One Day Surgery Sheri D. Nicks Langston University, Tulsa NR 4335 September 18, 2015 Saint John’s One Day Surgery (ODS) offers patients a convenient and efficient same day surgical procedure that allows most patients to return home on the same day to recover. The objectives of this paper is to describe the physical environment of the ODS unit and explain the unit’s criteria so that the patient’s surgery may proceed as planned. It will also discuss some of the many roles of the ODS nurse and list one actual diagnosis and two potential nursing diagnoses, with associated supporting evidence, for a patient in the ODS on this particular day. This paper will conclude with my personal experience, both positive and negative, during …show more content…
Depending on the time of surgery, the nurse may admit and discharge the same patient within the timeframe of his or her shift. The nurse obtains a history and physical (H&P) along with the progress notes from the operating surgeon or another licensed personnel written within the last twenty-four hours. The nurse sets the patient up with a peripheral intravenous line before surgery. He or she will interview the patient regarding the last time they ate and/or drank, what medications they take, and when the last medication dose was taken. The nurse also assesses the patient to see if he or she understands the procedure they are there for and asks if they have any questions or concerns. Depending on the health of the patient and what surgical procedure they will be subjected to, either a focused or full health assessment is performed. The nurse also makes sure that all labs pertinent to the patient have been obtained. These labs include a negative pregnancy test (or proof of a negative test within the last seven days) for any patient that could possibly be pregnant, even if the patient is currently menstruating, a finger-stick blood sugar test for all diabetic patients, a blood test for potassium levels for patients with end stage renal disease, and a prothrombin time or international normalized ratio test for patients on Coumadin. The nurse also makes sure that …show more content…
I enjoyed interacting with the patients, and my nurse. Karie, was amazing. She explained to me everything she did. The routine for each patient was very similar, and this repetition helped me anticipate what Karie needed and helped me feel fairly confident in assisting her with the new patients and their needs. On the other hand, I was extremely disappointed that I was not given the opportunity to administer an intravenous (IV) line. Karie was willing to allow me the opportunity after I watched her place an IV in three different patients, but her fourth patient was transported from a different hospital with peripherally inserted central catheter (PICC) line in place. It was beginning to get late in the day and the patients coming in was slowing down, so Karie told the nurses at the nursing station that I needed to practice IV’s, but no one had any to give. Although I was disappoint that the opportunity to insert an IV into a patient did not arise, I did gain much knowledge regarding the ODS unit. I am now familiar with the physical layout of the unit and what takes place with patients that go there. I know the role of the nurse. I was also given an opportunity to practice nursing diagnoses on a
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
In the operating room, there are many things that come into play to keep the patient and staff safe at all times. The safety checks that are double-checked before the surgery are extensive and they are
After surgery, they monitor the patient to see if there are any problems while they are coming off an anesthesia (Nurse Anesthetists, Nurse Midwives…) If there are no problems the surgery will be deemed as successful, and the nurse anesthetist will report all findings to the
The surgery nurse tells the postop nurse about how the patient tolerated the surgery overall. The surgeon comes and look at the patient. The surgeon told the nurse the location, length, and how many stitches were associate with the wound. The nurse applied bactroban to the wound and monitored the wound for any bleeding. If there was bleeding to the wound area, then the nurse would tell the patient try not to talk since the surgery was on the lip. Postoperatively, the patient receives the information verbally about discharge instructions that are ordered by the surgeon, but the discharge papers may be handed to the family members. Since the patient is not fully competent after surgery the family member may be asked to assign the form with discharge instructions that were provided. The family is then given a copy of the discharge instructions, anesthesia paper, and the information about the procedure that was done. The planning that takes place when outpatients have surgery and are discharged home directly from the postop area is educating the patient about not driving within the next 24 hours, monitor the site for drainage, and depending on the surgery depends on the additional teaching that is needed. Also the nurse explains the medications that need to be taken, how long the medication needs to be taken for, and why the medication needs to be taken. The nurse tells the patient that if there are any changes cognitively or physically to call the doctor and if it’s an emergency then call 911. Phase 2 of surgery is known as the second part of recovery before the patient is able to go home. During Phase 2, the patient is closely monitored for any complications that may occur such as difficulty breathing, drainage at incision site and many more. The patient’s vital signs are taken every thirty minutes for an hour and if the
On my first day in TCU I focused on trying to adjusted and found where the equipment placed and how it worked like IV machine, and where to find medications, treatment supplies, and scavenger hunting, I also give care for three patient assessment and medication administration. In addition, I joined a nurse team meeting and introduced myself to everyone most. This meeting taught me how meeting was mainly about how to make a g...
