4416 for answering machine 

Email lynda.staruchowicz@health.sa.gov.au 

taS tracey Beattie 

North West Regional Hospital 

Brickport Rd, Burnie, TAS 7320 

Tel (03) 6430 6588 

Mob 0408 317 411 

Email tracey.beattie@dhhs.tas.gov.au 

ViC Patricia McKenzie 

5 Royal Place, South Morang, VIC 3752 

Tel 1300 33 44 55 

Mob 0406 534 850 

Email pmckenzie@rdns.com.au 

Wa leigh davies 


6 Sundercombe Street 

Osborne Park, WA 6017 

Tel (08) 9242 0242 (w) 

Mob 0410 222 386 

Email Ldavies@silverchain.org.au

President’s report 

Sharmaine Peterson 

Welcome to the last edition of the journal for 2010. 

The Executive is very excited and proud to have had a proposal 

from CINAHL (Cumulative Index to Nursing and Allied Health 

Literature) to index our journal on their electronic database. 

CINAHL is based in Glendale, California, and is a comprehensive 

resource for nursing literature, providing indexes for over 3000 

journals and 500 titles in full text. This will provide greater 

exposure to the journal and authors worldwide. Future articles 

for publication will, therefore, need to have an abstract or 

summary as well as a list of cited references. 

Royal District Nursing Service (Victoria) has requested a link to 

the AASTN website. They have recently translated our patient 

handout brochure to several different languages including 

Greek, Italian, Vietnamese, Chinese and other languages. STNs 

and ostomates will be able to access them via this link. 

It is planned that the minutes of the Executive meetings, 

Treasurer’s report and Membership Coordinator’s report will 

also be on the website. 

I recently attended the SA Ileostomy Association AGM, and gave a 

talk on the WCET/WCON Congress. I also showed some slides of 

The future of post-operative care is clear to see... 

because the post-op dressing that you put on your patient should be the only thing 

they acquire before they go home 

OPSITE Post-Op Visible is the latest development in post-op film dressings, helping to reduce the incidence of 

infection caused by early and frequent removal. 

the Convention Centre, delegates, costumes and the promotional 

video for the 2012 WCET Conference. One of the volunteers, 

Val Masey, attended the ACSA AGM and discussed some of the 

presentations. One of interest to the ostomates and myself, was 

given by a nutritionist, Margaret Allen, an ostomate herself. She 

works at Northcote Integrated Health in Victoria and is able to 

provide practical advice and support to ostomates concerning 

diet and wellbeing. Ostomates and STNs can contact her via email 

on Margaret@foodfirst.com.au or info@foodfirst.com.au 

Another interesting fact from ACSA – if all volunteers who give 

their time at all Australian Ostomy Associations were paid, it 

would cost $43 billion!!! 

The Stoma Appliance Scheme review has been completed; 

however, due to the recent election, no further information has 

become available. 

At the WCET/WCON Congress, Elizabeth English retired as 

President of the WCET. Elizabeth is employed at the Royal 

Adelaide Hospital and is a dedicated and passionate STN. 

She has worked tirelessly for the WCET as Chair of the 

Education committee for six years; Vice-President for four years 

and President for four years. She has travelled to China, the 

Philippines, Iran and Indonesia teaching nurses about stoma 

and wound care. At present she is liaising with the WCET, 

companies and the SA Committee which is organising the 2012 

WCET Conference. Well done Liz. 

I would also like to congratulate this years scholarship winners: 

Elinor Kyte (Convatec) research scholarship – Ian Whitely; 

AASTN Travel Grant – Diana Hayes; CSSANZ (to attend 

conference) – Kara Torney. 

I wish you all a safe and happy Christmas and a healthy New Year. 

Customer Service: 13 13 60 www.smith-nephew.com.au/healthcare Trademark of Smith & Nephew. 186x120 (09/10) 


Editorial 

Theresa Winston 

In this month’s journal, there are several reflective essays 

written by nurses while undertaking their Graduate Certificate 

in Stomal Therapy. It is interesting to read about the progress 

of the authors during their clinical placements, how they grew 

in confidence, increased their knowledge base and were better 

able to communicate and collaborate with other members of the 

healthcare team. 

It also shows us the importance of having preceptors to work 

with these nurses, to share their vast knowledge and experience, 

to act as a teacher, mentor and role model. Although the role of 

the preceptor can be exhausting and sometimes draining, it is also 

very rewarding, especially when you read the reflections of your 

student. Knowing that some skill or advice that you’ve passed 

on may help a patient in the future also makes it worthwhile. 

As can be seen in the article by Carmen Smith, preceptorship 

roles are required internationally as well as nationally. Carmen 

writes about her experiences in Iran, where she assisted with 

the clinical component of the first Iranian Enterostomal Therapy 

Nursing Education Program (ETNEP). 

As Sharmaine mentioned in the President’s report, CINAHL 

will index our journal on their database. CINAHL is a widely 

used database that indexes and abstracts articles from a large 

number of nursing, medical and allied health journals. CINAHL 

itself does not include the full text of journal articles, but often 

links to the full text in other databases. It is, therefore, very 

important when submitting an article for publication in this 

journal to include an abstract. The information that will appear 

on CINAHL will be: 

• name of the author(s) 

• title of the article 

• title of the journal the article was published in 

• volume, issue and page numbers 

• abstract. 

The full article WILL NOT be available, but gives 

people enough information to find the article in print or 

electronically. Also, just a reminder, if you do have an article 

to submit, please send it in via the Cambridge Media website 

(http://www.cambridgemedia.com.au/). 

The answer to the Where am I? in the September journal was The 

Kremlin. 

Quote of the day: 

Whenever you are asked if you can do a job, tell ‘em, “Certainly I 

can!” Then get busy and find out how to do it. Theodore Roosevelt 

(1858–1919) 

Correction: The CoNNO report in the September journal was 

prepared by Lesley Everingham and Wendy Sansom, not Diana 

Hayes. 


All submitted articles are reviewed by peers for relevance, 

construction, flow, style and grammar. All reviewers spend 

considerable time in reviewing the articles and providing 

feedback to the authors. The length of time of the publication 

process can vary and depends on the quality of the work 

submitted. Several revisions may be required to bring the article 

to a standard acceptable for publication. The Editorial team 

undertake the final review and often have different questions 

for the author/s to consider. Please do not let these suggestions/ 

comments stop you from resubmitting your article. At the end 

of the day, this process ensures that your article will be of a high 

standard and well received by readers. Please note that due 

to the editorial review process there is no guarantee of when 

accepted articles will be published. 

PublIcATIoN deAdlINeS for 2011 

All materials for publication must be sent to the Editor by the 

following dates: 

January 15th – March 2011 issue 

April 15th - June 2011 issue 

July 15th - September 2011 issue 

October 15th - December 2011 issue 

I would like to thank everyone who has sent in an article for the 

journal over the last year. Please keep contributions coming. I 

wish all readers a merry Christmas and a Happy New Year. 

electronic submission 

of manuscripts to the journal 

the Journal of Stomal Therapy Australia now requires 

all submissions to be made online 

StEPS to SuBMiSSioN aNd PuBliCatioN 

• Go to the publisher‘s website: www.cambridgemedia.com.au 

• Click on Manuscript System. 

• Login. 

• Create an account if first time using the system. This will be 

retained for future enquiries and submissions. 

• Enter your personal details: all fields must be completed. 

• Confirm your details. 

SuBMittiNG aN artiClE 

• Step 1 – Type the title, type of paper and abstract. Select 

publication – JSTA. 

• Step 2 – Confirm author. Add co-author details (all fields) if 

applicable. 

• Step 3 – Upload files. Only Word documents are accepted. 

Please ensure your document contains the required 

information and is formatted according to the author 

guidelines. Photos to be sent separately in JPEG format. 

• Step 4 – Add any comments for the editor. 

• Step 5 – Review your information then click submit. 

Once submitted, the manuscript is reviewed by the editor and, if 

acceptable, sent for peer review. 

Peer review 

Peer reviewers will be asked to review the manuscripts through 

the electronic process.

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case studies 

Hollister Adapt Barrier Seals (7805) used in 

conjunction with negative pressure therapy dressing 

to maintain moisture control in complex wounds 

Jennifer Daniels • CNC/STN Wound Management/Stomal Therapy, Redcliffe Hospital Metro North Health Service 

District, QLD 

INTroducTIoN 

Since becoming exposed to stomal therapy nursing whilst 

working as a wound consultant in 2005 and subsequently 

becoming an STN in 2008, being able to use wound and 

stoma therapies concurrently has enhanced my overall practice. 

Confronted often with difficult to manage or highly exudating 

wounds, adapting principles from stoma care through pouching 

systems, powders, belts, wafers, seals and pastes has enabled 

reduced dressing costs, extended wear time of dressing products, 

reduced dressing application time, enabling enhanced quality of 

life for wound suffers and peace of mind for nursing staff. The 

following case studies look at using Hollister Adapt Barrier 

Seals (7805) to assist with wound care management. 

The first case study of three focuses on a patient admitted 

with multiple Stage 4 pressure injuries in some exceptionally 

challenging sites with the addition of high exudate. Although 

it is noted Hollister Adapt Barrier Seals are not considered 

sterile in nature (they do not come in sterile packaging) all other 

products previously used (Eakin seals, pastes, hydrocolloids, 

pouches and drapes) failed to maintain peri skin integrity and 

negative therapy seal. The Adapt seals did not compromise the 

wound as their placement was adjacent to the wound and not in 

direct contact with the actual wound bed. 

cASe STudy 1 

Patient history 

• Fifty-two-year-old male classified as C6, a complete tetraplegic 

using the ASIA (American Spinal Injury Association – ASIA– 

standard neurological classification of spinal cord injury) 

post-diving incident at age 19. 

• Chronic constipation requiring self-administration of 

aperients. 

• Multiple admissions for previous pressure injuries requiring 

extensive wound care/surgery: 

• In 2006: rectus femoris flap to L) trochanter: incision and 

drainage of gluteal abscess. Debridement of R) trochanteric 

bursa and direct closure: sacral pressure injury repair with 

local flap. 

• In 2008: admitted infected pressure injuries for wound care, 

discharged four months later. 


current 

• Admitted June 2010: septic from Stage 4 pressure injury to 

sacrum with osteomyelitis of pelvis. 

• Multiple pressure injuries to lower limbs, hips and elbows, 

all requiring sharp surgical debridement 6 June 2010. 

Medications 

Intravenous antibiotic (IVAB) vancomycin, multivitamins, 

coloxyl and senna. Iron transfusion and red blood cell transfusion. 

This case study will focus on the Stage 4 pressure injury to the 

sacrum including perineum. On admission, the patient had 

necrotic friable bone at ischium and fragmented ischium with 

possibly obliterated necrotic tissue. The patient was also noted 

to have osteomyeltis of the pelvis. 

Figure 1. Stage 4 pressure ulcer with fragmented bone on view. 

Extensive surgical debridement was carried out, which left 

fragmented bone on view and extensive structural injury. There 

was over 600ml of haemopurulent exudate in a 24-hour period, 

with periwound excoriation. The skin was fragile and the 

patient had excessive diarrhoea.

Management 

Vacuum assisted closure (VAC ® ) negative pressure therapy 

(NPT) was used, despite recommended precautions on use with 

fragmented bone on view; however, conservative dressings 

were not able to cope with the high exudate requiring changing 

1/241 . High exudate predisposed the patient to further wound 

deterioration and breakdown2 . Additional issues were faecal 

incontinence constantly contaminating the wound bed due 

to close proximity to and involving the perineum. Therefore, 

NPT was primarily used for exudate management and wound 

containment3 . Note: The area was not suitable for a wound 

pouching system due to the patient requiring positioning on his 

back (extensive, multiple, Stage 4 pressure injuries) and not able 

to draw away exudate. 

Issues 

• Excessive diarrhoea with subsequent faecal contamination of 

wound. 

• Fragile periwound skin ++. 

• Wound adjacent to perineum: difficulty to get a seal using 

negative therapy, causing further skin maceration and 

increased wound breakdown. 

Eakin seals were previously tried, but these did not adhere or 

conform to periwound skin or around the perineum, resulting 

in leakage of VAC ® negative therapy seal. Trials using pastes 

required more time to apply and were not found to be stable 

enough around the perineum with normal rectus movement. 

The advantages of the Adapt seal: 

• No warming is required, which, in this case of extremely 

high exudate, enabled fast application. 

• Mouldable. 

• High absorbency, which reduced non-adhesion while 

applying negative therapy. 

• Easy application for staff. 

dressing technique 

• 3m Barrier Wipe applied to periwound skin. 

• Coloplast Stomahesive ® Powder was applied to heavily 

excoriated areas of periwound skin prior to application of 

Adapt seals. 

• After first dressing change 48 hours later, periwound 

excoriation had healed and stoma adhesive powder no 

longer required. 

• Adapt seals were applied to the entire periwound skin 

single layer, distal wound close to rectum Adapt seal applied 

triple layers to build up wound edge for even surface and 

cope with normal motility of rectal muscles without losing 

negative therapy seal. Adapt Barrier Seals were able to be 

moulded and shaped as required. 

Figure 2. Adapt seals to protect periwound skin. 

• Application VAC ® dressing as per direction using WhiteFoam 

to exposed bone with Granufoam to remainder of the wound 

bed 3 . 

Figure 3. VAC ® dressing in situ. 

• Success was immediate with the Adapt seal and negative 

therapy dressing remaining intact between dressing changes. 

• Periwound skin healed and the patient eventually was able 

to transfer to conservative dressings earlier than expected 

and is currently awaiting discharge to rehab for final 

mobility clearance. 


Figure 4. Ceased VAC ® treatment. 

The surgeons formed an end colostomy in the left upper 

quadrant of the abdomen to assist with patient self-care and 

reduce continued perianal skin breakdown from incontinence 

and pressure injury formation. This patient was not expected to 

survive this pressure injury and did have a septic shower early 

on in his admission. 

Multidisciplinary teams have enabled this patient to make 

significant progress; however, continued social support and 

community support will be needed to reduce further pressure 

injury formation. 

Multidisciplinary team involved in patient care included: 

• Dietician for nutritional support. 

• Medical. 

• Wound care. 

• Nursing. 

• Social worker (patient severe depression). 

• Mental health. 

• Community health. 

• Domiciliary. 

• Family and friends who were fundamental to patient finding 

will to heal. 

The main factor in his progress was the ability to treat using NPT 

which could not happen without the use of the Adapt seals to 

maintain a seal and protect his fragile skin. Thus Hollister Adapt 

Barrier Seals resulted in a cost-effective sustainable solution 

enabling wound improvement and better quality of life. 


cASe STudy 2: 

Patient History 

57 year old male, insulin dependant diabetic with advanced 

neuropathy and osteomyelitis of Ist Metatarsal/phalangeal 

joint (MTPJ).The patient had stood on a nail, not realised due 

to neuropathy and the foreign body was in the foot for three 

days. He was admitted with a septic left leg and cellulitis. At the 

penetration site necrotic tissue extended 10mm x 10 mm on the 

planter aspect of the foot. Tracking from puncture site extended 

to the medial aspect of foot. 

