Forty Years Of NursingTidbits You might Need Someday
Years of preparation and intervention has gone into what I am about to tell
you. It's no guarantee by a long shot, but It's important things to know
ahead of time. That time before you become worried about needing surgery.
Surgery can be a scary thing. Your doctor says something needs to be fixed and surgery
is what you need. It does not matter that a procedure is small or large. You are trusting another person to fix what is wrong.
Meeting your surgeon. This can be a daunting affair. You will have a consultation in the office or maybe even in the hospital. This person is usually selected by yourself or by a recommendation. In some cases, it may be just whomever is On Call for that day for surgery. The meetings will be brief and you may not leave feeling confidant.
The same goes for your Anesthesia doctor. The consultation will be short and to the point.
The doctor will outline for you the necessity of the surgery and the risks involved.
He or she will tell you if there will be an incision or if it can be done laparoscopically.
The usual recovery time expected and the options available should be discussed.
It is then up to you to either accept, decline or seek another opinion. Research is key to your recovery. Have someone help you find out more information. You can do this online or through the library. Most offices will give you a pamphlet of information but it may not tell you enough. This is when you need to start asking questions. Write them down
and make sure you ask them before making your decision!
Read the consent. This does not mean skim over it and sign on the line. This is a legal document of authorization. In it there are many disclaimers. You have a right to understand fully and refuse any part of the consent.
Get a Living Will done before you have surgery.
Having a designated Health Care Surrogate is essential. Even the easiest surgeries can have unforeseen complications. This document is available at any hospital, surgery center or your lawyer's office. It can be changed at any time to designate your wishes if you are unable to make those healthcare related decisions on your own. Most people don't want to be kept alive on various machines. If this is you, get it in writing!
Present it upon admission.
Know your medical history.
This information is vital to your survival. Do not rely on someone to know this for you!
Who knows yourself better than you? Write this information down. Keep a copy with your Living Will.
Things to include:
Age Medications- names, doses, frequency
sex Medical conditions- Heart, B/P, Diabetes, Kidney Disease, Respiratory.
weight Previous surgeries- what and when
height Implants- Joint replacements, ports, pacemakers, shunts
Allergies Complications of any kind during any previous surgery ie: bleeding,
breathing problems, infection
Do what you are told. Do not take shortcuts when your health is at stake.
In other words, when you are told NOT to eat or drink past a certain hour, it means just that! Drinking and eating before surgery is extremely risky. While under the effects of anesthesia, you may get stomach content into your lungs. This can kill you.
The likelihood of aspirating is greatly reduced on an empty stomach. Trying to save your life will be a nightmare for your medical staff if you take this simple instruction for granted.
Do all necessary preps. This means showering with the antibacterial soap as instructed.
Do NOT shave your body hair at home. The reason it is done preop in the hospital is because your razor will cause micro abrasions or a cut which can introduce infection.
The clippers the hospital uses will not do this. Let them do it. If you have to do an enema, DO IT! A clean bowel means less risk for you.
Come to your Pre-OP appointment! You will meet with a screening nurse who will
go over all instructions and give you a detailed medical interview. Bring the above documents I mentioned Consent, Living Will, Personal Health History, lab orders. In addition, bring all forms from your doctor's office. The day of surgery is not the time to remember you left your consent on the kitchen table at home.
This interview is not meant to upset you. It is specifically meant to catch any other information that is needed to get you ready. Any referrals to another doctor for Medical, Cardiac or Respiratory clearances is essential to ensure you are going to get through your surgery without problems.
Once all the needed documents are in order you will be able to proceed.
On the day of surgery arrive at the time told. There are many other patients who may be going to surgery at the same time as you are. Adequate time is mandatory ahead of time to get you and all others ready on time. The medical staff does not want to rush and neither do you!
The reason no underwear is allowed in surgery should be obvious but it is because frequently a person will soil themselves under anesthesia. If so, we can clean you up easier.
Underwear is going to be in the way and will not be available for you to wear home when discharged. In the OR you need only you and no other contaminated articles.
