Several of the nurses in a hospital or outpatient surgical center play a role in the surgery itself. For many of those nurses, the time they spend in the operating room is only a small part of the care they provide. They're responsible for the patient before the operation and usually for some time afterwards. Their postoperative responsibilities usually begin as soon as the surgeon walks away.
Patient Transfer and Cleanup
The surgery itself is finished once all the pads, sponges and instruments have been accounted for, and the patient's incision has been closed. At that point, the circulating and scrub nurses who participated in the procedure have several tasks. The operating room has to be cleaned for the next procedure, disposable and soiled items have to be safely disposed of, and reusable instruments must be taken to the autoclave for sterilization. The patient has to be moved from the operating room to the post-anesthesia care unit, where the nurses have to be informed of the patient's identity and condition, and given the details of the patient's procedure.
Nurses in the PACU are responsible for the patient's care during the first hours after a surgical procedure. Coming out of anesthesia can take a long time, and some patients might experience breathing problems during the process. PACU nurses monitor the patient's airway, breathing and vital signs, and call for a physician if any complications arise. In an outpatient care facility, the patient is usually released a few hours after the surgery unless there are complications. In inpatient settings, patients are moved from the PACU to the regular recovery area once they're conscious and breathing normally.
The Recovery Area
Patients recovering from more serious procedures often remain in the hospital for a period of days or even weeks, depending on their condition. Nurses in the recovery area watch carefully for any signs of hemorrhaging, infection or inflammation, alerting an attending physician if necessary. Nurses help the patients change position frequently, to keep their blood circulating properly and prevent any buildup of fluid in their lungs. These nurses also administer medications, maintain IV drips, change dressings, clean the incisions, and provide bathing and basic hygiene.
One of the important parts of postoperative care is getting the patient ready to go home. Nurses play a large role, teaching both the patient and the patient's caregivers what to do and what not to do. This often includes practical tips on bathing and exercise, as well as how much exertion is enough. Nurses also provide some guidance about pain levels, so the patient knows what's normal and what's a danger sign. If necessary, a home care nurse might visit patients after they're released to ensure that the recovery is going well.
- Spine Universe: What Is Post-Operative Care?
- Essentials of Perioperative Nursing; Cynthia Spry
- Nurses for a Healthier Tomorrow: Perioperative (O.R.) Nurse
- Nursing Times.net: Care of the Post-Operative Patient
- Encyclopedia of Surgery: Postoperative Care
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.