Management: 

• Debridement of Left foot - 50 mm x 30 mm demarcated 

necrosis with copious infected tissue down to facia, tracking 

proximally to sole of foot 

• A week later returned to theatre for a wash out. Necrotic 

tissue to flexor tendon 2nd toe. At this stage Negative 

Pressure therapy was applied. 

• Four days later returned to theatre for a further washout. 

• Two days later had an amputation 2nd toe 

Medications: 

Novorapid, Diabex, Augmentin Duo Forte 

Issues: 

• Continued leaking of Negative Pressure Therapy Dressing 

reported by patient and staff due to difficulty and complexity 

of wound position. 

• Patient requiring frequent dressing application or 

reinforcement of dressing. 

• Heavy maceration to peri wound from exudate not able to be 

contained 

• Peri wound skin irritation from layers of film dressings to 

maintain seal of negative pressure therapy dressing resulting 

in stripping of skin (Patient mummified with drape). 

• Patient discomfort from requirement of dressing to 

encapsulate entire foot resulting in decreasing ability to 

maintain hygiene and increase perspiration to foot. 

• Need for monitoring and returning to clinics for management 

of dressing daily 

• Increased cost of dressing and nursing hours 

Solution 

Use of Hollister Adapt Barrier Seal (7805) to peri wound skin 

• Enhanced ability of dressing to maintain a seal 

• Conformability to odd shape and position of wound 

• Seal ability to cope with heavy exudate levels and moisture 

without increasing risk of maceration to peri wound skin. 

• Ease of application for all staff

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Figure 5. Maceration. 

conclusion 

• Seal maintained dressing for appropriate treatment time. 

• Increased patient comfort. 

• Reduced nursing hours. 

• Reduced consumable costs. 

• Decreased periwound skin stripping. 

• Resolution periwound maceration. 

• Quality of life for patient. 

• Patient D/C to share care with community podiatrist for 

ongoing management. 

Figure 6. Use of Adapt seals to protect periwound skin. 


Figure 7. Use of Adapt seals to protect periwound skin. 

Figure 8. Use of WhiteFoam. 

Figure 9. Bridging TRACT pad to front of foot for patient comfort.

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coNcluSIoN 

The use of stomal therapy techniques and accessories 

complements wound management while assisting with 

complex wounds to ensure patients have positive outcomes 

with enhanced wound healing. Hollister Adapt Barrier Seals 

(7805) are versatile enough to be moulded and remoulded to 

fit into odd shapes while being able to bevel edges to promote 

low profile of dressing edges, enhancing patient comfort. The 

use of Hollister Adapt Barrier Seals from ostomy care to wound 

care has increased dressing adhesion with difficult positioned 


wounds/highly exudating wounds and protecting fragile peri 

skin, while reducing costs of dressing changes and nursing 

hours, thus maintaining patients’ quality of life. 

refereNceS 

1. KCI Licensing Inc. V.A.C. ® Therapy clinical guidelines for deep 

sternal wound infection: A reference source for clinicians, 2006. 

2. Carville K. Wound Care Manual, 5th edn. Australia: Silver Chain 

Foundation, 2007. 

3. KCI licensing Inc. V.A.C. ® Therapy clinical guidelines: A reference 

source for clinicians, 2007. 

How would you manage these two stoma's? 

retracted ileostomy, high output 

Necrotic area between colostomy 

and laparotomy 

Any suggestions should be submitted to the editor and 

will get published in the next journal. 

If you have any photo's of difficult to manage stoma's 

please send your picture to the editor.

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Reflective essay 

Stomal therapy nurse: a year in the making 

Sally Langford-Edmonds 

When making the decision to embark on this study, I never 

thought it would be so enlightening, opening such a plethora 

of experiences and knowledge bearing in so many directions. I 

have been nursing since 1981 in a range of settings, providing 

opportunity for varied clinical experiences. Throughout these 

years I have really enjoyed the personal growth and challenge, 

working with remarkable people and providing care for a great 

variety of wonderful and, at times, testing clients. 

I’m currently an after-hours hospital nurse coordinator 

employed by a metropolitan private hospital and I find myself 

in a fantastic position, being able to manage, continue hands-on 

clinical care, role model and troubleshoot in my work. I trained 

in the hospital system, general and midwifery, then enjoyed 

working in rural and metropolitan hospitals, later undertaking 

a BHSc(Nursing) and working in rural domiciliary nursing and 

aged care. We have no specialist stomal therapy nurse (STN) 

on staff, so embarking on further study would fulfil my own 

interest in the areas of continence, wound management and 

stomal therapy and ultimately benefit my employer. Working 

after hours in a busy hospital has its own set of idiosyncrasies, 

so undertaking clinical experience was going to be an enormous 

adjustment; to begin with I would be working in daylight hours. 

I was unsure what to expect from my clinical experiences. I 

was lucky to ultimately gain this experience in several different 

environments: the majority with an STN in a private hospital, 

a continence advisor in a public adult hospital, a continence 

advisor in a public continence clinic, an STN in a major 

metropolitan, adult, public hospital and an STN in a private 

hospital wound clinic. What I really needed to know was what 

was involved and how do they accomplish their role as an STN? 

It was most interesting to discuss all areas of stomal therapy 

practices, clinical practices, policy, process, education, 

job descriptions, autonomy and resources. Each venue had 

slightly different requirements but work practices were very 

similar. Observing how all these preceptors functioned was 

most interesting. They were autonomous, relaxed, friendly, 

informative, appreciative and professional. Their individual 

responses to the constantly changing demands of the job was 

inspiring and something I would like to achieve. No single 

day could be replicated; the variety of clinical situations was 

continual. One client may present for preoperative education 

to have a stoma sited, to be prepared, full of questions with 

a support person. Another may present for exactly the same 

reason, but have spent an exhaustive day alone having tests and 

finding out they need to have immediate stoma surgery and are 

so fragile, closed and distraught that it is not possible for them to 

be dealt with the same way. Yet ultimately they will have similar 

needs. In the next moment you find yourself assessing pressure 


areas, teaching self-catheterisation or discharge planning to 

find a client along with their family with totally unrealistic 

expectations of their health management. They have not come 

to accept their change in health status and believe community 

services should do all the work, despite having shown great 

progress in learning to manage their changed health status. 

The STN’s level of advanced practice in their speciality role was 

evident when they slipped easily from one role to another. The 

scope and complexity of these roles was extensive, revealing to 

me the multifaceted skills I needed to achieve including: 

• advanced clinical knowledge, caring for any wound 

presentation, skin affliction and continence issues 

• stoma management expertise 

• teaching and sharing of related knowledge in a variety of 

setting to clients, community, family, peers and students 

• counselling and negotiating 

• keeping up to date with research, sharing and undertaking 

relevant studies. 

The role of the STN includes being: 

• an appliance expert, requiring creativity to find the most 

successful appliance 

• an administrator, ensuring that their service is accountable, 

appropriate and complies with corporate requirements 

• a consultant, using the opportunity as a specialist nurse to 

consult and refer as necessary 

• a resource person or mentor to those less experienced 

• an advocate for those who require support and have the 

courage to speak up when required and finally; change 

agent. 

I was impressed to see how different institutions approached 

tasks, used varied paperwork and products, each influenced 

by their own philosophies and practices, backed by research 

to form evidence-based care protocols. As an example, one 

hospital based their pressure sore management on the Waterlow 

Pressure Sore Prevention/Treatment Policy as cited in Carville 1 . 

Some of these tools and approaches alerted me to changes that 

could be beneficial in my workplace if adapted to suit. I also 

noted that the STN office library in the public hospital was 

magnificent and I thought how lucky those STNs were to have 

such accessible resources available, whereas my access was very 

limited in hands-on resources. I had never really thought about 

evidence-based practice in any depth and am now so much 

more aware of the necessity for nurses to be accountable for 

their practice, knowing why they are performing a task or using 

a certain product and that their reasons are based on evidence

not the vagueness of nursing know-how or because ‘that is how 

we do it here’. I have also found that this increased knowledge 

base is empowering and makes work so much more interesting. 

I had always thought that undertaking some kind of research 

would be complicated but was really interested when my 

preceptor explained to me how one of her associates (a fellow 

STN student doing this course) was undertaking some research 

using a recently released urostomy appliance on one of her 

clients for that company’s representative. It was also interesting 

to find myself involved in the evaluation of wound products; 

the corporate contracts for wound products were up for renewal 

for my employer and all hospitals were sent many products 

to evaluate in practice, then complete and return a feedback 

form. I was pleased to receive an email this week with the list 

of successful products now available on contract “that had been 

extensively evaluated” and understand that these products 

have been chosen as the most suitable to meet our needs, not as 

I might have thought silently to myself in the past as providing 

the best deal. 

I was fascinated by the variety of products and literature 

available (continence, wound and stomal therapy), finding great 

satisfaction as my studies progressed that I was able to assess a 

need, find then use, combine and adapt appropriate products 

or literature in a management plan. The literature available 

is diverse and freely available from company representatives, 

packaging, internet sites and journal articles. This literature 

becomes invaluable when educating clients whether teaching 

pelvic floor exercises to open transurethral resection of prostate 

patients, caring for a new ostomate, providing clients with 

information where they can obtain supplies, available support 

services or improving one’s own knowledge. 

What I really enjoyed most was the interaction with clients. I 

have always enjoyed nursing, being able to share in the process 

of supporting a client to progress from a state of being unwell, 

through to achieving a state of wellness and being able to 

regain their autonomy, then ultimately be discharged. My most 

significant learning experience was being able to follow a stoma 

client from first contact, admission, into the operating theatre to 

observe the stoma formation, postoperative management and 

then through to discharge and follow-up after discharge. This 

opportunity allowed me to be involved in the continuum of care 

for a client, to see how all the different stages in a management 

plan progressed, and how important it is to thoroughly assess 

and monitor patient needs, abilities, environment, goals, 

resources and progress. The opportunity also made me realise 

how necessary it is, as a care provider, to provide a clear written 

or visual plan so that the client and their significant others know 

what is required of them, how, when and why it will happen, 

over what time period and what to expect from me the care 

provider or others involved in their management plan, so that 

they can refer to it should they become confused or forget. While 

visiting one hospital, I was impressed with their photographic 

care plan and did not realise when the STN was taking photos 

continually while I was changing a stoma appliance that these 

would later be downloaded to the patient’s individual care plan 

so that they could refer to their own individualised situation. 

The opportunity also to visit the operating theatre to watch 

the patient’s surgery was really beneficial as it gave me the 

opportunity to see and identify the anatomical changes that 

were being made, and understand how physically brutal this 

surgery was for the patient. 

Since there was no opportunity in my workplace to learn from an 

STN, I had to secure clinical placement from elsewhere. This was 

to become a most frustrating exercise while I eagerly approached 

all the AASTN preceptors listed in my city area and I received 

no response. So I explored alternative avenues and discovered 

through the college’s CNnect a fellow student who also worked 

for the same employer but at a different site that was fortunate 

to work with one of the listed AASTN preceptors. I followed her 

suggestion to approach the STN and was fortunate to benefit 

from a very meaningful, remarkable, motivating year under 

the guidance of a mentor who not only showed friendship, but 

shared freely her special knowledge and skills, and encouraged 

me to step out of my comfort zone. This relationship not only 

benefited me personally, but also fostered closer ties between 

hospitals as well. Interestingly, when I first mentioned to my 

colleagues that I had a desire to undertake some study in stomal 

therapy nursing; they politely acknowledged and looked at me 

a bit perplexed asking, why? As my study progressed, they 

became increasingly enthusiastic and approached me regularly 

for support of related issues and information in the wards, as 

the opportunity for a resource person at night is often a bonus. 

I have also noticed a subtle, positive change in my peers’ 

attitudes as they realise with the new national registration and 

the necessity for earning CNE points how important continual 

education is. This has been supported by my employer, who 

is providing weekly, short, in-service opportunities in a great 

variety of topics where I have offered to present. 

The completion of this course brings some anxiety as to where 

to now for me? Hopefully for now I can combine my current 

position, compound my recent knowledge and experience, to 

provide services that can be beneficial to my employer as the 

need arises. I was pleasantly surprised recently to be approached 

by one of the colorectal surgeons and acknowledgement was 

made of my recent studies with references that we need a 

full-time STN. This I found both exciting and daunting as 

introducing an in-house STN service was not something I had 

considered; but echoing in my head was an article I had read by J 

Davenport 2 about the establishment of a stomal therapy practice; 

it was known not to be impossible either. 

What I have drawn from my clinical visits over 12 months is 

that, while I can learn the foundations to becoming an STN 

and apply them in my clinical practice with confidence, it will 

take much longer to develop the level of finesse and experience 

required of an expert STN. I have also witnessed the value of 

networking, motivating me to join the Australian Association 

of Stomal Therapy Nurses, The Continence Foundation of 

Australia and Australian Nurses for Continence. I must admit 

I’ve been impressed and a little intimidated by the motivating, 

positive and professional presence that these nurses portray 

as well as their obvious enthusiasm for their chosen specialist 

field. Through these memberships I have benefited from: some 

really informative education days, forums and meetings and 

the chance to sample and investigate multiple, new (to me) 

products. I have met company representatives, fellow students, 


specialist nurses, other health professionals and secured further 

opportunities for clinical placements. 

I cannot state what my supervisor’s views were about changes 

they noticed in me but they felt that my skills were at the very 

least developed. For me it was about the specific knowledge 

required to become a competent STN. I have noticed that with 

the increased understanding of continence, wound management 

and stomal therapy I have a more complete perception of issues 

and am able to confidently and aptly work through the process 

and address care of these clients with more competence. This 

knowledge has also enabled me to educate and assist nursing 

staff at ward level to resolve some unusual issues. 

cASe STudy 

Throughout this case study the Australian Nursing Federation 

Competency Standards for the Advanced Registered Nurse 4 will be 

applied with the competency standard identified in bold and in brackets 

following the related action. 

A female was admitted on Friday afternoon from her nursing 

home with a history of fracturing her left clavicle two weeks ago. 

She had been treated at the local regional hospital and transferred 

to the medical ward of a metropolitan private hospital as they 

could not care for her because she had a fistula and they had 

no STN; neither did we! Upon arrival she was found to be in 

great discomfort and of limited manoeuvrability because of 

the fracture and her large size. Her pain was managed and she 

was orientated then settled into the ward. Over the course of 

the afternoon the surgical nurse unit manager (NUM) assessed 

the fistula, establishing it was an enterocutaneous fistula, and 

devised a dressing but did not record any management plan in 

the notes except under no circumstances remove the dressing, 

and measure then record all output carefully (5.1). Over the 

course of the evening, the dressing started to leak and the 

nursing staff dutifully reinforced the dressing with whatever 

would soak up the effluent. I (student STN) was contacted for 

advice at the commencement of my shift around 23.00 hours 

about the management of a fistula with a continuous flow (11.2). 

