Body image is the mental picture one has of one's physical being that develops from birth and continues throughout life and is related to different factors affecting its formation and dynamics. A crisis such as the creation of a stoma leads to an alteration in body image and an awareness of the meaning of the change in appearance and function of an individual. The individual's behavior is examined in several domains: physical, mental, emotional, social, sexual, and economical. When one domain is disturbed the others will be influenced. A person's rehabilitation after ostomy surgery is a continuous process of adaptation and is directed toward returning to a normal way of life. Many factors affect this adaptation to an alteration in body image and are relevant to the patient and family. These factors include, but are not limited to, the disease process, treatment(s), and medical and nursing care in the hospital and community. Knowledge about actual and potential problems associated with an alteration in body image enables the nurse to assess the meaning of the alteration in body image for the individual patient and family, provide counseling before and after the surgery, and intervene so that the individual will be able to adapt to an alteration in body image and return to one's previous activities of daily living and lifestyle.
The occasional patient who has an incompetent stoma that does not respond to traditional methods of treatment by the general surgeon or the ET nurse might be aided by the use of a customized procedure designed by the plastic and reconstructive surgeon.
As new ET nurses and other nursing specialists assume positions on PEC, they will require knowledge of the process and problems that might occur. This article, describing a method of product selection and managing one's business relationship with sales representatives, is designed to help new ET nurses develop and maintain an issues oriented, professional image throughout the selection process.
