As a nursing assistant, the overall safety and well-being of your patients is your first responsibility. Although there are other health-care professionals in positions of higher authority, the nursing assistant is often the first person to recognize risks to patient safety or health and the person with the most direct contact with the patient. Keeping that in mind, there are a number of small, routine things you can do to ensure the overall safety and well-being of your patients with colostomies.
The nursing assistant is responsible for assisting the patient with activities of daily living on an as-needed basis. Some patients may be able to empty or clean their colostomy equipment by themselves, but those patients who have just come from colostomy surgery, have limited mobility or are cognitively impaired may need assistance to empty their colostomy bags and properly clean their colostomy equipment, and the nursing assistant should provide this assistance.
Nursing assistants are often the first members of the patient care team to notice a problem because they have more direct contact with patients. Thus, it is the nursing assistant's responsibility to monitor the patient's colostomy site and elimination patterns so any gastrointestinal dysfunction is identified and properly cared for right away. Be observant of any changes in the patient's bowel function or to the colostomy site itself and report these to the licensed nurse.
Adhering to Regulations
Because some states recognize any kind of stoma as an open wound, regulations may not permit nursing assistants to change dressings, perform general wound care or even change stoma equipment. Alternatively, in other states, nursing assistants are allowed to perform all of these procedures. It is the nursing assistant's responsibility to carefully review the regulations for her state.