A check of the patient’s chart (5.1) did not mention wound 

management but alerted me to the fact that the patient had 

had extensive abdominal surgery over many years and that an 

intestinal fistula had spontaneously developed two weeks ago. 

The patient had a history of Crohns disease and surgical review 

(at another hospital) stated that nothing could be done for at 

least four months. 

When I arrived at the patient’s bedside with the night nurse I 

noted an obvious malodour and that the patient was in some 

distress, her abdomen was stained with excrement as were her 

hands and fingernails, with the fistula freely draining under 

the dressing down into her body folds and groin (1.4, 1.10). I 

introduced myself, donned some gloves, held her good hand, 

looked directly at her (1.6) and explained that I had come to 

see if we could devise an improved dressing for the fistula, and 

make her comfortable (4.1). Privacy was maintained. I continued 

to interact and involve the patient in what was happening and 

gain some insight into her history, but she was a terrible historian 

(1.8). Together the night nurse and I carefully removed the entire 

dressing, using principles of skin care to preserve skin integrity 

and assess the wound (4.2). The skin below the fistula was badly 

excoriated and had a small ulcer, but it was also noted that the 


fistula was on the right, lower corner of a square-shaped, healed 

wound that had the appearance of a window with wound mesh 

exposed in the healed suture line, giving it the appearance of 

badly sewn, frilled lace on the upper and lower sill. Fortunately 

the integrity of these suture lines were fine and not inflamed, 

though the appearance was most unusual (1.10); the mesh was 

caked with a dry film. Using the principles of stomal therapy 

and wound care 1 , I devised a dressing plan that used protective 

care products (2.1), explaining my rationale to the night nurse 

as I went. (1.11, 14.2) The plan included protective film (Cavilon 

wipe), protective paste (Stomahesive Paste), protective powder 

(Stomahesive powder), adhesive barrier (Eakin Rings) and 

adhesive removal wipes to create minimal skin damage on 

removal of hydrocolloids. A hydrocolloid was used to protect 

the healed suture line (Comfeel plus) and finally the application 

of a cut-to-fit, drainable ostomy management appliance to 

contain exudate and odour. The patient was washed, her wet 

clothing and linen were changed, and she was repositioned for 

comfort of the left clavicle. I left the buzzer in the client’s reach 

and reinforced that she should use it if she had any concerns, 

wound leakage or further discomfort she should contact the 

nursing staff. 

I recorded my actions in the patient’s progress notes, making 

careful record of my wound assessment and dressing plan 

and discussed the patient’s care with the nursing staff. I also 

discussed measures (4.7) with nursing staff that they should be 

aware of, such as hydration, electrolyte imbalances, thickening 

agents (but these may be of doubtful use) and the use of low 

suction connected to the pouching system if the drainage 

continues to defeat the appliance seal 3 . Nursing staff expressed 

that they would like further in-service (13.2) relating to troubleshooting 

stomal therapy dressings and the risks associated with 

Crohns disease. I agreed to organise this with the nurse educator 

as soon as possible. A courtesy email was made to the surgical 

NUM as I would be off duty when she returned to duty. I 

reminded staff to contact me if they had any further issues; they 

had my pager number. I checked in with the patient later in the 

shift (3.5) to find her settled and dozing. 

This experience left me most troubled because I had so many 

unanswered questions about my patient’s management such 

as wound healing, foreign objects in healed wounds, further 

management options, ethical and social issues which I have 

explored further (1.9) by discussing with medical personnel (6.3) 

and peers (8.1), reading journal articles (1.7), using the internet 

(relevant articles I have given to ward to refer to [14.1]) and look 

forward to discussing with my preceptor and STNs at the next 

AASTN Q meeting. Of course patient confidentiality will be 

maintained at all times. 

refereNceS 

1. Carville K. Wound care manual, 5th edn. Osborne Park, WA: Silver 

Chain Foundation, 2005. 

2. Davenport J. Establishment of a stomal therapy practice: A 

retrospective. Journal of Stomal Therapy Australia 2002; 22(2)33–36. 

3. Toth P, Hocevar B & Landis-Erdman J. Fistula Management. In: 

Colwell J, Goldberg M & Carmel J. Fecal & Urinary Diversions 

Management Principles. Missouri: Mosby Inc, 2004. 

4. Australian Nursing Federation. Competency standards for nurses in 

general practice. Advanced registered nurses. Melbourne: ANF, 2005.


Katie Jane Bird 

INTroducTIoN 

This reflective essay will demonstrate my journey from a 

beginning stomal therapist practitioner to an advanced 

practitioner. It will provide different examples and experiences 

that have been significant to my individual journey. The 

Australian Nursing Federation Competency Standards for the 

Advanced Registered Nurse 1 will be applied throughout by 

the competency standard identified in bold and in brackets 

following the related action. Each point of the competency 

standard will be allocated a corresponding number, for example 

competency one, point three will be 1.3. 

reflecTIve exPerIeNce 

I first met Mr Kat on the ward on a Sunday while I was the 

clinical nurse in charge of the shift. He was transferred from ICU 

day two post-emergency Hartman’s procedure for perforated 

diverticulitis. I introduced myself to the patient and then the 

ICU nurse handed over to me and showed me Mr Kat’s stoma. 

The stoma was covered in a dark red blood clot so was not 

visible (4.1, 4.6). On my questioning, the ICU nurse said she 

thought the stoma had always looked like that but she could not 

be sure (5.1, 6.7). The patient’s notes did not give any further 

information (1.1, 1.3, 1.8, 1.9, 5.1). Blackley2 states a stoma should 

be inspected as soon as possible after the operation to make 

baseline observations. This includes ensuring the colour of the 

stoma is bright to dark red to indicate adequate blood supply 

(6.2). I decided to do a closer inspection myself (7.2). Mr Kat was 

awake and alert so I explained my role as a clinical nurse for the 

ward and a stomal therapist. I asked him if I could have a better 

look at his stoma because of the clot and the need to check blood 

supply (1.10). He was happy for me to proceed. I discovered the 

clot would not be dislodged easily and I could still not view the 

stoma (1.7, 8.1). I was not happy to continue to try and remove 

the clot as I did not know where the blood had come from or 

if I would disrupt something. I did not wish to do any harm 

(1.6, 3.2, 3.3). I opted to ring the on-call surgical registrar for 

advice; coincidently the patient was on her team (6.3, 6.6). The 

registrar agreed it was important to view the stoma and together 

we removed the clot to reveal a healthy, pink, moist stoma. I 

informed Mr Kat of the end result and documented my actions 

in the progress notes. 

This was my first experience of dealing with an abnormality 

in a postoperative stoma independently. I felt a sense of 

accomplishment that day as I realised I was able to adapt 

my practice and integrate the theory I had learned and prior 

experiences to competently and confidently advocate for my 

patient’s best interests (3.5). 

Mr Kat’s recovery started well, he was receptive to learning about 

his stoma and actively took part in his cares (6.6). Mr Kat chose a 

two-piece appliance. I chose a base plate with slight convexity, as 

his stoma was retracting, with a drainable bag until the output 

thickened. Both of these measures were working well. I was still 

doing most of the care with Mr Kat verbally instructing me as he 

watched in a mirror (6.6). One morning while the doctors were 

reviewing Mr Kat they came and got me to review Mr Kat’s 

appliance as there was a leakage issue. I discovered that one of 

the senior nurses had removed the appliance as some leakage 

had occurred due to the faeces becoming more formed and 

pancaking under the base plate. Instead of replacing both the 

base plate and bag, she had placed just the bag directly over the 

stoma. I had assumed that the senior nurses on the ward would 

be familiar with a two-piece appliance. This incident showed I 

was wrong and needed to do a teaching session with the staff 

(9.1, 9.4, 9.5). I approached the nurse unit manager (NUM) of 

the ward and explained that I would like to do an in-service 

and the reason why. She agreed and we made an appropriate 

time and I did it the following afternoon after the nurses had 

handover (13.1, 13.2, 14.2). I chose this time so I would have as 

many staff present as possible. There was a good mix of junior 

and senior staff. I took along different stomal appliances and 

showed them how they worked and let them have a play. I 

asked that they share the information with staff who were not 

present and reminded them to involve the patient with their 

stomal care. I asked if they had ay questions and let them know 

I was always available for support (11.2, 11.3, 15.1). The session 

took approximately five minutes and I feel it was effective as a 

repeat incident has not occurred again. Feedback from the staff 

was positive (9.6). As Mr Kat had chosen his appliance I started 

to prepare him for discharge from the stomal perspective. While 

I was filling out the forms for him to join the Stoma Association, 

I discovered he did not have a Medicare card or health insurance 

and was waiting to apply for permanent residency. Mr Kat and 

his wife were from South Africa. This was all unfamiliar ground 

for me so I started to figure out what I could do and what 

implications there were going to be for Mr Kat. 

The first thing I did was ring the Stoma Association (5.1, 5.2, 

5.3, 7.28.1). They told me Mr Kat would need to get his stomal 

supplies directly from the company and pay for them himself. 

I then rang the company of his appliance and they gave me 

prices and a sales phone number for Mr Kat to call for ordering. 

They also told me about a sample pack of the chosen appliance 

that I could get for Mr Kat free of charge so I organised that. I 

relayed all this information to Mr Kat and asked his permission 

to contact the social worker, which he agreed to (6.6). I rang the 

social worker who saw Mr Kat and his wife the next day and 

throughout the rest of his hospital stay. I continued to liaise 

with the social worker and in the process learnt much about 

the finances of staying in hospital (5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 

6.3, 8.1). Because Mr Kat ended up having an extended stay, I 

continued to use the stomal department’s stock and organised 

that on discharge I would give him additional stock to take 

home (7.1). Because the appliance Mr Kat had chosen was 

working so well and he was happy with it, it did not occur to me 

that I should consider looking at a more cost-effective appliance. 

When the stomal therapist nurse took over Mr Kat’s care she 

did change his appliance purely for the reduction in cost. On 

reflection it reminds me to think outside the box. 


The next learning curve Mr Kat gave me was when the proximal 

end of his abdominal suture line started showing signs of local 

infection. Carville 3 gives signs of local infection as pain, heat, 

oedema, erythema and exudate, either a change in amount 

or type. The proximal end of the wound had increased pain, 

erythematic, purulent exudate and was beginning to dehisce 

(1.4, 1.11, 4.1, 6.2). I was able to communicate my concerns to 

his treating team and they reviewed it straight away (5.2, 5.3, 

5.4, 5.5, 5.6, 5.7, 7.2). They removed the staples and opened the 

proximal end up. I did an initial wound assessment and took 

a swab for pathology, all of which I documented (1.10). The 

consultant stated he wanted a vacuum assisted closure (VAC ® ) 

dressing applied. I felt the wound could be effectively managed 

by a hydrofibre dressing like Aquacel packing and explained my 

rationale, but the consultant still wanted a VAC ® dressing (1.4, 

1.6, 1.11, 3.2, 4.4, 5.4, 6.4, 11.2). I explained the VAC ® dressing 

to Mr Kat and applied it to the wound (6.6). Two days later 

when I reviewed the wound with the doctor’s agreement, the 

VAC ® dressing was discontinued and the wound managed with 

Aquacel packing. On reflection, this experience highlighted to 

me that I am comfortable expressing and viewing my opinions 

with all members of the multidisciplinary team that I work with. 

Even if we do not always agree, we have the mutual respect for 

each other that allows us to comfortably question each other, 

which in turn helps us reflect on our own practice and ensure 

best practice is maintained (11.1). 

A PoSITIve GAIN 

One of the most relevant insights I have had has been about 

the role of leadership in general nursing and in the context of 

stomal therapy. When asked to submit an essay about a chosen 

professional issue in stomal therapy nursing I chose leadership. 

I chose leadership because I had a desire to increase my 

knowledge in this area as I had always felt it was an important 

component of nursing but I could not grasp the concept in 

relation to myself (8.1). 

My journey began with the learning guide then reading the 

applicable resources, and then began the research (8.4, 10.1, 10.2, 

10.3). I looked at research that was specific to nursing and other 

areas like business and personal growth. The research helped 

me to identify traits of leadership in my colleagues, my past 

and present employers and, most surprisingly, in myself. The 

realisation that I may be viewed as a leader and a role model to 

others gave me a positive feeling (8.4). 

I began analysing my interactions with others and discussed 

the issue with my mentor (whom I view as a leader) (8.4). This 

insight impacted my practice by giving me the knowledge that 

the things I do in my career will not only affect me but others 

around me. It is my responsibility as an advanced practising 

nurse to make this a positive effect. 

I am also pleased to say my peers read my finished essay, all 

enjoyed it and took something from it (12.2,13.1, 14.1, 14.2). It 

was also accepted for publication in the Journal of Stomal Therapy 

Australia, September 2009 4 , after I submitted it on the advice of 

my tutor (12.2). 


During my clinical placement I rediscovered the importance 

and helpfulness of relating theory to practice. Because the area 

of stomal therapy nursing, especially the continence component, 

was all relatively new to me it took a while for the theory to fall 

into place. Prior to starting my placement with the continence 

nurse advisor (CNA) I completed the recommended readings, 

worked my way through the learning guide, accessed the 

Continence Foundation of Australia website and read the 

relevant sections from the prescribed text to help prepare me. 

But it was not until I was performing a vaginal examination 

and pelvic floor function test that I felt the theory link with the 

practice. 

Prior to doing the examination I prepared myself by doing the 

aforementioned reading, but I also discussed in depth with the 

CNA what she felt was best practice in comparison to what I had 

read. The CNA helped me identify the gaps in the theory and 

gave rationale if she did things differently; we also referred to 

the hospital policies and guidelines (7.1, 7.3, 7.4). Because of our 

discussions, the CNA identified that she would like to increase 

her knowledge and competence with an assessment tool used 

for vaginal examination of pelvic floor function. 

A truly positive gain throughout this journey has been the 

positive recognition from my colleagues (11.1). When I took on 

the role of acting stomal therapist, it astounded me how others 

readily accepted me in the role and offered support. With the 

role came the responsibility to provide safe and accurate advice 

and knowledge surrounding all areas of stomal therapy nursing 

to my colleagues and patients. During this time I learnt to use all 

the available recourses to the greatest advantage (8.1). 

Working in this role gave me the opportunity to build therapeutic 

relationships based on mutual respect with members of the 

multidisciplinary team (11.1). I remember many occasions where 

one day I may be asking the consultant about a retracted stoma 

and the next day the consultant was asking my advice on a 

dehisced abdominal sutra line (11.3, 13.1, 14.2, 15.2). This mutual 

respect enabled me to articulate the care requirements for my 

patients and to actively advocate for them (5.6). 

PAST To PreSeNT 

The Graduate Certificate in Stomal Therapy Nursing course 

goal is to cultivate excellence in the delivery of nursing care to 

people of all ages with a stoma, wound or incontinence, through 

the promotion of partnerships, encompassing the client, family/ 

carer and the multidisciplinary healthcare team 5 . I believe I 

have achieved this goal which is evidenced by my self-appraisal 

against the educational and occupational outcomes that are 

listed alongside the course goal. Since beginning this course, I 

have become more aware of my role and others around me and 

how I can influence my patient’s outcomes. 

