Mad, crazy or to be expected? Katrina’s journey from child abuse, surgical violation and a hernia repair: How stomal therapy intervened to make a difference.

Mrs Naomi  Houston1
1Nepean Blue Mountains Local Health District, Kingswood, Australia

For a patient to self-discharge, following formation of an abdominal stoma without stock or education is non-seneschal: behaviour viewed as being mad or crazy.  However, when viewed in context, this patient who was a survivor of abuse, there is understanding.

This is Katrina’s story. It starts 2008 where she unexpectedly receives an ileostomy and is emotionally traumatised. Ten years later, following a parastomal hernia repair, she ends up in Emergency suffering uncontrollable leakages and in despair. Her peristomal skin is excoriated, the surface is incredibly uneven like corrugated iron and she is an emotional mess. Due to the severity of her situation and emotional state of mind, she is admitted for expert stomal therapy assistance.

This poster highlights not only the unexpected effect on Katrina’s quality of life as a result of a parastomal hernia repair but also the uniqueness of the stomal therapy role: a role requiring an understanding of mental health, skin care and how to use stoma products to achieve the best possible outcome.

Katrina has given permission for her story to be told and her name is a pseudonym.


Naomi Houston is a stomal therapy nurse for Nepean Blue Mountains Local Health District and is based at Nepean Hospital.  Before coming to Nepean she worked as a Health and Community Care Instructor at Mission Employment for 10 years training long term unemployed basics in nursing skills to either work as an assistant in nursing or to pursue further education such as enrolled or registered nursing.

She completed her nursing training at Royal Prince Alfred Hospital. She has a post Graduate degree in Family Health and a Masters in Primary Health Care – University of Western Sydney.