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DEPARTMENTS: Commentary

Honoring the 100th Birthday of Norma N. Gill, Founder of Enterostomal Therapy

Murphree, Rose W. DNP, RN, CWOCN, CFCN; Ayello, Elizabeth A. PhD, MS, BSN, ETN, RN, CWON, MAPWCA, FAAN

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Advances in Skin & Wound Care: June 2020 - Volume 33 - Issue 6 - p 288-289
doi: 10.1097/01.ASW.0000661784.40598.52
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Please join us in singing “Happy Birthday” to Norma N. Gill-Thompson on June 26.1 She would have turned 100 this year, so it is a perfect time to reflect on her many accomplishments to our profession and specialty of ostomy, wound, and continence care. They say that necessity is the mother of invention, and this is certainly true of Mrs Gill-Thompson (known to the world of stoma simply as Norma). An ostomy patient herself, she worked closely with her surgeon to develop the specialty of enterostomal therapy in the late 1950s with educational training to help persons adjust to their new life after ostomy surgery by managing their own ostomy care.

NORMA’S EARLY YEARS

Born in Akron, Ohio, Norma was married by the age of 18, and developed intestinal issues by the time she was 28.1 Her symptoms of ulcerative colitis came and went, with one debilitating episode occurring when she gave birth to her daughter, Sally.2 In 1955, she had an abdominal perineal resection, total colectomy, and end ileostomy performed by Dr Rupert Turnbull, Jr, at the Cleveland Clinic Hospital.2 By 1958, she was feeling healthy and revisited Cleveland Clinic where she ran into Dr Turnbull again. They discussed how Norma was spending her time, and she acknowledged that she was a stay-at-home mom.2 A few weeks later, Dr Turnbull called Norma and asked if she could help rehabilitate ostomy patients. She was hired by the Cleveland Clinic as their first “ostomy technician,” the role that later became “enterostomal therapist” (ET).2

OSTOMY CARE: PAST AND PRESENT

In the early years, Norma worked with scientists, inventors, and manufacturers to create ostomy barriers and pouches.3 Early versions were reusable pouches that adhered to the skin using various adhesives; some of these designs are still in use today. Norma helped educate both patients and professionals about the pouching and skin problems that persons with an ostomy faced and proposed practical and effective care solutions. Today, industry and manufacturers continue to work globally with ET nurses to improve ostomy pouching options and address the many needs of those with an ostomy.

NORMA’S MILESTONES

Dr Turnbull and Norma created the Cleveland Ostomy Association (COA) in 1960; Norma served as the chair of the organization for the first 2 years.4 By 1962, the COA became the United Ostomy Association, organized by Norma and Archie Vinitky.4

During this time, Dr Turnbull openly discussed the phenomenal impact Norma was having with ostomy patients. Other physicians noticed these outcomes and requested their own ETs to help with their patients. With Norma’s assistance, the Rupert B. Turnbull Jr School of Enterostomal Therapy opened in 1961.5 Norma served as the director of the school until 1978. In those early years, attending ET school required one to either have an ostomy or be a caregiver for someone with an ostomy. Of course, having compassion, an avid desire to help others, and a boatload of tenacity helped too—all of which were Norma’s traits.

Figure
Figure:
NORMA N. GILL-THOMPSON© The World Council of Enterostomal Therapists, reprinted with permission.

During one of the COA meetings, Norma’s heart broke when an attendee did not understand the need for ETs. Consequently, Norma and Dr Turnbull created the American Association of ETs in 1968.6 But Norma did not stop there. People from all over the world were attending the ET schools that began to spring up. As global interest in ostomy care increased, Norma felt an international group was needed and went about contacting other international stoma care pioneers. On October 6, 1976, 11 representatives met for the first time in the UK to discuss such a group. The World Council of Enterostomal Therapists (WCET) was formally founded on May 18, 1978, when 30 ETs representing 15 countries and 20 industry representatives (in conjunction with the International Ostomy Association) attended the first 2-day congress held in Milan, Italy. Naturally, Norma served as the first WCET president and later as the first editor of the WCET Journal.1

During the 1970s, nursing was evolving as a profession, and hospital care was becoming more complex. The ETs were being asked to provide more complex care as they were well known for healing skin problems and wounds associated with ostomies. In 1976, the ET schools began to require a nursing license to attend. Of course, this did not deter Norma from her involvement. She continued to partner with the ET school at Cleveland Clinic by serving as guest lecturer. Many of these sessions were recorded and are still viewed by nurses who attend the school today.

