The care pathway covers the different stages of
preparation, operation and recovery that you will go through. It is
a systematic approach, designed to make the surgical procedure
itself as safe as possible and the result as good as possible.
On Arrival
When you arrive at the Day Surgery Unit (DSU), you will be seen
by administrative, nursing, anaesthetic and surgical staff to
ensure that nothing has changed since your POAC visit.
A member of the surgical team will mark the operative site using
a marker pen - i.e they will put a big arrow or cross on you, where
the surgery is to be!
The anaesthetist will discuss the anaesthetic and also
post-operative pain relief and anti-nausea measures with you.
There will be some final checks, and you will be told how to get
ready, perhaps changing into a hospital gown or removing
jewellery.
Timing
It is worth repeating that it is impossible to predict the
timing of your surgery with any great precision. Usually, things
take longer than you expect and it is not unheard of for things to
change at a moment's notice - for example, the order of the list
may change, some procedures make take more or less time than
expected. The DSU staff will keep you informed as well as they are
able to.
Your time of arrival does not give any indication of your time
of surgery.
In The Anaesthetic Room
You will be asked for a final time if you are fully informed and
happy to undergo anaesthesia and surgery. You may be asked to
confirm your signature again on the consent form. The operative
site will be checked to ensure it is marked. The anaesthetic team
will apply the monitoring devices to you and insert an intravenous
cannula. The anaesthetic will then be administered.
Some units do all this in the operating theatre itself rather
than in the anaesthetic room.
The Immediate Post-operative Period
After your procedure is complete, you will be moved into the
recovery area. How long you will spend in here will depend on the
anaesthetic used, the type of surgery you have had, and any pain
relief medication that you might be given. It is quite normal to
feel a little disoriented at first, and you might find it hard to
focus on what people are saying or doing. If you have received
strong pain relief, this disorientation may be heightened.
Once you are awake enough, you are likely to be given something
to eat and drink. The postoperative staff will monitor you until
they are happy that your condition is stable.
Pain Relief
It is important that you understand what and how much pain
relief you should take after your operation. It is also important
that you take it regularly, as instructed by the nursing staff. It
is far more effective to prevent post-operative pain than it is to
deal with it only once it has developed.
You will be given pain relief throughout your surgery and
probably in the recovery area too. It works best if you start
taking your post-operative pain killers before the hospital
medications wear off. The anaesthetic or nursing staff should give
you a detailed schedule about what to take and when to take it.
Hospitals vary in the drugs they are able to provide to take
home but over-the-counter pain killers are very effective if taken
regularly and in adequate doses.
Post-operative Nausea and Vomiting
Post-operative Nausea and Vomiting is an unpleasant condition
that some patients experience. You will be given appropriate
anti-emetic medication during your surgery if required, but more
will be available to you afterwards if necessary.
Observations and Examination
The anaesthetic and nursing staff will monitor you for pain,
nausea and other after-effects such as drowsiness, headaches or a
sore throat after a general anaesthetic. Any necessary treatment
will be administered.
Special Instructions
If you require any equipment or appliances - dressings,
crutches, splints, mobility aids - the DSU staff should be able to
provide them (or tell you where to get them from and how to return
them).
Discharge
When the nursing staff in the recovery area are satisfied that
you are ready for discharge from the hospital, you will be allowed
to go home. There is generally no need to see your surgeon or your
anaesthetist post-operatively.
It is most unlikely that you would be allowed to drive yourself
home and usually you are advised to have someone with you for 24
hours after a surgery. Your companion needs to be aware of their
responsibilities: how long they should stay with you (including
over-night if necessary), symptoms or signs that may require
treatment, a telephone contact number for assistance.
These arrangements should already have been sorted out in the
Pre-operative Assessment Clinic.
