Running head: OR EXPERIENCE
Observational Experience in the Operating Room
and Post Anesthesia Care Unit
LaGuardia Community College
March 19th, 2013
The preoperative phase is the time period between the decision to have surgery and the beginning of the surgical procedure. For some patients, the preoperative period may last for months, during which testing and other procedures may be done. For an emergency, such as an appendectomy, the preoperative period may last only a few hours. During the preoperative phase, preadmission testing is done to assess health history, family medical history, and any known allergies to ...view middle of the document...
Surgery is very personal to an individual and therefore their perspective regarding surgery has to be carefully assessed. Psychological preparation begins with talking to the patient about their procedure and watching for cues that would indicate fear or stress. Many patients will show up for preoperative testing and act as if nothing is wrong, but there may be some underlying fear that may go unnoticed. Fear is one of the most common psychological factors that can be a debilitating emotion for someone about to have surgery. It can block all communication and learning so it must be the first to address. It is important to assure the patient that there will always be assistance available to guide them along the process.
There are other fears that need to be addressed, such as the of type pain associated with surgery, and also how the patient feels about being incapacitated for a length of time. This actually has a big impact on someone psychologically because we are dealing with a variety of issues with incapacitation. When someone is put in a position of being out of work, possibly for an indefinite amount of time, or perhaps even losing an income, more obvious concerns of psychosocial displacement will come up that must be addressed. This allows us as nurses to look at the support systems that are in place for our patients and what will also help us on what we need to educate our patients on further along. Psychological preparation for patients undergoing surgery also consists of looking at their spiritual and cultural beliefs, identifying coping strategies, identifying learning deficits, and answering all questions involving their surgery which includes what to expect before and after surgery. (Smeltzer, et. al, 12th Ed.)
The components of immediate preoperative physical preparation of the patient begins with the admission to the surgical center/unit, identifying yourself as the nurse and assessing for any anxiety or fears. It then proceeds with identification of the patient, completing preoperative assessment including baseline pain and nutritional status, because patients should be NPO prior to surgery and also verifying the type of surgery they are having. Patients should be changed into a gown, and jewelry including wedding bands is removed, dentures are also removed because of the risk of airway obstruction, and all assistive devices should be given to family members for safe keeping. It is important to leave glasses and hearing aids with the patient until the patient is given anesthetics so they can hear and see what is being done to reduce fear and anxiety. The nurse establishes an intravenous line and also verifies that the operative consent has been signed. Additionally, the surgeon and anesthesiologist introduce themselves to the patient and assess orientation by asking them their name and type of surgery once again. This is done as a precautionary measure to ensure that the patient is fully alert and oriented and...