I have learnt to collaborate information from many different 

sources to enable me to better advocate and assist my patients (5, 

6). An example of this is when I was providing care for a patient 

post-Hartman’s procedure and we were having multiple leakage 

issues with the chosen appliance and her skin integrity was being 

compromised. At this early stage of my training I felt I lacked 

sufficient knowledge to deal with this issue and at the time I felt 

quiet overwhelmed and inadequate. So I decided to ask for help 

and I quickly learnt that there were many different areas that I

could approach for this. I spoke with other nursing colleagues, I 

spoke to one of the company representatives of stomal products 

and I spoke to the treating team (4, 5, 6, 7, 8.1). Throughout this 

I maintained open communication with the patient and their 

family to give them a feeling of acknowledgement and active 

participation (6.6). 

Throughout my stomal training it has become more evident as I 

continue this journey that patients and family first (PAFF) play 

a major role (2.1). I have only just become aware of this term 

but realised when I heard it how much it impacts on stomal 

therapy nursing (2.1, 8.3). The patient discussed earlier with the 

leakage issues is a good example of PAFF. I actively sought out 

her family and made my visits at corresponding times when 

they would be present. Education was given to both the patient 

and the family. I believe this support and involvement from her 

family enabled her to cope more effectively, especially when we 

were dealing with the leakage issues. 

When I first began this course I had ward experience of dealing 

with stomal patients and very limited experience of the actual 

role of the stomal nurse. At the beginning I thought it was 

defined as just caring for patients with stomas. I remember 

while I was on clinical placement with the stomal therapist 

and a ward ringing her to ask advice about a dehisced suture 

line that was having heavy output. I asked the stomal therapist 

why they would call her and not the wound team especially as 

there was no stoma involved. As she explained the rationale to 

me my whole conception of the role of a stomal therapist nurse 

changed. That moment made me realise how diverse the role is 

and how much it could offer me. 

I believe I am now practising as an expert practitioner. This is 

defined by Benner 6 as having an intuitive grasp of situations 

and not requiring analytical rules or guidelines to facilitate 

this understanding. Important traits I attribute to an advanced 

practising nurse or expert practitioner is someone who uses 

their resources to their advantage. It is not a nurse who knows 

all the answers but one who recognises their own knowledge 

deficits and is comfortable to ask for direction and clarification 

as required. It is a nurse who is active in self-reflection. 

On my reflection and from taking into account the feedback I 

obtained from my clinical placements and working with various 

clinical nurse specialists, I have identified some areas I wish 

to further develop (9.6). Firstly I would like to become more 

proactive in the area of stomal therapy by attending conferences 

and seminars (12.1). I have taken a small step towards this by 

attending an education session about new stomal products 

outside work time (12.1). By doing this in my own time it 

demonstrates commitment to my ongoing education. I would 

also like to further develop my interpersonal skills with members 

of the multidisciplinary team and clients (11.1, 11.2). I believe 

this is an area in which I can always improve and as I do it will 

give me more confidence to interact with others. I feel by the 

development of these skills that I will be better equipped to be a 

role model for others. I hope to participate in more education on 

a larger scale in the future as well. This will be beneficial to my 

educational needs and those of others. 

coNcluSIoN 

This reflective essay has enabled me to conclude my journey. 

The course has been an enjoyable experience by allowing me to 

rediscover interests I wasn’t aware of or perhaps would not have 

considered. At times it has been challenging and my optimism 

wavered, but the feeling of achievement and completion always 

won in the end. I am glad I have completed this course as it 

opens many new opportunities for my career now and in the 

future. 

refereNceS 


general practice. Advanced registered nurses. Melbourne, VIC: ANF, 

2005, pp. 2–7. 

2. Blackley P. Practical stoma wound and continence management. 

Australia: Research Publications, 1998. 

3. Carville K. Wound care manual, 5th edn. Australia: Silver Chain 

Nursing Association, 2007. 

4. Bird K. Clinical leadership. The Journal of Stomal Therapy Australia, 

2009; 29(3)6,8–9. 

5. New South Wales College of Nursing. Graduate certificate in stomal 

therapy nursing: course information book. Burwood: The College of 

Nursing, 2009. 

6. Benner P. Interpretation of data. In: From novice to expert: Excellence 

and power in clinical nursing practice. Menlo Park, California: 

Addison-Wesley, 1984, pp. 17–34. 

AASTN MEMBERSHIP 

RENEWALS & REcEIPTS 

The AASTN Executive Committee would like to notify 

and/or remind all members: 

• Membership fees are due by the 31st December of each 

year (AASTN Constitution 2003). 

• Membership ceases if in arrears for 60 days. ie: 

1 March. (AASTN Constitution 2003). 

• Please note from 2011 AASTN will implement the late 

fee charge ($20) for members who renew later than 

1 April. 

• Late fees DO NOT APPLY to new members applying 

after 30th March. 

• AASTN’s preferred method of fee payment is by direct 

banking. Please consider this payment method. Your 

membership ID (MID) and surname should be included 

in the payment description for easy identification. 

• from 2011 receipts will not be issued unless the 

request is indicated on the renewal form. Preferred 

format of issue will be via email. Please ensure your 

provided email address is current. 

This notification by The Executive Committee has been 

prompted by the large number of AASTN members 

renewing late into the membership year, and increasing 

postage costs. 

Thank you for your understanding and cooperation. � 


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Colleen Pope 

This article was written as an assignment for the Graduate 

Certificate in Stomal Therapy Nursing and it may help other 

student nurses as an example of how to write a reflective essay. 

The Australian Nursing Federation Competency Standards for 

the Advanced Registered Nurse 1 will be applied throughout 

with the competency standard identified in bold and in brackets 

following the related action. 

Reflection is defined as a serious thought or consideration 

and to be reflective is to be thoughtful 2 (Oxford Dictionary). 

An important part of my practice is considering my actions 

in relation to patient outcomes and my responsibility towards 

the implementation of effective treatments, in my role as a 

stomal therapy nurse (STN) and in all my nursing roles (8.3, 

8.4). The Code of Ethics for Nurses states that fundamental 

responsibilities are to promote health, to prevent illness, to 

restore health and alleviate suffering 3 . Sometime during my 

initial education I was taught that the aim should be: to do good 

not harm, and I have adopted this as my personal philosophy. 

This requires being informed with the latest best practice 

information and acknowledging the person you are treating and 

their expectations. 

An experience during my clinical placement was food for 

thought. A male paraplegic, Indigenous person had suffered a 

full-thickness burn to his foot. He suggested that if amputation 

would hasten his discharge, that would be his option because 

his mate was at home alone. When asked about “his mate” he 

told us it was his dog, his only friend in the world. His wound, 

although important to us, was less significant in his life (1.4). 

The evaluation of clinical practice is a pivotal part of delivering 

quality patient care and provides assurance that patient needs 

have been met 4 . “To act confidently, competently and creatively 

we need to reflect on our caring intentions, the ends we have 

in mind and the means we might choose in order to achieve 

them” 5 . Daily experiences build on an individual’s body of 

knowledge and comparing these outcomes with those of others 

is a way of learning and evaluating. I often compare myself 

unfavourably and sometimes wish I was less critical of myself 

in work situations. I want to be as successful as my fellow STNs 

and feel competent in their company. 

I have been working for some time relieving the STN in the 

hospital in which I am employed. I have made every effort to 

employ evidence-based practice because that is part of “doing 

good” ( 1.6 ). However, I felt that the time had come to legitimise 

my practice by undertaking a formal course in stomal therapy 

nursing and subjecting myself to peer review (2.1, 2.2). “The 

STN evaluates and reflects on own practice and engages in peer 

review” 6 . I have been fortunate in being mentored by a STN who 


has the appropriate attitudes as outlined by Pellatt 7 , “mentors 

are accountable for both the safety of patients and clients and for 

the development of student competence”. There also needs to be 

a high degree of trust between mentor and mentee. 

During my clinical placement for this course, my preceptor 

has facilitated and supervised my clinical experience, a role 

described by Busen and Engebretson 8 , showing me the same 

accountability and professionalism. I realised that there is 

a difference of available resources between the private and 

public hospital systems and often a slightly different approach 

is required. The lower socio-economic situation of the patients 

(during my placement) caused me to re-evaluate my approach 

to patient education (1.10, 1.11). In the private sector, we have 

the luxury of time to provide education postoperatively for 

our stoma patients. A man whom I sited for a non-functioning 

ileostomy would spend only 2–3 days in hospital after his 

surgery. This meant that the preoperative education I provided 

had to be more intense. I had to ensure more extensive written 

information was given at the pre-admission visit so that my 

patient could begin to process this information before the 

anaesthetic and surgery took effect (4.1). Johnson and Porrett 9 

advise that patients might find it useful to have written 

information. A folder with leaflets and brochures relating to: 

stoma function, diet, skin care, sexual activity and appliance 

scheme was given as well as a demonstration of available 

products (4.7). His previous history of inguinal and umbilical 

hernia and the need to wear a hernia support garment were also 

discussed (6.5). His wife was included in this education session. 

I felt relieved that the patient had not come alone, as support 

at home would be essential with the reduced hospital stay. I 

reflected on how I would address his postoperative education 

and realised that the ward staff must be well educated as 

they would play an important role in his education (3.1, 13.2). 

Norman and McCaughan 10 discuss education of clinical nurses 

to perform after-hours patient education and stoma siting. This 

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brought to the clinic for her previous appointment. The ulcers 

had gone untreated for five days. The bandages were soiled, 

and due to the bottle shape of her legs, were inappropriate and 

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fragile skin (5.5). After addressing the issue of the inappropriate 

bandaging, (13.2), my preceptor and I collaborated in the 

dressing of the wounds (5.1). It was clear that additional support 

was required to ensure adequate treatment was provided for 

our patient. Her carer was contacted to emphasise her needs 

and ensure future appointments were kept, she was provided 

with a meal and a taxi was organised to take her home (6.5, 6.6). 

The next appointment was kept and our patient was admitted 

for intravenous antibiotics after extensive collaboration on the 

part of my preceptor (5.4). This provided me with an example 

of advocacy in action. Beyea 11 states that, practising registered 

nurses (RNs) have the authority and the responsibility to act in 

their patients’ best interest. 

My primary mentor also provided me with examples of advocacy 

during the extensive hours I spent working with her equipping 

me with the knowledge to become an advocate myself. Recently 

a male patient had undergone an extensive debridement of a 

necrotic perineal lesion, including debridement of part of the 

anal sphincter. After consultation with the infectious diseases 

consultant (ID) and the surgeon (5.1) I attempted to apply a 

suction dressing to the area. However, due to the proximity 

of the wound to the anus, it was impossible to obtain a seal 

without covering the anus. The patient was ventilated in 

intensive care and neutropaenic as a result of treatment for 

lymphoma; therefore the friability of the rectum prevented the 

use of rectal tubes to control faecal output. Containment devices 

were also inappropriate as they would not stick. This man was 

also receiving alimental feeding through a nasojejunal tube. 

This was causing diarrhoea so the wound was being constantly 

contaminated. After considering many dressing options, 

discussion with my mentor and ostomy and wound care 

suppliers and reference to The Journal of Stomal Therapy Australia, 

World Council of Enterostomal Therapists Journal and online 

literature search (6.1) I approached the ID consultant regarding 

the possibility of a temporary stoma to facilitate wound healing. 

This took some courage as up till now I have played a minor role, 

always deferring to my mentor. I also realised that if I made a 

recommendation that was inappropriate, the patient could suffer 

(3.2). Vaartio, Leino-Kilpi, Saantera and Suominen 12 believe 

that the question of appropriateness of an action can only be 

answered by the patients who are supposed to benefit from it. I 

chose the ID consultant with whom to discuss this issue because 

he had the best overall knowledge of the patient’s condition and 

would not be biased towards surgical options (5.3). Meanwhile 

I prescribed dressings with a hypertonic saline-impregnated 

gauze twice daily and as required after bowel motions (4.7). 

This type of dressing promotes a cleansing effect on exuding, 

malodorous wounds, absorbs exudate and bacteria, promotes 

autolysis of slough and maintains a moist environment 13 . The 

ID consultant initially rejected the stoma idea, stating that he 

would be reluctant to recommend this action since the bowel 

was not a major factor in the patient’s current condition. 

However, as the patient’s general condition improved and it 

became evident that he was going to recover, this consultant 

and the surgeon agreed. He now has a temporary ileostomy 

and a negative pressure dressing, which is rapidly contracting 

his wound and maintaining a base of clean granulation tissue, 

expected outcomes as described by Dyson 14 . As the debridement 

surgery involved part of the anal sphincter, the next issue will 


be continence (4.1). Intact sphincter function is essential to 

maintenance of continence 15 . I was concerned that the stoma 

might be reversed before investigations of sphincter control had 

been performed. The consultant involved is a general surgeon. 

I discussed this issue with him after careful consideration of the 

correct approach to use (5.4). He assured me that he is planning 

to refer to a colorectal surgeon for investigations. 

My involvement in the care of this patient has also required 

stoma education. His mental status has improved from 

unconsciousness to full awareness and participation in his 

daily care. He is now independently caring for his stoma, 

including the cutting out of the hole to accommodate the stoma 

because it is a “double-barrel”, oval shape. This single case has 

encompassed multiple dimensions of stomal therapy practice, 

including patient teaching, wound management, stoma care, 

continence management and the professional responsibilities of 

being a patient advocate and practising within one’s scope of 

competence. Through the support of my mentor I have been able 

to play an influential role (5.5). “Effective clinical supervision 

can help to maintain the practitioner’s balance, and effectively 

facilitated reflective practice will stimulate self-awareness and 

personal growth, thus transforming the life and practice of the 

individual ” 16 

Treatment of a female patient who underwent a pelvic 

exenteration has allowed me to follow through multiple levels 

of care. I was asked to provide her pre-admission education for 

ileal conduit and colostomy (1.1, 1.3). Her husband was present 

during this education and on the day of admission when I 

answered their questions and sited her for both stomas. The 

surgery was performed on a Saturday. She spent two days in 

intensive care. I visited her next with the STN. Her colostomy 

was dusky. The surgeon was informed (7.2). Blackley 17 states 

that this is appropriate. The stents were visible in the urostomy, 

which was pink and had a satisfactory spout (1.5). Due to the loss 

of vascularity of the colostomy, the stoma became sloughy and 

the spout was no longer effective, which resulted in leaks when 

the colostomy was active. Both the urologist and gynaecologist 

were made aware of the situation (5.5). Both were reluctant to 

consider refashioning due to the complexity of the previous 

surgery. The problem of colostomy management had developed. 

