This topic is about the challenges faced when hospital nurses change a Hollister two-piece colostomy system. The person sharing their experience was in the hospital and noticed that nurses often applied the wafer to damp skin, which led to poor adhesion and leaks. This was surprising because it's a basic rule that sticky surfaces need to be applied to dry skin. Here are some helpful insights and advice based on this experience:

1. Hospital experiences can vary greatly. Unless you're in a specialized colorectal or ostomy ward with certified ostomy nurses, most doctors and general-duty nurses might not have much hands-on experience with these appliances.

2. Be your own best advocate:
- If you're able, change the appliance yourself and politely decline staff assistance.
- If you can't do it yourself, ask for an ostomy or wound-care nurse or someone with experience. Don't hesitate to stop someone inexperienced during the procedure.
- Keep track of who is providing care and speak to the charge nurse if the care is not up to standard.

3. Bring plenty of your own supplies. Hospitals often have only generic products that might not work as well as your preferred brand, like the Hollister two-piece. You can refuse to use hospital-issued supplies.

4. Educate caregivers when needed. Calmly explain that wafers need to be applied to clean, completely dry skin because moisture prevents them from sticking properly.

5. Have a family member or friend trained in changing the appliance. They can help if you're unable to do it yourself and no ostomy nurse is available.

6. Be aware that competence can vary by unit. Specialty surgical floors usually perform better, while ICU, cardiac, or general wards might not have the same level of ostomy care skills.

7. Under-staffing and time pressure can lead to shortcuts. Politely insist on proper technique rather than accepting rushed care.

8. Practical tips from others:
- Use alcohol wipes or other methods to dry the skin before applying the wafer if it's damp.
- Make sure the pouch is positioned upright; if it's sideways, it can make emptying difficult.
- Avoid having bags emptied or changed while you're lying flat unless it's absolutely necessary.