My clinical week was emotional and physically draining this week. I enjoyed being the lead on Thursday because it gave me the opportunity to stop and observe. The nurses and the CNAs were very stressed out, and I clearly saw the effect on the patients. For instance, one of the CNAs asked me to help her with an occupied bed change. I was excited. However, she kept passing a bunch of comments of how hard nursing is and how she did not want to be old. I did not acknowledge any of her comments. Perhaps she thought she could express herself (as a result of her stress) in front the patient since the patient was non verbal and could not understand. I felt very bad. I was very uncomfortable and sad. For me, it doesn’t matter whether the patient
I believe that with every experience, there is a lesson to be learned. While volunteering, the nurses taught me how...
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
This time, I decided to be more talkative and ask more questions about the patients. My senior nurse showed me a patient who fell down a couple flight of stairs and due to his accident, he injured his brain severely to the point where he couldn’t speak anymore. She explained to me all the medications that he had to take and how she had to look up the patient’s lab report because the medications he takes might affect him in different ways. After she was done with looking up his lab reports, I watched her feed the patient for an hour and thirty minutes. During this time, I really felt bad for the patient because he was half-awake and half-asleep while eating. It saddened me how we had to disrupt his resting time to feed him before he could take his medication. After the patient was done eating, I watched the nurse give the patient Lovenox, which I learned was given to patients who are immobile in order to stop blood clotting. After giving him his medication, we had to transfer him off the bed and into a chair, which was my favorite part about this clinical observation. I got to physically help move him off his bed and into a chair. This took 3 nurses, including myself to move him and it made me realize how nursing really requires teamwork. I then got to help clean him up and after changing him, it was time to leave the hospital. This clinical observation made me really excited to be a nurse because I
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
People in Cleveland, and throughout Ohio, often require surgery to identify, address and repair a range of injuries and medical conditions. When going in for surgery, patients generally expect the doctors and staff to be focused on performing the procedure, and to exercise good judgment. Unfortunately, surgical mistakes commonly occur. These types of errors may cause people to suffer additional or worsened medical ailments, or death.
The first procedure, hemorrhoidectomy, which is the removal of hemorrhoids, the OR nurse was a traveling nurse from Alabama. In the preoperative role, his were to prep the site, administer any medication if needed, insert any catherization needed, chart the patients’ status or changes, and get other supplies, if needed. In the preoperative check list, the scrub team counted out the inventory for the supplies. The OR nurse documented what was opened. During the preoperative observation, the patients
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.
One of the many categories would be that of the circulating nurse. Ensuring that the operating room is set up correctly based on the preference of the surgeon, the circulating nurse makes sure all the necessary equipment’s are in place, functioning appropriately, likewise ready to go. In addition, the circulating nurse also verifies the patient identity, surgical site, and consent with the surgeon upon entering the operating room to make sure that they are all the same page, before proceeding with the schedule procedure. Yet another function of the circulating nurse is to make sure that the patient is positioned correctly on the surgical table, hooking up the basic suctions needed, and assisting the anesthesiologist or anesthetist during intubation. Moreover, monitoring the overall condition of the
Circulating nurses must check the expiry date and the integrity of the packaging and wear the correct PPE prior to opening the articles. Each article must maintain its sterility; therefore the setup must be continuously monitored. Instrument nurses must create the sterile field using sterile drapes as they minimise the transference of microorganisms. They must also keep their hands at chest level, as areas below table height can be easily contaminated (Australian College of Operating Room Nurses, 2010).