The output was liquid so at an appropriate postoperative 

recovery stage when bowel function was confirmed, steps were 

taken to facilitate thickening of the stool (8.1). Benefibre and 

Loperamide were introduced. The fluid thickened but there 

were still leaks. My mentor and I tried several methods of 

approach, including the use of seals, paste and convexity with 

a belt (13.1) until we reached a successful outcome. Although 

thicker, the output remained liquid. The concern was that after 

discharge when a firm stool developed, stenosis of the stoma 

might result in inability of the faeces to be expelled 17 . It was 

decided to introduce Codeine Phosphate to further thicken 

the faecal output, with the surgeon’s cooperation (6.4), to test 

the ability of the stoma to pass a thicker motion. I performed a 

digital examination of the stoma tract to identify any stenosis. 

None was identified. Digital dilatation may be helpful for stomal 

stenosis 18 . Codeine Phosphate was introduced, and as this can 

be used to control mild to moderate pain, the Endone which 

the patient had been taking was ceased. Codeine Phosphate

causes a decrease in gastrointestinal motility 19 , the desired effect 

in this case. This was explained to the ward nurses so that they 

understood the aim of treatment (14.1). When the desired result 

was apparent, the Loperamide was ceased because the Codeine 

produced a more satisfactory outcome (1.7). The faecal output 

was thick enough to facilitate management of the colostomy 

without leakage and the stoma continued to function. When she 

was ready for discharge, the stents were still in place. I contacted 

the urologist to inform him of the pending discharge (5.7) 

and was asked to remove the stents 17 after giving intravenous 

antibiotic cover. I worked with the ward nurse to ensure the 

antibiotics were given (5.5). I removed the stents according to 

instructions given on previous occasions (6.3). A graduate nurse 

who was working in the area asked to observe the procedure. 

I explained to her the principles as I worked (13.2). I also 

explained to the patient that she should observe for continued 

drainage of urine from the urostomy to ensure the ureters 

remained functional and to report fever, back pain, feeling 

unwell or blood in the urine (4.3). I documented the orders and 

signed for removal of the stents in the patient’s chart (3.1). 

During my development from clinical colorectal nurse to student 

STN, I have attended conferences, workshops and product 

launches (6.1, 6.2, 6.3). A very professional case study was 

presented by a fellow student at one meeting, which impressed 

me with the quality and depth of knowledge displayed (10.5). 

I compared my own knowledge and realised the need to 

continually strive for improvement (2.2). However, the best 

learning experiences have been when I have been asked to 

provide education for others. I have given a presentation titled 

Stoma Products. Diverse Uses at a wound management course 

conducted yearly at our hospital by my mentor (STN ) (12.1). 

The basics had been formulated by another STN with whom I 

have worked. I expanded on this by adding some information 

and photographs of my own. I acknowledged her contribution 

(11.1) to the audience, which consisted of RNs and enrolled 

nurses (ENs) from our organisation and others, as well as the 

community, and sales representatives (13.1). This activity helped 

me gain confidence in my own knowledge and ability. I have 

recently given a presentation at a vascular workshop consisting 

of 40 delegates. My contribution was a 40-minute lecture on 

leg ulcers (13.2). This was an ideal learning experience for me, 

as I undertook extensive literature searches and compared our 

treatments with those described in the literature to ensure that 

the information I was giving was factual and relevant (10.2). 

I have also given an informal presentation relating to stoma 

care and the expectations placed on the ward EN to a group of 

student ENs on placement in my workplace (14.2). My aim is to 

always be sure of the facts so that teaching others comes more 

easily. 

An issue of importance to me has been my integration into 

the profession of STNs. A continuous process of development, 

internal discussion and external feedback shapes a profession’s 

current identity 20 . This is evident in every meeting of these 

nurses. Mantzoukas and Jasper 21 believe that there still exists 

an unequal relationship between RNs and doctors. However, 

every day I witness the respect in which the STN is held 

by the consultants with whom we work. I feel proud to be 

accepted into this group and am committed to upholding this 

image. Hornby and Atkins 20 state that just as an individual 

needs to have a satisfying self-image, a profession needs to 

establish, promote and protect a strong, cohesive and satisfying 

professional image with which its practitioners can identify. The 

Standards of Stomal Therapy Nursing 1 include in the philosophy 

“a responsibility to share their knowledge and skills with others, 

including those in the health profession”. I have experienced this 

firsthand. Ideas are regularly shared and support offered. 

The area of research is a weakness in my practice which I intend 

to change. I have been involved in only minor areas of research, 

such as evaluation of products. I have helped collect data 

for evaluation of intravenous site dressings and new ostomy 

products (9.2). I have participated in the use and evaluation of 

alternative negative pressure wound devices. I realise that when 

qualified, as a member of the AASTN it is imperative that I 

become active in the association and participate in maintaining 

the high standards already set. This will necessitate an ongoing 

commitment to education. Newhouse, Dearbolt, Poe, Pugh 

and White 22 state that the move towards informed professional 

practice requires evaluation of existing practice, synthesis of 

current available evidence, and incorporating the best new 

evidence into practice. 

As a clinical nurse working in the colorectal ward at my 

organisation, I was responsible for producing the clinical 

pathways for general and colorectal surgery (12.2). It was also 

my responsibility to teach staff how to record variances and to 

audit these variances (9.2) for quality improvement 23 . Currently 

at my workplace the STN is involved in product evaluation, 

pressure area prevention and monitoring of all reports of 

skin tears to ensure protocols are followed and patient safety 

is maintained (9.6). At this stage of my development I am 

participating in some of these areas but have not taken part in 

the product evaluation group. 

Assessing my development during this course, I believe I 

now have a better grasp of the theory behind the day-to-day 

practice. Although I have taken advantage of the available 

journals and texts, particularly those of Blackley and Carville, 

literature search for assignments has taught me to look further 

afield also. Bawden and McKinnon 24 imply that the dynamic 

nature of learning means that it is never really completed. I 

do not consider myself an expert STN. I believe that I am at 

the proficient stage as described by Benner 25 . I have had the 

experience over time but must still at times resort to analysing a 

situation before deciding on a correct course of action. 

refereNceS 


general practice. Advanced registered nurses. Melbourne, Vic: ANF, 

2005, pp. 2–7. 

2. Oxford Dictionary. Accessed 4 April 2008, askoxford.com/results/ 

?view=searchresults&freesearch=reflection&branch=&textsearchtyp 

e=exactuseaskoxford.com 

3. Ghebrehiwet T. Doing what’s right: The ethics of nursing. Helping 

nurses make ethical decisions. Reflection on nursing leadership. 

Third quarter (Feature six), 2005. Accessed 28 February 2006, www. 

nursingsociety.org/RNL/RNL3rdQtr.pdf 


4. Leach MJ. Revisiting the evaluation of clinical practice. International 

J Nurs Pract 2007; 13(2)70–74. 

5. Ghaye T. The role of reflection in nurturing creative clinical 

conversations. In: Ghaye T & Lillyman S (eds). Effective Clinical 

Supervision: The role of reflection. Trowbridge, Wiltshire: The 

Cromwell Press, 2000. 

6. AASTN Inc. Standards of stomal therapy nursing practice. Journal of 

Stomal Therapy Australia 2001; 21(2)14–15,18–19. 

7. Pellatt GC. The role of mentors in supporting preregistration nursing 

students. Br J Nurs 2006; 15(6)336–340. 

8. Busen NH & Engebretson J. Mentoring in advanced practice 

nursing: The use of metaphor in concept exploration. The Internet 

Journal of Advanced Practice 1999; 2(2)n.p. 

9. Johnson A & Porrett T. Discharge Planning and Supporting Patient 

Self-Care. In: Porrett T & McGrath A. Stoma Care. Oxford, UK: 

Blackwell Publishing Ltd, 2005. 

10. Norma T & McCaughan J. Addressing the shortfalls of a part-time 

stomal therapy nurse role in relation to preoperative education and 

siting. The Journal of Stomal Therapy Australia 2006; 26(1)5–8. 

11. Beyea S. Are You “ Just a Nurse”? AORN J 2008; 87(2) 441–444. 

12. Vaartio H, Leino-Kilpi H, Salantera S & Suominen T. 2006 Nursing 

advocacy: how is it defined by patients and nurses, what does it 

involve and how is it experienced? Scand J Caring Sci 2006; 20(282– 

292). 

13. Carville K. Wound Care Manual, 5th edn. Osborne Park, WA: Silver 

Chain Nursing Association, 2005. 

14. Dyson M. Adjuvant therapies: Ultrasound, laser therapy, electrical 

stimulation, hyperbaric oxygen and negative pressure therapy. In: 

Morrison MJ, Ovington LG & Wilkie K (eds). Chronic wound care: 

A problem-based learning approach. Edinburgh: Mosby, 2004, pp. 

129–157. 

15. Bliss D, Doughty D & Heitkemper M. Pathology and Management 

of Bowel Dysfunction. In: Doughty D (ed). Urinary & Fecal 

Incontinence. Current management concepts, 3rd edn. St Louis, 

Missouri: Mosby Elsevier, 2006. 

16. Freshwater D & Stickley TJ. The heart of the art: emotional 

intelligence in nurse education. Nurs Inq 2004; 11(2)91–98. 

17. Blackley P. Practical Stoma Wound and Continence Management, 

2nd edn. Vermont, VIC: Australia Research Publications Pty Ltd, 

2004. 

18. Whitely I. Clinical case study: conservative management of a 

necrotic colostomy. Journal of Stomal Therapy Australia 2008; 

29(1)12–15. 

19. MIMS ONLINE. Accessed 9 May 2008, www.mims.hcn.net.au/ 

fmx-nsapi/mimsdata/?MIval=2MIMS_abbr_pi&product_ 

code=7927&product_name+Codeine+P 

20. Hornby S & Atkins J. Working identity and collaboration. In: Hornby 

S & Atkins J. Collaborative Care. Interprofessional, Interagency and 

Interpersonal, 2nd edn. Oxford, UK: Blackwell Publishing, 2000. 

21. Mantzoukas S & Jasper A. Reflective practice and daily ward reality: 

a covert power game. J Clin Nurs 2004; 13(8)925–933. 

22. Newhouse R, Dearbolt S, Poe S, Pugh LC & White KM. Evidencebased 

practice: A practical guide to implementation. JONA 2005; 

35(1)35–40. 

23. Australian Council on Healthcare Standards (ACHS). Standards 1.1 

to 1.4 in The Australian Council on Healthcare Standards EQuIP 

standards, 3rd edn. Ultimo: ACHS, 2002, pp. 3–9. 

24. Bawden R & McKinnon C. The portfolio. HERDSA News 1980; 

1(1)4–5. 

25. Benner P. Interpretation of data. In: From novice to expert: Excellence 

and power in nursing practice. Menlo Park, California: Addison- 

Wesley, 1984, pp. 17–34. 


colorectal Surgical Society of Australia 

and New Zealand (cSSANZ) 

Scholarship for Stomal Therapy Nurses 

PurPoSE 

To foster and further develop the relationship 

between the Australian Association of Stomal 

Therapy Nurses Inc. (AASTN Inc.) and CSSANZ, 

the CSSANZ will present a scholarship for a novice 

stomal therapy nurse (stomal therapy nursing 

education programme completed within the 

previous three years) to attend their annual Spring 

Meeting. This is an annual award and will be presented at the 

AASTN Inc. Annual General Meeting. 

aWard ValuE 

This scholarship will cover registration to the annual CSSANZ Spring 

Meeting, economy class airfare and $500 towards accommodation. 

EliGiBility CritEria 

Applicants must: 

• Be a full member of the AASTN Inc. 

• Be currently registered in the state where they are working and 

utilising their stomal therapy nursing skills. 

• Have completed an AASTN Inc. recognised stomal therapy 

nursing education programme within the previous three years. 

• Be able to attend the Spring Meeting in or outside Australia. 

ProCESS 

Submit an article suitable for publication in The Journal of Stomal 

Therapy Australia (JSTA). The article may be in the form of, but not 

limited to: 

• A clinical case study. 

• Research project. 

• Book review not previously published in JSTA. 

• Educational poster or teaching tool. 

• Professional issue pertinent to either speciality. 

The article, plus a completed official application form with a copy 

of current nursing registration, must reach the national executive 

secretary by 15 May in the relevant year. Contact details for the 

secretary can be found in the current JSTA. Application forms are 

available from the AASTN Inc. Executive Secretary and AASTN Inc. 

website www.stomaltherapy.com 

All applications will be reviewed by the judging panel. A decision 

will be available and all applicants notified within six weeks. The 

judging panel will consist of: 

• The Editor, JSTA (or delegate). 

• Committee member of the AASTN Inc Education and 

Professional Development Subcommittee. 

• Nominated member of the CSSANZ. 

Late applications will not be considered. The scholarship award is 

not transferable. 

SElECtioN CritEria 

The decision of the judges is final and based on the following criteria: 

• Presentation. 

• Originality. 

• Appropriateness to stomal therapy nursing and colorectal 

surgery. 

• Demonstrated integration of theory and practice. 

• Suitability for publication following the JSTA Guidelines for 

Authors found in the current JSTA.

Iran, an experience 

Carmen George 

In November 2009 I had the privilege of travelling to Tehran, 

the capital of Iran, to assist in the clinical component of the 

first Iranian Enterostomal Therapy Nursing Education Program 

(ETNEP). The trip had initially been planned for much earlier 

in the year; however, there had been political unrest in Tehran 

following the elections so the programme had been altered. This 

meant that the ETNEP had been split, with the students doing 

the theory component in March and now in November they 

were doing the four-week clinical component. I was there for 

five weeks with Elizabeth English and Keryln Carville joining 

me for a couple of weeks each. 

The clinical component was held mostly at the Hazrot Rasool 

Hospital in Tehran. This is a large government hospital, where 

Dr Marjoobi, the colorectal surgeon and joint programme 

coordinator, worked. There were also opportunities for the 

students to go to the Arjiminajad Kidney Hospital and the burns 

hospital; both of these hospitals had qualified enterostomal 

therapy nurses (ETNs) working there. There was also the 

opportunity for the students to go to the Iranian Ostomy Society 

where clinics were held. There were 13 students doing the 

programme from around Iran. 

As a foreign nurse, there were many challenges working in Iran. 

These ranged from wearing a scarf at work to understanding 

and working within a user-pays health system. 

The students were exposed to many different types of wounds 

as well as patients with stomas. The cost of wound dressings and 

Figure 1. Working with a headscarf. 

stoma supplies is borne directly by the patient or their family. The 

hospital pharmacy carried a small but useful variety of products; 

however, the affordability of these products was often outside 

the budget of the patients. Teaching and practising the principles 

of wound management within the financial constraints of the 

patient was often challenging. Fortunately, when Elizabeth 

English and Keryln Carville came they were able to bring many 

wound and stoma products with them. This resulted in the 

students being able to experience using a variety of products to 

Figure 2. Using incontinence pads as secondary dressings in large wounds. 

Figure 3. A highly exuding groin wound following surgical debridement. 


achieve the desired patient outcomes without costing the patient 

any money. Of course, in many cases compromises had to be 

made so teaching principles became important. 

