When David Platt woke up from surgery with a urostomy bag, he was gripped by uncertainty about what the future held. Diagnosed with prostate cancer in 2004, the disease eventually spread to his bladder, requiring its surgical removal and the creation of a stoma—an opening in the abdomen to allow bodily waste to pass into a collection bag. For Mr. Platt and his wife, Paula, navigating this life-changing adjustment was incredibly daunting.

Thankfully, a dedicated stoma nurse at Mount Gambier Hospital was there to guide him. After several sessions, she gave him the confidence to manage it independently. Today, Mr. Platt views his urostomy bag as just another part of his body. However, he warns that this level of essential, life-changing support is now under threat due to a critical shortage of specialist stoma nurses in the region.

A Drastic Reduction in Care

Mount Gambier, the largest city in regional South Australia, has seen its specialist stoma care dwindle from two full-time practitioners to just one nurse available one day a week. This rapid decline has left more than 200 stoma patients across the South East region vulnerable and struggling to access vital care.

While routine daily maintenance is performed at home, more complex issues and emergencies require specialist attention. Without local support, some patients have been forced to make the arduous journey to Adelaide just to receive treatment. For elderly patients, some in their 80s, travelling hundreds of kilometres for basic healthcare is an immense physical and financial burden.

The Recruitment Struggle

The Limestone Coast Local Health Network (LCLHN) is currently attempting to fill the vacant specialist positions. LCLHN Chief Executive Emma Poland acknowledged the gap in service, noting that the two previous stoma nurses left for other opportunities, and recruiting replacements has been highly competitive.

"We acknowledge we face growing competition from intrastate, interstate and overseas for qualified professionals," Ms. Poland said.

In the interim, Ms. Poland stated that the network is utilizing its Nursing Education Team to train regional staff in wound, stoma, and continence management. Some staff have also attended specialized workshops in Adelaide, and the network is working with locum agencies to secure temporary support.

Calls for Systemic Reform

The shortage has prompted political action. Travis Fatchen, the Independent Member for Mount Gambier, recently raised the issue in state parliament, calling for a broader look at how stoma care is integrated into the nursing profession. He suggested that basic stoma care should be incorporated directly into general nursing university curricula.

"That may create a bit of a buffer where you've got three or four nurses that are day-to-day doing their normal role, but they can be called on if and when needed to help fill these gaps," Mr. Fatchen said.

Currently, obtaining a specialist stoma qualification in South Australia requires a year of post-graduate study and costs approximately $14,000. This high barrier to entry has contributed to a broader knowledge gap among general hospital staff. Mr. Platt recalled a recent hospital stay where a fully qualified nurse admitted she had never even seen a stoma before, highlighting the urgent need for wider medical training.

The Power of Regional Advocacy

The campaign for regional stoma care is not new to South Australia. In 2021, Yorke Peninsula resident Helen Colliver successfully spearheaded a community push that secured a permanent stoma nurse for her region, which supports about 140 patients.

Reflecting on her own experience after bowel surgery, Ms. Colliver recalled the isolation and anxiety she felt prior to having local professional support, constantly worrying about leaks, odors, and public embarrassment.

"It really makes you antisocial. You don't want to go out for fear of embarrassing yourself and everybody else," she said.

Ms. Colliver emphasized that having a dedicated regional nurse has transformed the quality of life for local patients, offering them a safe and understanding environment to discuss highly personal health challenges that would otherwise go unaddressed.