Connecting the disconnect between hospital and home.

Mr. D, 76 years old, underwent a colostomy in a local hospital after several weeks of preoperative outpatient radiation therapy that caused severe diarrhea. The nurses at the hospital managed his colostomy and told him he probably "would not need to wear a pouch" after he was taught how to irrigate. They showed him how to empty a two-piece system before he was discharged 7 days after his surgery. Mr. D was able to manage emptying but did not pay much attention to the procedure because he viewed wearing the pouch as a temporary situation. After his discharge, the home care nurse informed him that due to the diarrhea he was experiencing, colostomy irrigation would not be an option and he would have to use a pouching system - one different from the one he had learned to use in the hospital. Mr. D was disappointed and bewildered.