Figure 4. Modified parcel dressing. 

This young man had been an IV injecting drug user. The wound 

was a result of debridement of a necrotic and infected groin, his 

Stage 4 wound is in a difficult position adjacent to his scrotum. 

Within the wound bed are two ligated blood vessels which 

need protection. Students doing the programme were unused 

to having to touch male genitals to provide effective wound 

management. 

Other types of wounds encountered during the clinical 

practice included large pressure ulcers, fungating tumours, 

acute traumatic wounds, Fournier’s gangrene, compartment 

syndrome, numerous diabetic foot wounds, fistulas and draining 

wounds. 

Figure 5. Stage 5 pressure ulcer. 


This poor, quadriplegic lady had pressure ulcers all over her 

body in addition to ischaemic lesions on her lower limbs. Her 

husband was her primary carer in the hospital and used to 

get up on to the bed and turn her by himself. The bed had no 

mechanism to raise or lower it and a pressure-relieving mattress 

was unheard of. Patients all require a ‘sitter’ to care for them. 

These sitters do most of the tasks we would consider to be 

nursing, including performing basic hygiene, feeding, changing 

bed linen and obtaining medications from the pharmacy. They 

may also be required to do wound dressings and carry out 

stoma care. 

Figure 6. Diabetic foot ulcer following surgical debridement. 

Students had plenty of exposure to lower limb ulcers. There 

were numerous patients with diabetes and vascular lesions. The 

students were fortunate to have Keryln Carville running the 

debriding, lower limb assessment and compression bandaging 

workshops which they all participated in. There was plenty of 

opportunity for the students to develop and hone their skills. 

Figure 7. Debriding workshop using lambs’ feet instead of pigs’ trotters.

What was often challenging for me was the appearance of 

indifference to the plight of some of the patients. We are used to 

working in a society that takes care of sick people and ensures 

that not only they receive appropriate medical and nursing care 

whilst in hospital but plan for the patients’ discharge, ensuring 

systems are in place to continue appropriate care. One of our 

patients was a man who had been assaulted whilst in jail, 

resulting in a traumatic injury to his rectum, peritonitis, wound 

breakdown and a stoma. He would soon be returning to the jail. 

Whilst in hospital, all four limbs were shackled to the bed, two 

guards stood by him and he had no sitter, so no one to assist him 

with basic hygiene, never mind emptying his stoma bag for him 

whilst his hands were immobilised. 

Figure 8. Difficult to empty one’s ileostomy bag when one’s arms are shackled. 

One woman we came across who was having reversal of her 

stoma the following day had been sent home with her new 

stoma and the phone number of the company representative 

who sold ostomy bags. When we met her she still had the deep 

tension sutures in from the surgery eight weeks prior and she 

had not had a single night without leakage from her stoma. 

Figure 9. Eight weeks post-surgery, tension sutures still in situ. 

She was wearing an inappropriate stoma appliance; needless to 

say she had never seen a stomal therapy nurse. The company 

representative’s job was to sell product, so there was no incentive 

to find a leakproof bag for the lady. We were able to assess the 

lady’s stoma and apply a suitable appliance. Fortunately her 

skin was not badly eroded as during the day the bag did not 

leak. The lady had her first leak-free night immediately prior to 

stoma. 

The Iran Ostomy Society provided us and the students with 

opportunities to meet the people who run the association, the 

volunteers and, of course, the ostomates. Ostomy supplies at 

the society are mostly donated to them for distribution by the 

Friends of the World. The society also sells products. 

Figures 10 and 11. Dr Vafai, the founder of the Iranian Ostomy Society, with 

students, members of the IOS, volunteer workers and Liz and myself. 

At the beginning of 2009, Iran had six ETNs. Two of these work 

as lecturers in university and aren’t involved in clinical care. 

Two work in private hospitals where they practise in stoma and 

wound care, one works for industry and one is the director of 

nursing at a major hospital. Now with 13 graduates from the 


first programme there are four ETNs in Shiraz, one in Esfahan, 

one in Yars and seven more ETNs in Tehran. These nurses will 

never be short of work, their skills and knowledge are needed 

and appreciated by the many people with stomas that have 

never had a stoma nurse assist them with their life-altering 

surgery. 

The work of Marshid Suriady in organising this programme 

and the dedication of the students who enthusiastically took 

every opportunity to learn made this ETNEP possible. The 

opportunity for Keryln, Elizabeth and myself to be involved 

resulted in a truly memorable experience for all of us. 

Figure 12. Ileostomate wearing a urostomy bag. 

Figure 13. Postoperative urostomy, Iranian style. 


Figure 14. Marshid Suriady and Keryln Carville. 

Figure 15. The graduation. 

aaStN: values, purpose and vision 

our values 

Quality, respect, accountability, commitment and innovation. 

our purpose 

To provide support and leadership to stomal therapy nurses 

in their endeavour to provide quality nursing practice. 

our vision 

Enduring recognition for excellence and innovation in 

stomal therapy practice at a national and international level.

Stomal Therapy Nurses of Newcastle give Birth OR 

Newcastle Stomal Therapy Study Day 28/8/10 Report 

Sharon Gibbins 

In February Jill Fairhall, Jenny O’Donnell STN’s at John Hunter 

Hospital and Tess Richards STN from the Mater decided it 

would be great to hold a study day for local nurses, geared 

towards those in aged care facilities and the community. Back 

in 2005 Jill, Jenny & Tess were involved in the organisation of a 

successful study day. 

Running a study day could be compared with having a baby. It 

comes from a small seed, there is preparation of the nest, lots of 

fluffing about wanting to make it perfect, a few hiccups, some 

indigestion, then there’s the delivery. Jenny, Jill, and Tess, like 

many mothers, had forgotten the pain and intestinal fortitude 

needed, only remembering the successful birth. 

The name choosing came fairly early, after the pregnancy 

was confirmed, as we knew it was going to be a study day. 

Named using the KISS method, Keep It Simple and deScriptive, 

we chose: “Newcastle Stomal Therapy Study Day”. Monthly 

meetings were held at the local coffee shop (no alcohol before 

the birth, and we tried to avoid inhaling the cigarette smoke). 

The choice of hospital was a problem. One hospital we chose 

was found to be overbooked - no room at the inn! The next 

wouldn’t allow us to bring our own food - akin to not letting 

your partner in (one of the most vital parts of a successful study 

day). So we chose a more homely setting for the delivery - the 

local community hall, a lovely converted theatre, complete with 

plenty of seating, tables, a kitchen, and yes, a stage. 

We gained approval and support from our parent body, the 

AASTN. Banking and money collection - tick. Invitations 

announcing the due date - tick. Professionals enlisted to present 

- tick. Catering (high on the list) - tick. Invite company reps - tick. 

Produce a handbook - tick. A “things to-do” list for the day - tick. 

Bags packed? Sounds so easy, doesn’t it? 

So, after 6 coffee meetings, innumerable phone calls and over 200 

emails, August 28 th , the due date arrived. Our baby “Newcastle 

Stomal Therapy Study Day” was about to be induced. The 

delivery went smoothly. Husbands, sons and friends assisted in 

the birth. 

Jill as MC kept the ball rolling by adding a few snippets of her 

experiences, between contractions. We all cracked up when she 

talked about her husband’s flatus issues! (hope he isn’t reading 

this). 

“Loved Jenny’s graphic intestinal display”. No, Jenny O’Donnell 

didn’t expose her bowels, but did manage to produce a 10 metre 

calico intestinal tract and stretch it across the stage. 

Few had heard of the topic for Deb Day’s case study - “Devine” 

was the colostomy. Sharon Gibbins gave all the tips for basic 

care. Tess Richards had the pick of the pics showing us all the 

abnormalities, and then some. Put them on your screen saver? 

Julianne Feather kept us well hydrated and BGL’s elevated 

with all levels GI foods. Were they all on Julie Farrow, the 

dietitian’s recommended list? Were all our medications being 

absorbed according to Jenny Payne, the Pharmacist? We weren’t 

concerned on the big day. Give us all the drugs! Our baby was 

almost there. 

The final push came from Cath Adams, the psychologist. She was 

the climax. Cath had the audience in tears, relating poignant and 

thought- provoking sexual scenarios encountered by ostomates. 

Bursting at the seams, stitches were the order of the day. 

It was so sweet, with comments such as: “one of the best 

presented”, “food was fantastic”, “very well organised”, “most 

impressed”, “awesome day”, “can’t improve on excellence”, 

“sign me up for the next one”. The oohs and ahs of the visitors, 

everyone joined in to appreciate our baby. “Newcastle Stomal 

Therapy Study Day” was a hit. 

Thanks go to all our helpers, presenters, the 83 attendants, and 

ourselves. 

Guest speakers: Julie Farrow, Jenny Payne, Cath Adams. 

From the team: Jill Fairhall, Jenny O’Donnell, Tess Richards, Deb 

Day, Sharon Gibbins, Lara Riley , Julianne Feather, and Kellie 

Russell and Rhonda Farthing. 

Will we do it again next year? Perhaps later…… when we forget 

the pain or when our baby is out of nappies…….. 

But don’t forget the chocolates. 


conference report 

Carol Stott 

I was fortunate enough to attend the BEECHAC Conference on 

13 June, where I took part in two panel discussions and gave a 

talk on Healthy Body Image. During my time at the conference, I 

met many of the children, their families, organisers and speakers. 

This is when I realised what a huge commitment it had been to 

organise such an event and how committed the organisers were. 

The term ‘BEECH’ is used collectively to describe the congenital 

conditions of bladder exstrophy, epispadias, cloacal exstrophy 

and hypospadius which are rare conditions of the genito-urinary 

(GU) system. The defects range from bladder exstrophy, which 

is a severe defect characterised by externalisation of the bladder, 

splaying of the urethra and separation of the pelvic bone to 

relatively mild defects such as glandular epispadias, which is 

a minor defect on the top of the penile shaft 1 . The incidence of 

such defects is rare, occurring in about 1 in 10,000 to 50,000 live 

births, and is twice as common in males, than it is in females 1 . 

Because the conditions are rare, it is often difficult for people 

with BEECH conditions to access the care that they need, 

especially holistic care – or to even understand exactly what care 

is needed for themselves or their children. 

WCEt report 


Preparing for cairns 2011 

Brenda Sando CNC STN • The Wesley Hospital, Brisbane, QLD 

The Adelaide WCET congress committee is still hard at work 

to ensure the congress which is being held in Adelaide 20–24 

April 2012 will be a congress which will attract people from 

many different nations. They meet monthly and sometimes 

more frequently as well as communicating via email. There is 

still a lot of work to be done but they are meeting their timeline 

requirements. The website is now up and running and you can 

access it at www.wcetn.org as well as the AASTN website to 

submit your expression of interest. You will then receive updates 

on information about the congress. 

There will also be a lot of information at the AASTN conference 

from 3 to 7 July 2011, which is being held in Cairns, so register 

online for this inaugural event Joint Conference with Tripartite 

Colorectal Surgical Society. Log onto the Stomal Therapy website 

at www.stomaltherapy.com and click on new and events to find 

out more and register. If you register before 18 March, the cost 

is only $525 for members, which is a great price considering 

it is two conferences for the price of one. The theme of our 

conference is: Leaders in Practice – Captured in Paradise. 

Fees are now due for the WCET, so if your membership is due 

by 31 December 2010 please go online and pay them now. You 

The aims of the conference were to give Australian BEECHAC 

members the opportunity to meet and network with each 

other and strengthen support with health professionals and 

agencies. There were guest speakers from similar associations 

around the world including the UK and USA. There were 

health professionals from all over Australia and other parts of 

the world with an interest in BEECH conditions. The children’s 

activities organised were for children with BEECH conditions 

and their siblings and included a trip to Taronga zoo. 

The conference was a huge success thanks to Alana Sullivan and 

her team, which included Katy Hargreaves, Chris Sylva, Julie 

Fitzhardinge and Imogen Yang. The feedback received from 

attendees has been tremendous. 

refereNceS 

1. Wong’s nursing care of infants and children. Chapter 11, Conditions 

Caused by Defects in Physical Development. St Louis: Mosby, 2003, 

p. 482. 

may like to pay for two years while the exchange rate is very 

favourable and then you won’t have to remember next year. I 

have sent a reminder to those whose membership is now due, 

so if you did not receive that reminder it means you are paid up 

until end of 2012 or, in a few cases, 2013. 

By the time you read this report in the journal I will be retired. I 

retired in my position as CNC STN on 28 October this year after 

having been at The Wesley Hospital for 25 years, 19 of those 

as an STN. I have had a wonderful career, especially in stomal 

therapy nursing and have met many wonderful people along 

the way as well as worked with a great team at Wesley. I would 

like to thank my many STN colleagues that I have shared with 

over the years for the friendship, care and sharing of knowledge 

and assisting me to solve difficult problems. You are a wonderful 

group of people who show so much compassion and care as 

well as being innovative in ways that amaze patients and other 

nurses. 

I will be going to the AASTN conference in July next year as 

I will fulfill my commitment as WCET Australian ID until the 

2012 congress, so see you in Cairns.

aCSa report 

Australian council of Stoma Associations Inc (AcSA) 

2010 review 

Peter Lopez • Member of the ACSA Executive Committee 

The year 2010 has been eventful for ACSA. There has been a 

significant change in the make-up of our Executive Committee; 

there has been a review of the Stoma Appliance Scheme (another 

one!); then there was our usual annual conference; and in 

November we will be attending what is likely to be the last IOA 

Congress as we have come to know it. Also there has been a 

notable increased activity from the Australia Fund. 

Our long-serving President, Gerry Barry, retired this year after 

13 years as President and five years as Vice-President. His 

contribution to the ostomy community, both in Australia and 

internationally, has been extensive and will be long remembered. 

Our new President is Peter McQueen, who served as Vice- 

President for some years and whose contribution is also of 

considerable import. Peter resides in Melbourne and is well 

known to most ostomates and STNs. 

The new Vice-President is Geoff Rhodes from Canberra. Geoff 

is new to the national scene but has been active in the ACT 

association for many years. He has been an ostomate since 

childhood. 

The remaining members of the Executive are the Secretary, 

Norm Kelly, and myself as Treasurer. 

We are both from Queensland and are active in the Gold Coast 

association. 

The Stoma Appliance Scheme (SAS) has once again come under 

review by the government. This is the third or fourth such 

review since the scheme’s inception. The results of the current 

review are in the hands of the Department of Health and Ageing 

and the Minister for Health. Because of this year’s federal 

election and its protracted result, the results of the SAS Review 

have been delayed. We are hopeful that its conclusions will be 

made known to ACSA in the near future. 

Our annual conference was held in Melbourne this year and 

it was well attended as usual, with delegates from all over 

Australia. One of the outstanding features this year was a 

presentation by Bruce Treagus, perfusionist, St Vincents Hospital, 

Melbourne. Bruce introduced himself as a qualified perfusionist 

and toolmaker and explained how he was using his skills 

to assist people with problem stomas and difficult wounds. 

