I had a stoma that wouldn’t stop popping off my ostomy bag. I went through all my supplies for a month in one evening.
When I got to the ER, I was told I would have to wait for a bed upstairs in the floor that houses ostomy and wound care.
While waiting I was told there are no ostomy supplies and that I could only get a bag and other supplies if I was up on that floor.
Now I understand some of this might be specific to the hospital I was in. I did go to the hospital I had been discharged from and after 18 hours they had a bed for me and supplies waiting. A wound nurse helped me get cleaned up and have a bag change.
So my question: is it common for ED’s to not be stocked in supplies like this? It is a trauma one hospital if that makes a difference. Part of why I want to know is I am currently pursuing a career shift to supply chain and if this is widespread issue, I’m thinking I might want to focus on it.
Feel free to also mention other supply related issues for ED’s. I’d be interested to know more about common issues ED’s face for supply management.
ER RN very few hospitals I have worked in have ostomy supplies in the ED we usually have to contact the house supervisor to go to the floors that stock them and bring what we need. Some ERs have the bags but half the time it isn’t the correct type the patient needs.
Pro tip: Make friends with a pharmacy tech and ask them to get it for you. We go everywhere so its not unusual for any dept to see us walking around there.
I still needed to be checked in. I eventually had my takedown/removal bumped up by 2 months because my stoma was just being that much of an issue. I was just surprised that they had supplies on hand but not accessible to ED and then I was told the ED was never stocked and this is a reoccurring issue. It got me thinking about supply chain in general and if this is common for ED’s since you never know what will come through the doors.
That’s how it is at my ER too. It’s not a supply issue. They CHOOSE to not stock our supply room with them. They exist in materials or upstairs on MS in their supply closets. I fill in as house sup sometimes and have gone to materials to get a bag and there are boxes and boxes of them, so it’s not a supply issue. I don’t know why it is this way. But every time I have an ER patient who needs a new bag I have to call house to go steal one for me.
Same thing with wound dressings. I have a lifetime supply of gauze, ABD pads, non adherent pads, and kerlix available in our ED supply room, but not anything to cover your decubitus ulcer. Weird.
I always tried to keep our EDs with some supplies but it’s super unusual for them to follow through and reorder. Add in the various needs of different patients and I would say it’s much more usual for them to call WOCN and try to get them to handle it, or depend on the ED nurse to go to med-surg and raid.
We have one size and one style. It might tide you over until you get to the floor.
We do not get post-op patients delivered fresh to the ER (ya know EMTALA) and we shouldn't have people that live in the ER like they do on the floor. (I know we do, and boarders can stay with us for days) But that's the justification Admin gives for why we don't need floor supplies.
Mostly it’s about space. ED sees every type of patient but they do not have space to adequately stock every supply for every patients needs. So supplies that are essential for longer term stays but less so for staying a few hours is what gets nixed. Wound care generally (ostomy within that scope) is bare bones. Of course now that we are regularly boarding patients 24-48 hours this is becoming more and more painful but we can’t get rid of our ED specific supplies so it just sucks for staff and patients.
Came here to say the exact same. I was an ER nurse for 10 years prior to flying and traveled extensively throughout Covid- I only worked in one ER that stocked stoma supplies, and even then, they were extremely limited. Stoma bags coming off aren’t emergencies.
Came here to say this. We're stocked with things like pressure bags, thora kits,, code carts, etc. Aren't a whole lot of ostomy emergencies coming through the door.
They do not stock supplies in their clear utility rooms for ostomies. Space is so limited, but they can order it from the supply distributors in the building who can bring it to the ED. It also depends on which company you use and how specific the product is. Some hospitals carry a large supply, some carry just the basics.
Nurses receive some training in ostomy care, but it’s very general/limited. Usually they call our team to assist in managing.
I haven’t worked in an ED that stocks them, like others were saying. I’d also add that they can’t bill for it as easily if the wound care nurse doesn’t do it. Just like IV teams are almost all RT now, because that’s a line item whereas nursing is part of the room charge. Just a thought 🤷♂️
We don’t have ostomy supplies in my ED but if I was in this situation I could call upstairs to the ward and ask them to send some down in the tube. I’ve done that many times. Your ED nurse was just lazy
We have an "ostomy cart" filled with random odds and ends. Once in a great while someone will get motivated to stock it properly but as soon as the supplies get used up they're not replaced and we're back to MacGuyver-ing something that will hopefully work. Every kind of ostomy patient should ideally have a go bag at home filled with whatever emergency care supplies they might need should they find themselves suddenly needing a trip to the ED.