Norma, however, was not satisfied to just have educational programs within the US, and she was determined to work with international groups of nurses. She began developing ET nursing education programs (ETNEPs) throughout the world. She worked tirelessly to make her vision for the WCET a reality: that every person, regardless of where they were in the world, would be cared for by an ET/nurse with specialized knowledge of ostomy care.7 Over the years, the specialty has expanded to also include skin, wound, and continence care needs. Although nurses in different countries may have different titles, the focus on education to benefit patients needing this specialized ostomy, wound, or continence care remains. Today, the WCET encompasses this trispecialty and has 62 ETNEPs and other Recognized Education Programs in all three areas listed on their website (www.wcetn.org).7

Sadly, we lost Norma in 1998. As a memorial to her, the WCET organized the Norma N. Gill Foundation, which provides educational scholarships for nurses to support their instruction in wound, ostomy, or continence care and fosters international working relationships through donations and fundraising activities. The Foundation’s Twinning Project, created in 1999, serves as a platform for ET nurses within developed countries to work with ET nurses in emerging countries to explore resources, needs, and potential ETNEP development.7 Some of the successful twinning programs include the creation of 12 ETNEP programs in China by ET nurses from Hong Kong and the implementation of training courses in Kenya by Australian ET nurses.7

NORMA’S LEGACY

Norma continues to impact countless ostomy patients and wound, ostomy, and continence nurses globally. She has been and remains the face of the WCET. Several years ago, the WCET designated June 26th as WCET Norma N. Gill Day and encouraged our members to use it as an opportunity to let people know about Norma and what specialty-educated nurses can do for their patients. As we look to commemorate her 100th birthday, we ask that all ostomy, stoma, wound, and continence care practitioners remember Norma’s passion, persistence, and practical pearls, especially for those with ostomy/stoma care needs. We would like to challenge each of you to identify how you can partner with the WCET or your national/regional association to carry on Norma’s legacy of education, love, and vision for a world improved by specialty-educated nurses everywhere so all people with ostomy/stoma, wound, or continence care needs can benefit. That will be our wish when we blow out the candles on Norma’s birthday cake—what’s yours?

REFERENCES

1. Ayello EA. The WCET Journal in the 21st century—“so far… so good”. In: Erwin-Toth P, Krasner DL, eds. Enterostomal Therapy Nursing: Growth & Evolution of a Nursing Specialty Worldwide—A Festschrift for Norma N. Gill-Thompson, ET. 2nd ed. Cambridge, England: Cambridge Printing; 2012:16–24.
2. Thompson SJ. Living with a legend. In: Erwin-Toth P, Krasner DL, eds. Enterostomal Therapy Nursing: Growth & Evolution of a Nursing Specialty Worldwide—A Festschrift for Norma N. Gill-Thompson, ET. 2nd ed. Cambridge, England: Cambridge Printing; 2012:151–60.
3. Fenton L. Reminiscence. In: Erwin-Toth P, Krasner DL, eds. Enterostomal Therapy Nursing: Growth & Evolution of a Nursing Specialty Worldwide—A Festschrift for Norma N. Gill-Thompson, ET. 2nd ed. Cambridge, England: Cambridge Printing; 2012:117–8.
4. Davidson W, Fischer J. History of ostomy products manufacturers. In: Erwin-Toth P, Krasner DL, eds. Enterostomal Therapy Nursing: Growth & Evolution of a Nursing Specialty Worldwide—A Festschrift for Norma N. Gill-Thompson, ET. 2nd ed. Cambridge, England: Cambridge Printing; 2012:82–94.
5. Faller NA. ET nursing education: a global perspective. In: Erwin-Toth P, Krasner DL, eds. Enterostomal Therapy Nursing: Growth & Evolution of a Nursing Specialty Worldwide—A Festschrift for Norma N. Gill-Thompson, ET. 2nd ed. Cambridge, England: Cambridge Printing; 2012:103–9.
6. d'E Stevens PJ. Development of enterostomal therapy as an international specialty. In: Erwin-Toth P, Krasner DL, eds. Enterostomal Therapy Nursing: Growth & Evolution of a Nursing Specialty Worldwide—A Festschrift for Norma N. Gill-Thompson, ET. 2nd ed. Cambridge, England: Cambridge Printing; 2012:75–81.
7. World Council of Enterostomal Therapy Nursing. www.wcetn.org. Last accessed March 19, 2020.
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