Bruce explained his method of identifying ways of overcoming 

problems such as huge fistulas, crevices and retracted stomas. 

Bruce also advised that he is the only person in the world who 

offers this type of service. 

There was a consensus of opinion by all delegates and the 

Executive that this man’s work must be nurtured and supported 

by all concerned. It was agreed that Bruce’s work needs to be 

encouraged and developed because it is the only work of its type 

being carried out, certainly in Australia, probably throughout 

the world. In order to progress this matter, the Executive 

resolved that discussions would be held with Bruce as to what 

sort of organisational structure would be appropriate and 

suitable for him to develop the proposal. 

This would probably involve the provision of secretarial or 

administrative assistance together with future development of 

other persons to acquire his expertise. This may well be a project 

where the AASTN and ACSA could work together to ensure that 

this valuable contribution is not squandered 

In November I will be attending, as Australia’s delegate, the 

International Ostomy Association’s annual meeting in Frankfurt, 

Germany. Our President will also be attending as Regional 

President. This year’s meeting is significant in that it will be 

reviewing its organisational structure. Instead of it comprising 

five regions, it is proposed that it be made up three regions, 

namely, Europe, the Americas, and the Asia-South Pacific area. 

The South Pacific Ostomy Association (made up of Australia and 

New Zealand ) is to be disbanded and added to the Asia region 

under the name of the Asia-South Pacific Ostomy Association. 

Each region will then be responsible for its own administration 

and assistance programmes. 

In this respect, the Australia Fund has been very active this year. 

For those of you who don’t know, this fund was created under 

the auspices of ACSA for the purpose of assisting ostomates 

less fortunate than ourselves in other countries. It is wholly 

funded by Australian ostomates and administered by ACSA. 

In recent years, appliances have been donated to Indonesia, 

Nepal, Ethiopia, Fiji and New Guinea, with a total value of some 

$350,000. 

It only remains for me to wish all your members a merry 

Christmas and a prosperous and happy New Year, with the 

hope that our fruitful relationship improves and endures over 

the coming year. 


State reports 

Australian capital Territory 

Hi everyone 

I hope you all enjoy the upcoming festive season. We have 

been unable to hold an AGM this year in Canberra due to other 

commitments from the members. Hopefully in the first meeting 

next year we will have an AGM and a new committee. 

Congratulation to Kirsti, our Education Subcommittee 

representative, on the birth of her baby daughter in September. 

All reports are that mum and bub are doing very well. 

Regards 

Kellie 

New South Wales 

Our second monthly meetings continue with a good attendance, 

with teleconference a very good option for members who are 

unable to physically attend the meetings. Our last meeting for 

the year is on Friday 3 December, followed by our Christmas 

dinner at the nearby Newtown Vegetarian Restaurant. If you 

would like to attend the dinner, please call Jenny. 

The October meeting was our AGM. The elected office bearers 

are: Chairperson/State Rep Jenny Rex; Secretary – Trish Morgan; 

Treasurer – Susan Dunne; Committee members – Mark Murtagh, 

Jackie Johnson, Anne Marie Lyons, Sally Auld and Lee Gavegan; 

Education and Professional Development Subcommittee Reps 

– Susan Dunne and Lesley Everingham; Education Session 

Organiser – Heather Hill. 

Our educational speaker at the August meeting was Lachlan 

Davis from Medtronic talking about Sacral Nerve Stimulation 

(Interstim Therapy). Our speaker for the October meeting was 

Carol Stott presenting her Stomal therapy education in Indonesia. 

The Newcastle study day on 28 August was very successful, 

with 83 registrants. The plans for the South Coast study day 

are going will, with a very good programme offered. For more 

information,please contact Julia Kittscha on 0414 421021 or email 

Julia.Kittscha@sesiahs.health.nsw.gov.au 

We welcome new members to the AASTN NSW branch: Lisa 

Clare, Kerry Terry and Samantha Butcher. Meetings for 2011 

are held on Tuesdays: 1 February, 5 April, 7 June, 2 August, 4 

October and Friday 2 December. 

If you are an AASTN member and do not get our branch 

minutes, please contact me on 9515 8990. 

Merry Christmas and cheers, 

Jenny rex 


Northern Territory 

The NT has been busy of late, with lots of changes at the wound 

and stomal therapy front. We would like to welcome a new 

stomal therapist to the role at Royal Darwin Hospital (RDH), 

Donna Fisher who previously worked at Alice Springs. Donna 

is now working part-time at RDH and brings our numbers to 

four stomal therapists employed in the NT. I will be taking a step 

back from stomal therapy as Donna takes charge of the stoma 

management in RDH, whilst I take on a more extensive wound 

care focus as I expand the role of wound management nurse 

practitioner at RDH. 

Gail McBean and Chris Clarke continue to work in their 

respective roles in the Darwin community setting as stomal 

therapists and continence and wound advisors. It looks like 2010 

will be an exciting year and more changes are afoot. 

It was great to see so many STNs at the WCET/WOCN 

conference in Phoenix, and exciting to see the interested raised 

for the next WCET conference in Adelaide. 

Looking forward to seeing everyone in Cairns in July next year. 

That’s all from the NT for now. 

Cheers, 

Jenni 

Queensland 

This year has certainly flown and we are organising our 

Christmas lunch breakup. Brenda, Colleen, Jan D and myself 

have all just returned recently from trips on the Rhine and 

Danube rivers in Europe. We all had an amazing time and would 

recommend this area/trip to anyone. Petra is in the Netherlands 

for a family reunion, so we are waiting to hear all about her 

adventures at the November meeting. 

Panel of STN’s.

Ray Garske presented with certificate of by Shirley Jones and Jan Fields. 

Congratulations to Sally Langford-Edmonds, Krista Cue, Di 

Greathead and Kelly Dunk for completing their Certificate in 

Stomal Therapy and we welcome them to our meetings. 

Brenda Sando has decided to retire from her position at the 

Wesley Hospital on 28 October 2010. She has worked there 

for 25 years, with 19 years as an STN. Brenda has been well 

respected by surgeons, STNs and colleagues over these years. 

She has mentored many STNs in Queensland as well as doctors 

and nurses. Her involvement at AASTNQ, national STN body, 

conferences and WCET are a credit to her and I know she has 

enjoyed working in all these roles. Queensland STNs have 

all gained from her incredible knowledge and she will be 

sadly missed at the Wesley Hospital. There have been many 

celebrations organised for her farewell. Brenda will continue 

to attend meetings and be involved on the WCET committee, 

fully supporting the conference in 2012. Brenda will continue 

on special projects as well as being a new grandmother for her 

second grandchild. She is also building a new house and moving 

up to Caloundra, so her time will be busy. We all wish her well 

in her retirement. 

Gerry Barry presenting flowers to Brenda Sando 

Brenda Sando thank you with K. McGory 

We held a very successful ostomate education day on Saturday 16 

October. Approximately 90 ostomates attended and many STNs 

from the Brisbane region. Thanks go to the Queensland Stoma 

Association (QSA) and Queensland Colostomy Association for 

organising and encouraging a great response. It was a day of 

celebrations as QSA celebrated their 50 years of service. Topics 

discussed were: Hernia management and support garments, 

update on the ostomy scheme, discharge and community 

planning, Brisbane ostomate support group update (BOSVS) 

and panel questions. BOSVS celebrated their 10 year-service last 

November. Jan Fields (on behalf of the AASTNQ) presented Ray 

Garske (President) with a certificate in recognition of the 10 yearmilestone 

and all their excellent and rewarding work. We are 

very thankful for the contributions from both Shirley Jones and 

Sheryl Waye as representatives from AASTNQ. Shirley Jones has 

been part of the BOSVS team since its inception and is passionate 

about the ongoing support of this wonderful team of volunteers. 

Gerry Barry (President of ACSA) presented Brenda Sando with a 

beautiful bunch of lilies for all her support and professionalism 

throughout her career. Thanks also to the wonderful company 

representatives that provided a scrumptious afternoon tea as 

well as trade tables. 

Our meeting dates for 2011 will continue to be held on Tuesday 

at the Mater Hospital at 1700. We encourage new members to 

attend: 

18 January 

1 March 

3 May 

28 June 

6 September 

8 November 

We hope the festive season finds you all well, bringing you 

Greetings and Christmas cheer, and hope for a very happy New 

Year and successful 2011. 

Helleen Purdy 


South Australia 

Although there have been no meetings for the wider South 

Australian Stomal Therapy Nurses group since June, regular 

monthly meetings continue for the organising group of the 

WCET congress meeting in 2012. I gather the arrangements are 

progressing slowly but well, with new ideas gradually coming 

to fruition. 

At the Royal Adelaide Hospital, a group of 22 nurses are 

undertaking the first module of the South Australian stomal 

therapy course. Some of the nurses will go on to complete the 

rest of their Stomal Therapy Certificate, while the others will 

have completed the Ostomy Resource Person Certificate and 

finish at the end of the week. The participants come from a range 

of settings and quite a number are from country health centres, 

which is very pleasing to see as continuity of care is always 

important. 

Another activity involving stomal therapy nurses was the 

Riverland Study Day held at Berri on Friday 24 September. 

This event was sponsored and organised by Hartmanns and 

Independence Australia and 32 people attended the day. Topics 

presented covered wound, ostomy and continence issues and 

Merle Boeree was there to present an overview of stomas and 

their management. 

On Friday 15 October, the annual quiz night will be held at the 

Clarence Park Community Hall. Many stomal therapy nurses 

have organised tables with families and friends in readiness for 

an evening of entertainment. The Royal Adelaide Hospital table 

has pulled out all stops to recruit talent and are expecting to win 

after a very low placing last year! 

December will be a busy month with the usual stomal therapy 

nurse Christmas celebratory dinner along with other seasonal 

functions. We are also anticipating an invitation from the South 

Australian Nurses for Continence Interest group to attend a 

dinner with Doctors Mary Palmer and Jan Paterson speaking 

on issues relating to continence matters. Dr Palmer is visiting 

from America and is well known for her interest in continence 

and aged care, while Dr Paterson runs the continence course at 

Flinders University of South Australia and is a widely respected 

member of the international continence community. With such 

speakers, a good attendance is expected as many of us are keen 

to enlarge our knowledge in this area. 

Tasmania 

Christmas greetings from Tassie! 

Tasmanian STNs have had a busy year both on the work front 

and in education. Carolynne Partridge and I have completed 

our Master in Clinical Nursing, with clever Carolynne also 

completing a prostate cancer nurse course! We are both very 

much looking forward to a study-free 2011! 

We would like to say a very happy 50th to Sue Delanty, who 

escaped to a northern, more tropical island to celebrate her 


birthday in style. Good work Sue. Sue continues to represent 

us in education and professional development with the AASTN 

and has had a recent trip to SA in that capacity. 

Our latest journal club meeting was held in Hobart. Guest 

colorectal surgeon, Emilio Mignanelli, discussed the latest 

in colorectal cancer statistics and surgery, which was very 

interesting. The evening was very enjoyable and well worth the 

travel for us northern girls. 

Congratulations to Karen Campbell who has become a 

grandmother with the birth of an adorable little boy, Oliver. 

Continuing on with the congratulations, we are looking forward 

to high tea at the Grand Chancellor to help celebrate Teena and 

Evan’s upcoming nuptials. We wish them every happiness as 

they begin the rest of their lives together. 

All in all, it has been a very busy but successful year in our state. 

Wishing one and all a very merry Christmas and a very healthy 

and safe 2011. 

Tracey beattie 

victoria 

As we come towards the end of another busy year, the Victorian 

branch has enjoyed an interesting and hectic time. The focus 

of this year has been to provide our members with education 

sessions that have been current, topical and relevant to our 

practice. 

The last two education sessions of the year have proven to 

be relevant to our stomal therapy roles, within the hospital 

environment and the community setting. Both sessions were 

well supported by our members from the metropolitan and 

country areas. 

In August, the topic of the session was nutrition. Margaret Allen 

is a nutritionist, in private practice. Her special interest is in 

the nutrition and fluid needs of the ostomate. Her presentation 

Nutritional troubleshooting for the STN gave a unique insight into 

these issues from both a professional and personal perspective. 

Margaret has personal experiences of Crohn’s disease and an 

ileostomy. She certainly gave us a lot of useful hints and tips, 

as well as an in-depth look into the fluid management of highoutput 

ileostomies. 

In September, the topic was Neobladder versus ileal conduit, 

presented by Kay Talbot, urology nurse consultant, working in 

private practice, in a specialist urology clinic. This presentation 

gave an insight into the selection of clients who would be 

suitable for the ongoing management of a neobladder and 

those who would be better suited to having an ileal conduit. 

The information on client selection for neobladder surgery, 

the commitment required to make this surgery work and the 

information that clients would need to make these decisions, 

was of interest to our group. Ileal conduit surgery is much more

familiar to us and it was great to discuss the alternatives. Kay’s 

knowledge and commitment to her speciality was obvious from 

her lecture and was enjoyed by all in attendance. 

We wish to recognise the achievements of Diana Hayes, 

stomal therapy nurse consultant with Western Health. Diana 

was honoured, by the state government, with the Award for 

Excellence in Nursing Practice. Her research was focused on 

patients having surgery on the small intestine. Some of these 

patients were not receiving the full benefits from their slowrelease 

medications and were suffering the effects of fluid loss 

and dehydration. Diana has developed a therapy and treatment 

programme, specifically targeting these patients, addressing 

areas such as, hydration levels, salt intake and modified diet. We 

congratulate Diana on her achievements. 

The conference committee continues to work very hard, in the 

organisation of the Tripartite Colorectal Conference, in July 

2011. We encourage all our members to support their effort and 

inform all your colleagues to participate. Hospital-based nurses, 

colorectal nurses, as well as stomal therapy nurses. 

The last meeting of the year will be Christmas drinks and 

nibbles, thanking all our members for their hard work and 

commitment to the branch over this year. Keep your eyes peeled 

for the events that are being organised for 2011. Check the 

website for details. 

We wish everyone a very merry Christmas and a happy New 

Year. 

See you in Cairns. 

Patricia McKenzie 

Western Australia 

The year 2010 has been yet another wonderful year here in 

Western Australia. The AASTN WA branch goes from strength 

to strength. 

Another successful STEP was completed on 19 September 2010 

with 13 new STNs graduating. Welcome to the budding STNs 

and good luck on the journey of stomal therapy. A big thank you 

to Lorrie Gray, course facilitator, who as usual gave 100% and 

to the co-coordinators: Liz Howse, Keryln Carville and Carmel 

Boyle who all contributed to making this a success. 

Following the AGM, the new committee consists of: 

President: Carmel Boylan 

Vice-President: Karen McNamara 

Acting Secretary: Shannon Tassell 

Treasurer: Rita Mcilduff 

State Representative: Leigh Davies 

Country Representative: Robyn White 

Newsletter Coordinator: Debra D’Silva 

Committee Members: Keryln Carville, Leigh Davies, 

Brigid Keating, Mileva Basic 

Education Representative: Sandy Hyde-Smith, Lorrie Gray 

Clinical updates and the professional development day (PDD) 

were both interesting and informative. Dr Callum Pearce, 

gastroenterologist at Fremantle Hospital spoke on Intestinal 

Failure, the research project currently being undertaken at 

Fremantle hospital with great results. 

