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…
clinical rotation in the ODS unit. The ODS is located on the third floor and looks a lot like many other floors in the hospital. It is quite large and occupies approximately forty rooms. Each room has only one bed, which provides patients adequate privacy. The rooms are not very large, but will accommodate one to two visitors comfortably. Due to the short stay in the rooms, there are no televisions in the rooms. Each hallway within the unit is equipped with a water station for guest/s of the patients. There are bathrooms that are easily accessible in two different locations on the unit. The nursing station is located in the center of the unit and is staffed with a charge nurse, many registered nurses, and technicians per shift. Each patient coming in for surgery is given a list of criteria that must be followed and adhered to so that surgery may proceed as planned. The patient must not eat or drink for at least eight hours prior to surgery. There are certain medications that are not to be taken on the day of surgery (or even days before), such as anticoagulants along with medications that may interfere with anesthesia. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB) are also to be held and not taken prior surgery. The patient is to remove all personal belongings before going into the operating room. This includes all clothing (except for hospital gown), jewelry, glasses, contacts, hearing aides, dentures, etc. The patient must have had an electrocardiogram (EKG) test within the last six months. The role of nurse is extensive and must be followed thoroughly in making sure the patient is ready for surgery.
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…
all consent forms have been signed and that the patient understands the forms. An actual diagnosis for a patient in the ODS on this particular day was ‘blood clot behind right knee on below-knee amputation (BKA)’. The amputation was less than two weeks old. One potential nursing diagnosis is ‘ineffective peripheral tissue perfusion related to decreased venous circulation’ (Doenges, Moorhouse, & Murr, 2013). This nursing diagnosis would be as evidenced by diagnosis of blood clot (thrombus) behind the knee. A second diagnosis for this patient would be ‘risk for depression and/or severe anxiety’ (Doenges et al., 2013). This second nursing diagnosis would be related to diagnosis of blood clot and recent BKA. Another potential factor that could attribute to the patient’s risk for depression and/or anxiety is his age; he is only fort-eight years old. In conclusion my experience on the ODS unit was a bittersweet one.
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
patient. References Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2013). Nursing diagnosis manual: Planning, individualizing, and documenting client care. Philadelphia: F.A. Davis Co.
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 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
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
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...
Surgical Nursing requires a special person to meet the demands of the precision this task calls for. It is a fine-tuned art that requires keen senses to have the ability to multitask with precise perfection to ensure the patient will be afforded the utmost care, comfort, safety, teamwork among staff, and confidence they should expect in a situation that does not exhibit the best of times in their life. In this paper, we will inform the reader of the meticulous role of the surgical nurse, salary range and job availability, pros and cons, and how the patient takes number one priority in order for them to receive the best care possible within the Surgical Nurse’s scope of practice.
I believe that with every experience, there is a lesson to be learned. While volunteering, the nurses taught me how...
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).
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 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
Luckily, I am very comfortable with patients, which made providing care very easy. I was not afraid to go into other patient’s rooms if they rang for help. I would try my best to help the patients; however, if I needed help I was not afraid to ask a fellow student or nurse on the staff. It is very important to be able to talk to patients and work as a team with fellow coworkers as it made the job easier. On the other hand, I need to go over mother and baby assessments to become more familiar with both. I was able to complete the assessments; I now need to do so in a timelier manner while ensuring I do not forget any key areas. Lastly, it is vital that I continue to go over patient teaching prior to clinical. Being comfortable with the patients made the teaching easier, though I need to become more familiar with all the material that needs to be taught.
Certainly, I began with the goal getting of his vital sign and giving him a bed bath. Fortunately I had practice how to take a vital sign and giving a bed bath before my first clinical at the university skill lab and I had developed this confidence before my clinical tour. That day will be mastering the skill which I had just learned in manikins, and applying in real human with huge safety precaution. In between morning my instructor was giving me a brief before I getting to the patients room. From her experience she knew what kind of challenges and a patient behavior can be I face. As I proceeded to my own patient, I hit a roadblock that would give me a flat tire for the rest of the shift.
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
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.