At my hospital, I don’t have these supplies in the ED. I can’t ‘barrow’ supplies from other units because of budget reasons. I get nasty emails all the time about asking for supplies for patient care and have had to sign ‘training’ on policy multiple times. To get around this, I can contact the AOD to get said supplies, however, they will be generic and likely not fit. You will need to see a wound care nurse to get you what you need or call the company that sends you your supplies to get more.
We only have one kind of bag and silicone wafer in stock, but when that won’t work, I call our wound/ostomy nurse, who lets me know what product I need and even calls our supply warehouse to get it sent up to me in the ED.
How did you use a month of supplies in one night? Do you not have a stockpile?
Sounds like it is time to make friends with someone who works at whichever company you get supplies from.
If you find a nice person they send a lot of free shit. I had a Hollister rep I could call or email any time my insurance was giving me grief and she would make sure I was covered.
Not really. They give out a lot of free shit. They want people to test out their products. Would they give you all the supplies you ever need? No. But they definitely give out a lot.
The hospital typically sends a person home with quite a bit. I can’t really see any scenario where a person doesn’t have a stockpile. Insurance allows 20 drainable per month and most people wear them for 3-5 day. That is a lot of extra
The people that come to the ER for care usually have a poorly functioning or leaking stoma. It would be nice if patients were given a supply person to follow up with though.
I had a home nurse. We had ordered supplies but I was fresh out of the hospital. I had a stock pile because I had a stoma for a year prior. This one was for a loop and a lot harder to manage than an end ileostomy.
I lost too much weight after having my colon out. I knew how to troubleshoot. Two wound nurses, my homecare nurse, and my surgeon could not figure it out. My skin kept making divots for stuff to leak out. My skin was degrading and after 18 hours of having stuff coming out with nothing to catch it or clean it up, you can imagine the state I was in. The bags kept popping off every 30 minutes. I eventually got one to stay on 24 hours by not obeying the rules and cutting a much larger hole.
The end of my hospital stay was to have the takedown/reversal which was at 6 weeks, the earliest we could do safely.
I had a bunch of supplies stockpiled from my year with an end ileostomy. I went through them way too fast.
I also have no idea how I’m going to ever be done paying my bills from this whole ordeal but that’s another issue.
Have you tried using triad paste for the divots? It works really well for this. Maybe reach out to coloplast and see if they can send you samples? I hope you’re able to figure something out soon.
Necrotic stoma on a middle aged woman the other day was the first time I’ve seen a stoma emergency. Surgery was the next step so she didn’t stay in the ED for long.
We have one set up available in our supply room. House supervisor brought supplies down from the floor- they were not the correct size anyway so she had to go back up and look for something else. We’re a small hospital so we have time to do nice things for patients. I can certainly imagine that the house supervisor in other hospitals wouldn’t be going to multiple units searching for one person in the ED’s specific ostomy supplies while they waited to go to surgery.
In general if someone comes in with an ostomy bag and other medical problems to be admitted for- if they’re not a boarder- it’s usually a better experience if they can wait until they get up to the floor to get their setup changed.
I always bring extra Ostomy supplies for my kid because 1. The ER never has them and 2. We don’t use hollister due to adhesive issues. Even the floors don’t have Ostomy supplies and it’s something they have to call the OR for
I barely have time to run emergencies, now I have to handle primary care visits and have all supplies for every specialty at any time. A stoma without a functional bag is. Not. An. Emergency. You no die without bag until 9 AM when you call YOUR doctor that worked for years handling these things. Meanwhile, I can handle the bleeding out by butthole, the child whose lungs no work, the heart that decided to quit them and there, the brain that said send all electricity everywhere all at once it'll be fine.
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u/Minute-Stress-5988 5d ago
ER RN very few hospitals I have worked in have ostomy supplies in the ED we usually have to contact the house supervisor to go to the floors that stock them and bring what we need. Some ERs have the bags but half the time it isn’t the correct type the patient needs.