No jewelry is allowed to be worn. Metal is an electrical conductor. You can be burned
when equipment is used during surgery. Remove it. Yes, belly button rings, tongue studs, earrings, ankle bracelets and toe rings, too!
Do NOT bring valuables to the hospital. This should speak for itself, but expensive jewelry,
money and a wallet full of credit cards needs to be monitored at your home or by someone you designate to take care of them.
Bring equipment that is asked of you to bring. C-Pap machines are in frequent use at home and the mask is designed for your face. After surgery you may have to use YOUR own mask while coming out from under anesthesia. You are at a much higher risk of sleep apnea up to 48 hrs after surgery and beyond while taking pain medication. Give machine to your Pre-Op nurse. They will ensure it is in the Recovery Room on your arrival and ready to use if needed.
You will have an intravenous line inserted. It is not easy to thread a needle into a vein. Your nurse is very skilled but sometimes more than one attempt is needed. Dehydration and previous medical conditions make this task most challenging. When you are allowed to drink before surgery and before your cut off time, drink as much water as possible. It will really help you and your nurse!
Read your Post-Op instructions and place them where you can refer to them and have readily available should you need to call the doctor.
Practice a few old school things at home.
Learn how to deep breathe. Inhale through your nose as deeply as possible.
Hold that breathe and then exhale through your mouth.
Do this at least three times in a row.
On the last exhale, forcefully make yourself cough.
This will help open up your lungs and allow oxygen to enter your bloodstream. It will also facilitate secretions to move up and out of your airway.
If you smoke, now is the perfect time to quit! You will recover quicker and coughing after surgery is always uncomfortable. Your body needs oxygen to heal. Pneumonia is always a threat.
Turn over at least every 2 hours. Seeking another position will alleviate pressure spots
and help your circulation. Position as necessary with pillows.
Get up out of bed as soon as possible and allowed. Sit up on the side of the bed. Sit in a chair several times a day. Ask for assistance before doing anything. A change in your blood pressure upon standing can cause you to faint and fall. Walk with assistance. Use devices as instructed. Wheel chair, walker or cane with someone next to you. Falls are the number one complication after a surgery. A sense of euphoria can cause one to think they are not at risk but it precisely the most dangerous time for an accident to occur.
Take your medication appropriately. Do not increase your dose without authorization from your doctor. Drink plenty of fluids. Rest afterwards and do not do activities which may affect your safety. Do not drive, drink alcohol or operate machinery when taking pain medication.
Eat. This is not the time to diet. You need food that is good for you. Nothing spicy or greasy. Lean protein, vegetables and fluids. Keep it simple. The easier to digest the better. Small frequent portions will keep you satisfied. There will be less of a chance of vomiting when done slowly. Start out on clear liquids then progress as allowed. Your body is in high gear right now repairing itself.
Resist the urge to peek under your bandage. Unless you are having prominent bleeding there is no need to look. Removing the initial bandage that was placed during surgery under sterile conditions only puts you at risk for infection. When you are allowed to remove it you will be instructed to do so. Wash your hands or have the person doing the task wash. If you have to replace the bandage here is how. Open all bandage packages ahead of time and lay them on a clean surface still inside their wrapper. Apply gloves. Redress wound and tape perimeter. Do not get area wet until instructed by your doctor. Do not apply anything to the incision unless ordered to do by your doctor. Report any redness or drainage that is of concern or a smell. Staples and sutures on the exterior of your skin will be removed by your doctor in 7-10 days. Internal sutures will be absorbed. Any tube for collection of drainage needs to be emptied every 4 hrs. The volume and character of the fluid should be written down so that when you have to see the doctor for removal they will be aware. Let them know if drainage is fast and needing emptying more than one time per hour.
It is good for you to do small things around your home. Do not lift or push anything.
Moving around helps with your circulation and helps prevent blood clots.
Utilize good posture when sitting or standing and walking. Do not hunch over.
Walk slowly.
Once a few days have passed you will feel stronger and more capable of doing more activity. Do not jeopardize your recovery by trying to do too much too soon. You may experience a set back and even risk a return to surgery!
The body usually needs several weeks to months to recover from surgery fully.
Be patient.
Take care of yourself and your body will respond.
Cathy Windham RN
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