Carol Mathews has been a WOC nurse for 40 years, 20 of those years functioned as a sole practitioner in a 450 Bed hospital. The hospital has transitioned into the specialty of oncology and now has a team of 8 nurses. (5 WOC nurses and 3 OCA/WTA nurses.) The bulk of the ostomy surgical procedures performed at the hospital are tumor debulking surgeries which is an aggressive surgical approach to manage mucinous cancer that seeds in multiple areas of the peritoneal cavity. The majority of the patients are left with short bowel syndrome and high output diverting ileostomies. Carol has worked with a group of physicians, pharmacists and fellow WOC nurses to develop a clinical care pathway to best manage these patients.