1. History of ET Nursing
CAET Academy ETNEP

2. Early history
References to fecal diversion in Old Testament

3. Early Surgery
1776 – French surgeon performed first documented ostomy surgery for bowel blockage. A sponge was attached to the opening with a bandage to absorb any effluent.

4. 1950 - Preparing supplies Nurse preparing bandages
Ostomy supply cart behind
Frequent dressing changes part of care at Cleveland Clinic, since there were no ostomy pouches
Ostomy product development suffered from limited technology and resources
Stoma construction suffered from poor surgical techniques.
Patient care suffered from lack of standards of care.

5. 1950’s
Rags or a tin cup held in place by a leather belt to contain effluent
Patients housebound

6. 1950’s
Norma Gill enters Cleveland Clinic with ulcerative colitis, meets Dr. Rupert Turnbull and discusses an ileostomy to save her life.
After 9 weeks and several surgeries, Norma begins a new life with an ileostomy.
Dr. Turnbull enlists Norma as a “stoma technician” to help patients with an ostomy.

7. Bertha Okun First Canadian Enterostomal Therapist
1957 Ileostomy Surgery for UC
Founder United Ostomy Assoc
Became an ET with Norma Gill
Served 17 hospitals & Clinics in Montreal
Established Montreal Ostomy Center with her Husband
Founded North American Association for Enterostomal Therapists (now WOCN)
Member of CAET in 1982

8. 1960’s School of Enterostomal Therapy opens at Cleveland Clinic
Students must have an ostomy but RN not necessary
Development of post-operative pouch,
light weight, low cost, odor barrier plastic ostomy pouches are adapted from the food industry
Skin barriers developed
North American Association for Enterostomal Therapy founded in Cleveland.
Membership 33 therapists

9. 1960’s Start of ETs developing expertise in wounds:
ETs asked to consult for veterans returning from Viet Nam with ostomies and wounds.
Wounds next to stomas found to heal under ostomy skin barriers
Dr. Winters investigates moist wound healing

10. 1970’s 200th person graduated from ET School
3 Canadians graduated from Cleveland Clinic as ETs
German ET School started with help of Dr. Turnbull and Norma Gill
Representatives from 32 countries met in 1978 for first WCET meeting

11. 1980’s 1980 - First Canadian ET School started in Vancouver
Canadian ETs split from IAET to form C AET to address Canadian issues
U of T and Université de Montréal open ET nurse certificate programs
Scope of practice expands to include acute and chronic wounds
Scope of practice expanded to include continence care

12. 1990’s Programs at U of T and Montreal close
Nurses go to the USA for ETN training
1995 – 55 countries recognize Stoma Therapy Nursing with schools in 21 countries
CAET starts bilingual ETNEP

13. 2000 + 2007 - CAET- ETNEP goes online
ET nursing is 50 years old – one of the oldest nursing specialties!
CNA recognition as a Nursing specialty
2009 – 60 ETNS write the 1st Certification Exam
2014 – 2nd Canadian Certification Exam
2016 – Competency redevelopment