Enterostomy Nurse Career Overview

What Is an Enterostomy Nurse?

An enterostomy nurse, also known as an ET or stoma nurse, cares for patients who need a surgical procedure called an enterostomy. During an enterostomy, part of the gastrointestinal tract – typically part of the intestine – is pulled through the skin of the abdomen. This procedure creates a stoma, which is the part of the intestine that sticks out through the skin. A colostomy, ileostomy, or jejunostomy can bypass bowel blockages and allow the continued function of the gastrointestinal tract despite medical diagnoses that may otherwise cause severe illness or even death.

Enterostomies can be temporary or permanent, but no matter which, patients need copious educational and emotional support as they get used to handling both their new reality and the appliances used to collect fecal matter from their new stoma. This process can take a lot of trial and error, and ET nurses know all the tricks and tips to seal an ostomy, prevent leaks, and empty the collection device without incident.

Where Do Enterostomy Nurses Work?

Most enterostomy nurses work in hospitals, where they can monitor patients before and after surgery or manage ostomy complications. But ET nurses can also work in other settings, like:

• Assisted living facilities
• Clinics
• Home care
• Long-term care
• Nursing homes
• Offices of physicians
• Skilled nursing facilities
• Urgent care

Enterostomy nurses who work in the hospital see brand-new ostomies and understand how to manage them in this critical period of healing.

Patients live with various types of ostomies in the community, and for the majority of their time, they won’t need to be in the hospital. As a result, many ostomy nurses can work in clinics and primary care offices to check in on ostomies new and old, and continue patient education.

Home care ET nurses visit patients after they come home from the hospital and can field questions and concerns that crop up in the early days. They can also assist patients in changing their ostomy bag the first several times and reinforce education given in the hospital.

If an enterostomy nurse works in an urgent care or clinic, they may see patients in the first stages of an ostomy complication. Their experienced eye can help patients understand what’s going on and if they need to be seen at a higher level of care.

Ostomies can be fairly common in a geriatric living setting, so some assisted living and nursing home facilities may employ a nurse who has enterostomy experience to assist with residents’ devices.

What Does an Enterostomy Nurse Do?

New ostomies require a lot of specialized care, and enterostomy nurses can be an invaluable resource for their patients. ET nurses are responsible for typical nursing tasks like starting IVs, monitoring Foley catheters, and performing dressing changes. But their specialty tasks look more like this:

• Assisting patients in choosing an ostomy appliance and medical supplies that will work best for them
• Cleaning, changing, and emptying ostomy appliances
• Counseling patients on necessary lifestyle changes that come with an ostomy
• Educating patients and families/caregivers on ostomy care and troubleshooting
• Managing post-operative pain
• Performing preoperative prep for patients before enterostomy procedures
• Providing information on the best nutrition for ostomy health
• Treating ostomy complications such as blockages, fistulas, and skin irritation

Patients need ostomies for all kinds of reasons, and enterostomy nurses must be familiar with each patient’s history and diagnosis. Some common indications for ostomy necessity include:

• Bowel ischemia
• Chronic inflammatory bowel disease (CIBD)
• Crohn’s disease
• Colon cancer
• Fecal incontinence
• Low rectal or coloanal anastomosis
• Perforating diverticulitis
• Perineal necrotizing fasciitis
• Rectal trauma or sphincter injury
• Ulcerative colitis
• Unresectable rectal carcinoma

How Do I Become an Enterostomy Nurse?

To become an enterostomy nurse, candidates first have to graduate from an accredited nursing program with a two-year Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). The BSN degree typically takes four years to complete, but some programs offer an accelerated option that can be finished in as little as a year. After graduation, nurses may apply to ET nursing jobs as graduate nurses (GNs).

Many facilities hire GNs to do their training under a nurse preceptor while they prepare to take their state licensing exam, the National Council Licensure Examination (NCLEX-RN). After passing the NCLEX, nurses can practice on their own as registered nurses (RNs) once they finish their facility’s orientation.

After some experience, enterostomy nurses may pursue specialty certifications. The Wound, Ostomy, and Continence Nursing Certification Board (WOCNCB) offers multiple certifications for enterostomy therapy nurses:

• Certified Wound Ostomy Continence Nurse (CWOCN)
• Certified Wound Ostomy Nurse (CWON)
• Certified Wound Care Nurse (CWCN)
• Certified Ostomy Care Nurse (COCN)
• Certified Continence Care Nurse (CCCN)

For these certifications, the WOCNCB requires applicants to:

• Hold a current RN license
• Have earned a bachelor’s degree
• Graduate from an accredited wound, ostomy, and continence nursing education program within the past five years OR
• Have 1,500 direct patient clinical hours in the specialty of their certification, or 4,500 for wound, ostomy, and continence certification

How Much Does an Enterostomy Nurse Make Per Year?

An enterostomy nurse can earn the same as any other registered nurse (RN), which averages $94,480 per year, according to the US Bureau of Labor Statistics (BLS). This amount can vary depending on your work setting and the cost of living in the area. The low-end average is $63,720, and the high-end is $132,680. Depending on where you work, your employer may be able to offer higher or lower compensation:

• General Medical and Surgical Hospitals: $96,830
• Offices of Physicians: $83,110
• Outpatient Care Centers: $102,640
• Home Health Care Services: $87,430
• Nursing Care Facilities (Skilled Nursing Facilities): $79,280

Salaries also vary depending on which state an enterostomy nurse practices. The West Coast, some New England states, and Alaska may pay their nurses the best, but they also have a higher cost of living. The lowest-paying states are in the Midwest and some Southeastern states.

The top-paying cities for enterostomy nurses include:

• San Francisco-Oakland-Hayward, CA: $174,370
• Vallejo-Fairfield, CA: $171,620
• San Jose-Sunnyvale-Santa Clara, CA: $170,780
• Napa, CA: $166,180
• Sacramento–Roseville–Arden-Arcade, CA: $154,510
• Santa Rosa, CA: $152,930
• Modesto, CA: $145,190
• Santa Cruz-Watsonville, CA: $140,880
• San Luis Obispo–Paso Robles–Arroyo Grande, CA: $140,560
• Stockton-Lodi, CA: $138,420

Certified enterostomy nurses can be paid more than a nurse who is not certified, depending on the facility. In general, the more experience and proof of expertise, the more an enterostomy nurse will be able to earn.

Are Enterostomy Nurses in High Demand?

An estimated 100,000 Americans have surgery that requires an enterostomy every year. With every new ostomy comes a huge need for support, practical ability, and education. Nurses from all specialties are in high demand in the United States, according to the US Department of Health and Human Services, which reports that 24% of US hospitals have reported critical staffing shortages, and at least eight states have had to call in help from the military for staffing. Enterostomy nurses have skills and knowledge that will stay in high demand for many years.

Additional Resources About Becoming an Enterostomy Nurse

To learn more about becoming an enterostomy nurse, these additional resources may help:

• Wound, Ostomy, and Continence Nurses Society
• Journal of Wound, Ostomy, and Continence Nursing
• World Council of Enterostomal Therapists