A survey of the ostomates in WA was conducted to capture 

any deficits related to support, product supply/ordering or 

suggestions to improve either or both areas. There was a great 

response with a positive outcome. The STNs were also surveyed 

to identify management aspects of care for WA people with 

stomas that could be developed, altered or improved. The 

branch committee wants to ensure the best services possible are 

provided for both the STNs and patients. 

At the 2010 Nursing and Midwifery 

Excellence Awards, hosted by 

the office of the Chief Nurse and 

Midwifery, we were delighted to 

announce that Dr Keryln Carville 

was awarded the inaugural Lifetime 

Achievement Award. It was wonderful 

for Keryln to be recognised by her 

peers in the nursing profession. As a 

nursing expert in wound care, ostomy 

and continence management working 

in both Australia and overseas, Keryln’s many publications 

and presentations support her recognition as a driving force 

that has seen wound management and improved patient care 

pushed to the forefront of nursing practice in WA. Her skills in 

this complex field of healthcare transcend the usual boundaries 

associated with this role. Congratulations Keryln,we are all so 

very proud of you! 

Merry Christmas and happy New Year to all members of 

the AASTN and I am sure 2011 will bring more outstanding 

achievements. 

leigh davies 

Merry Christmas 

and Happy New 

Year to all 

our readers 


Articles printed in the Journal Stomal Therapy 

Australia: index 2008-2010 

Abbreviations: 

CS: Case Study HP: Historical perspectives 

AuTHor/S voluMe 

oSToMy MANAGeMeNT: 

convexity 

• CS: Using a convex appliance to achieve a variety of 

positive outcomes 

Carmen George March 08 

diet 

• Does a modified diet reduce the incidence of fluid output in 

people with an ileostomy? A preliminary study 

Diana Hayes March 08 

flatus 

• Flatus: prevention and management 

Angela Castle June 08 

General 

• How my first stoma encounter lead me to a career in stomal 

therapy nursing 

Nobuki Murphy Dec 08 

• Psychological aspects in ostomy care 

Julia Thompson Sept 09 

• What is the consensus? How do you organise preoperative 

assessments? 

Julia Thompson Sept 09 

• Clinical case study of a high output stoma and the AF300 

filter 

Dec 09 

• Should colostomy irrigation be a last resort? 

Anne Marie Lyons & Roger Riccardi Dec 09 

• Evaluating a postoperative see-through dressing 

Diana Hayes Dec 09 

• The implementation of traffic light guidelines for hospitalbased 

stoma management 

Sandy Hyde-Smith Dec 09 

Hirschsprung’s disease 

• Hirschsprung’s disease: my personal experience 

Carolynne Partridge June 08 


Patient education 

• Preoperative information for colorectal cancer patients: does 

it make a difference? 

Maria Stirling, Veronica Knowles & P. Livingston June 08 

Special Patient Groups 

• Stoma, wound and fistula management in gynaecological 

oncology patients 

Carol Stott & Jennifer Duggan Sept 08 

• CS: Partial jejunal resection for mesenteric infarction 

Lesley Jack Sept 08 

Stoma complications 

• CS: conservative management of a necrotic colostomy 

Ian Whiteley March 08 

• Management of a retracted stoma 

Leonie Cartlidge-Gann June 08 

• CS: Stenosing vesicostomy: a novel solution 

Judy Wells March 09 

• Parastomal hernias revisited, including a cost-effectiveness 

analysis: is an ounce of prevention worth a pound of cure? 

Julia Thompson June 09 

• Poster presentation: (37 th AASTN Conference) 

CS: Improving the quality of life in an ileostomy patient 

Arum Pratiwi Sept 09 

• Case study using Adapt rings to prevent appliance leakage 

Anne Onions June 10 

Therapeutics 

• Probiotics 

Teena Cornwall Sept 08 

• Medication awareness: loperamide hydrochloride for the 

treatment of a high output ileostomy 

Theresa Winston June 10 

• Medication awareness: topical corticosteroids for the 

treatment of irritant contact dermatitis 

Theresa Winston Sept 10 

WouNd MANAGeMeNT: 

• A study to evaluate the effectiveness of daily TenderWet 

Active 24 (R) dressings as a wound debridement agent 

Annie Thompson, Gaye Speed & Sunita McGowan Sept 08

• CS: Management of a complex faecal fistula within a 

wound dehiscence using Eakin and KCI Medical VAC 

Andrea Farrugia Sept 09 


CS: Management of an adolescent patient using a 

nanocrystalline dressing with probable pyoderma 

gangrenosum 

Lisa Kimpton Sept 09 


CS: Wound healing against all odds 

Renee Gilmour & Eileen Lim Joon March 10 

• Management of a scalp wound using topical negative 

pressure therapy 

Penny de Winter & Louise Walker March 10 

• Effective use of a faecal management system to aid healing 

of a grade 4 pressure ulcer 

Ian Whiteley March 10 

• Hollister CS: Wound management of enteric fistulae 

Petra Prokop Sept 10 

• Hollister CS: Hollister Adapt Barrier Seals (7805) used in 

conjunction with negative pressure therapy dressing to 

maintain moisture control in complex wounds 

Jennifer Daniels Dec 10 

coNTINeNce MANAGeMeNT: 

• CS: Management of chronic radiation proctitis 

Kara Torney June 10 

ProfeSSIoNAl ISSueS: 

AASTN AGM 

• News headlines: AASTN holds AGM via national tele-video 

for first time (President’s report) 

Leeanne White June 08 

• The AGM 2010 

Sharmaine Peterson June 10 

• Website Coordinator’s report 

Karen McNamara June 10 

• Stomal Therapy Nurses of Newcastle give Birth OR 

Sharon Gibbins Dec 10 

Australian council of Stoma Associations (AcSA) 

• News and views from ACSA 

Gerald Barry (ACSA President) March 08 

• ACSA report: Partnerships in progress – AASTN / ACSA 

Peter McQueen (ACSA Vice President) Sept 08 

• Australian Council of Stoma Associations Inc. (ACSA) report: 

STNs and ostomates: an evolving relationship 

Peter Lopez Dec 08 



• A Partnership in progress continued 

Peter McQueen (Vice President ACSA) June 09 

• ACSA: The Australia Fund 

Bruce Harvey ACSA Sept 09 

• ACSA report 

Ed Webster, ACSA Dec 09 



• The partnership continues 

Peter McQueen (Vice President ACSA) June 10 

• ACSA report 

Norm Kelly (ACSA Secretary) Sept 10 

• ACSA report – 2010 review 

Peter Lopez (Member of ACSA Exec.) Dec 10 

AASTN education and Professional development 

Subcommittee 

• Chairperson’s report – Workshop October 2007 (repeat) 

Cynthia Smyth March 08 

• Chairperson’s report – AGM March 2008 

Cynthia Smyth June 08 

• Chairperson’s report – AGM 2008 

Fiona Bolton June 09 

coalition of National Nursing organisations (coNNo) 

• CoNNO report 

Lesley Everingham Dec 08 


Lesley Everingham & Wendy Sansom March 09 


Lesley Everingham & Wendy Sansom Sept 09 


Lesley Everingham & Wendy Sansom Sept 10 

Stomal Therapy Issues 

• Seeking stories on the history of stomal therapy in Australia 

(Editorial) 

Diana Hayes June08 

• Patient story telling and qualitative nursing research 

Ian Whiteley June 08 

• Historical edition (Editorial including referencing) 

Diana Hayes Sept 08 


• A stomal therapy nurse abroad: a Canadian experience 

Patricia Sinasac Sept 08 

• HP: Pioneer stomal therapy nurses welcome a new group 

beginning their STN journey (WA) 

Lorrie Gray Sept 08 

• HP: Early stoma appliances in Australia 

Terry Carver (Ileostomy Ass Vic) Sept 08 

• Conference report: 1 st International paediatric enterostomal 

therapy convention – caring for children! Montreal, Canada 

Lisa Kimpton Sept 08 

• Behind the scenes: Phil Morton (Website Coordinator) and 

Robyn Simcock (AASTN Membership Coordinator) 

Sept 08 

• Credentialing report: Congratulations to all! 

Sue Delanty Sept 08 

• Congratulations to Fiona Bolton (Winner of Shelley Simper 

Award - SA) 

Sept 08 

• Congrats to Sarah Axman-Friend (AASTN Treasurer) on 

birth of Chloe 

Sept 08 

• Stomal therapy nursing: participation, publication and 

research (President’s report) 

Leeanne White Dec 08 

• Towards nurse practitioner status (Editorial) 


• Comparing the Australian and Danish health financing 

systems: a focus on health insurance and payment for 

medical services 


• WA stomal therapy nursing education programme 2008: a 

student perspective 

Beverley Offer Dec 08 

• Conference report: 17th Biennial WCET Congress 

Ljubljana, Slovenia 

Heather Hill Dec 08 

• Fostering key relationships (President’s Message) 

Leeanne White March 09 

• Obesity in Australia: a population health issue 

Diana Hayes March 09 

• Indonesian experiences 


• In fond memory – Kim Robyn Holland (Obituary) 

March 09 


• Work and play (President’s message) 

Sharmaine Peterson June 09 

• Taking the journal forward (Editorial) 


• A global perspective: (37 th AASTN Conference) June 09 

Australia in review 

Leeanne White 

Stomal Therapy in New Zealand 

Sue Wolyncewicz 

The stomal therapy / wound care nurse in Indonesia 

Julie McCaughan 

China’s evolution 

Huo Xiaorong 

Iran – a new beginning 

Fariba Nasiri Ziba 

The meltdown in nursing 

Prilli d’E Stevens 

• New website coordinator (President’s message) 

Sharmaine Peterson Sept 09 

• Psychological aspects of caring for our patients with 

wounds or a stoma (Editorial) 


• Clinical leadership 

Katie Bird Sept 09 

• Position statement: Scope of nursing practice for stomal 

therapy nurses 

E&PDS Sept 09 

• Cairns 2011 (Victorian Conference Cmttee) 

Helen Nodrum Sept 09 

• Profile: Sharmaine Peterson 

Sept 09 

• AASTN Membership fee structure notes 

Robyn Simcock Sept 09 

• Merry Christmas and Happy New Year (President’s message) 

Sharmaine Peterson Dec 09 

• Caring and Sharing (Editorial) 

Theresa Winston Dec 09 

• Profile: Leigh Davies 

Dec 09 

• AASTN/SPAP report: AASTN/SPAP liaison contact 


• AASTN Membership fee structure notes 

Robyn Simcock Dec 09

• Diversity of a Stomal Therapy Nurse 

Theresa Winston March 10 

• More about working together 

Julie Bege March 10 

• Gastrointestinal Week 2009 report 

Sandy Hyde Smith March 10 

• How to write a journal article (Editorial) 


• Fast track surgery – should all components of fast track 

surgery be introduced into the Australian hospital system 

or certain aspects? 

Lisa Wilson June 10 

• Enhanced recovery after surgery (ERAS): report on 

multidisciplinary course in NZ 

Diana Hayes June 10 

• Continuing professional development (CPD) made easier 

E&PDS June 10 

• Leaders in practice captured in paradise: Conference update 

Helen Nodrum June 10 

• Thirty years of the Journal of Stomal Therapy Australia 


• Stomal Therapy Nurses’ involvement in stomal therapy 

nursing activities in Western Australia 

Lorrie Gray Sept 10 

• Stomal therapy nursing in Indonesia 

Carol Stott Sept 10 

• Leaders in practice captured in paradise: Conference update 

Helen Nodrum Sept 10 

• Iran, an experience 

Carmen George Dec 10 

• Stomal therapy nurse: a year in the making 

Sally Langford-Edmonds Dec 10 

• Reflective Essay 

Katie Jane Bird Dec 10 

• Reflective Essay 

Colleen Pope Dec 10 

• BEECHAC Conference report 

Carol Stott Dec 10 

World council of enterostomal Therapists 

• WCET Australian delegate election forthcoming 


• WCET report: WCET 30 th anniversary 

Carmen George June 08 

• WCET report: Hello from your new WCET ID 

Brenda Sando Sept 08 

• WCET congress report: Ljubljana, Slovenia 2008 

Carmen George Sept 08 

• WCET report: Greetings from your Aussie ID! 

Brenda Sando Dec 08 

• WCET report: Happy New Year 

Brenda Sando March 09 

• WCET report: More conferences to come 

Brenda Sando June 09 

• WCET report 


• WCET report: Phoenix, Arizona 2010, Adelaide, Australia 

2012 



Brenda Sando June 10 



• WCET report : Preparing for Cairns 2011 


AustrAliAn AssociAtion of stomAl therApy nurses inc. 

educAtion And professionAl development subcommittee 

PoSitioN StatEMENt 

Scope of nursing practice for stomal therapy nurses 

It is recognised that stomal therapy nurses practise 

in a variety of settings and must operate in accordance 

with their scope of practice as determined by their 

relevant state registering body. 

Stoma appliance Scheme: 

updated schedules 

Available from the Department of Health website 

www.health.gov.au/stoma 

If the page does not show immediately, use the 

www.health.gov.au search system and you will find it by 

typing in stoma appliance scheme 

Journal of Stomal therapy australia – Volume 30 Number 4

ConvaTec Skin Care Accessories 

A natural part of 

stoma care 

Stomahesive ® Paste, Stomahesive ® Powder and Orabase ® Paste all contain Pectin – 

an ingredient derived from citrus fruits. Used correctly, these accessories can help heal and 

protect peristomal skin. ConvaCare ® Barrier Wipes can help improve attachment and 

removal of the appliance whilst ConvaCare ® Adhesive Remover Wipes gently remove 

adhesive from the skin without the need for harsh soaps or scrubbing. 

Compatible with ConvaTec appliances and other pouching systems, ConvaTec skin care 

accessories can be considered a natural solution to peristomal skin protection. 

Skin care accessories are available from ostomy associations or call 

Australia: 1800 006 609 

ConvaTec (Australia) Pty Limited. ABN 70 131 232 570. Unipark Monash, Building 2, Ground Floor, 195 Wellington Road, 

Clayton VIC 3168 Australia. PO Box 63, Mulgrave, VIC 3170. Phone: (03) 9239 2700 Facsimile: (03) 9239 2743. 

® / Indicates trademarks of ConvaTec Inc. © 2010 ConvaTec Inc. November 2010. O277 

Looking after peri-stomal 

skin is an essential part of 

long-term stoma management. 

But sometimes a simple 

appliance is not enough. 

That’s why ConvaTec skin care 

accessories can serve as an 

important accompaniment to an 

ostomate’s daily routine. 

www.convatec.com

JSTA December 2010 - Australian Association of Stomal Therapy ...

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