The Person with an Ostomy shall:

1. be given pre-op counselling
2. have an appropriately positioned stoma site
3. have a well constructed stoma
4. have skilled post-operative nursing care
5. have emotional support
6. have individual instruction
7. be informed on the availability of supplies
8. be provided with information on community resources
9. have post-hospital follow up and life long supervision and
10. benefit from team efforts of health care professionals.

Do all of you out there know what an Enterostomal Therapist is or does?

Enterostomal Therapy (ET) Nursing is a specialty area of nursing that provides acute and rehabilitative care for people with select disorders of the gastrointestinal and genitourinary systems. The Enterostomal Therapy Nurse plays a "pivotal role" in the provision of optimum patient care. Functions of the role can include consultation, direct patient care, education, research and administration and can encompass such activities as:

1. recognizing and describing indications for ostomy surgery.
2. counselling and teaching patients and their significant others pre-operative, postoperative and rehabilitative phases of ostomy surgery.
3. Stoma site selection and marking.
4. Diagnosing stomal complications and prescribing appropriate nursing interventions.

With what is happening currently with the health care system in Ontario (once sought after by authorities throughout the world) seems to be disintegrating before our eyes. A number of ETs in Ontario have lost their hospital positions over the past few years. This puts greater demand on the ETs in the community who are already stretched beyond their capacity. One of the ways which you may be able to help not only yourself but future persons facing ostomy surgery, is to write a letter to the President or Chief Executive Officer of the hospital to which you are attached, either where you had your surgery or where you are currently living, and ask the powers that be about the ET services in the hospital, such questions as:

• If I am admitted to the hospital for an ostomy or other problem, am I going to be cared for or helped by a qualified enterostomal therapist if I am not in a position to look after my ostomy myself?
• How do I get follow-up help with my ostomy as an outpatient when problems arise or for routine checkups?
• Are new people facing ostomy surgery receiving the counselling and skilled post-operative care necessary to be rehabilitated back into society?
• Who is going to advise me as to the availability of supplies and community resources?

I am certain you can think of many other questions which you could ask. I would suggest that you telephone the hospital and get the name of the top person and address your letter as "private and confidential". It would also be of benefit to send along a copy of the "Bill of Rights for a Person With an Ostomy". Ask for details of what ET services are available and when they are available. Point out that if surgeons are qualified to do ostomy surgery then it is the responsibility of the hospital to provide the additional skilled postoperative care for those people with an ostomy. There should therefore be a full time ET on the staff and not a nurse who looks after the ostomy patients. If we are going to make any changes we are all going to have to take the matter seriously and sit down and write your own individual letter for your own special needs. When you receive a reply, (and insist on getting one) please forward a copy of the letter to the United Ostomy Association of Canada Inc. Office for their records.

Source: Dianne Garde, E.T.

Halton-Peel: via Metro Halifax News, February 1997.

Editor's note: This article is specifically about Ontario, but the Bill of Rights is applicable world-wide and the erosion of health care is happening right across Canada.