Nursing Process Change Paper

Upon observation of the circulating nurse, I noticed that she was very interactive and involved in the surgery. One of the responsibilities of the circulating nurse is to retrieve any surgical supplies that are not available in the operating room and to make or receive any calls for the surgeon. During the surgery, I noticed the nurse call for an x-ray for the surgeon, the laboratory for biopsy samples, and the operating room floor front desk to inform them that the surgery would be later than expected. This is her responsibility as the surgeon cannot break sterility by touching the phone and it is easier for him to communicate through her and not leave the surgical site. Also in the operating room, I observed the scrub nurses’ roles. Before the operation, the scrub nurse opened all of the sterile packages, arranged them on the sterile field, and took count of what was there along with the circulating nurse. The scrub nurse did this because she is sterile during the entire procedure, and once the sterile packs are opened, the contents can only be handled by sterile personnel. The scrub nurse also was ready and waiting at the sterile field at all times to get the surgeon any equipment needed from the sterile field. This is helpful to the surgeon because it enables the surgeon to stay at the surgical site and convenient for when

S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.

Also, by properly conducting a time-out session where the patient is provided with a standardized briefing prior to the patient is sedated in the OR could also eliminate some the sentinel or adverse events in the OR. Furthermore, follow a checklist, which not only pertains to the surgery itself, but also focuses on the other procedures involved such as admissions, anesthesia equipment, and discharge (Mulloy & Hughes 2008).

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

This process paper will evaluate the complex relationship between disease pathophysiology and how it has progressed to the patient’s current state of health. It will include a comprehensive discussion of chronic and acute problems leading to the patient’s hospital admission, a complete description of interrelationships and pathophysiology for all medical diagnoses, a comprehensive discussion of the client’s signs and symptoms and results of all diagnostic studies to the underlying pathophysiology, and a comprehensive listing of all medications ordered at the time of admission with explanations of why each was ordered and identification of the most common side effects which may

The pre-op nurse did not pass the information on when giving report to the OR nurse. The OR nurse is responsible for giving addition hand off information both about the patient along the information from the procedure she all so communicates with the surgeon during the procedure. It was during this interview that some insight about a breakdown in communication between departments became apparent.

Once the nurse and patient establish a rapport, and the patient is comfortable and willing to proceed with the intervention, preoperative care

Pre-op Nurse—is responsible for working closely with the attending surgeon. Her list of accountabilities include, talking with the patient or guardian forms and asking vital questions to allow for a safe operation. The pre-op nurse prepares all paperwork and makes sure all signatures have been obtained. This is done in the presence of a physician. She is responsible for taking the patients vital signs (blood pressure, temp, and heart-rate, start IV’s) to ensure that are not outside the lines of normalcy. In short the pre-op nurse will perform any duty to ensure that the patient is prepared for surgery this may include talking to family members. The nurse is also responsible

The nurse on fifth surgical west stayed very busy throughout the day. When she comes on shift her day consists of beside report. Where they are at the patient’s bedside giving report. It is to ensure everything that is said is accurate and nothing is left out. How she prioritizes her day depends on the patient’s needs. It is difficult to know what will happen that day because patient’s can be discharged and admitted. The nurse prioritizes her patients by looking at the reason they are being treated. If everyone is doing ok then she goes by what medications are due. This is to reduce the risk of late medications. She also is aware of the patient’s pain level. She mentioned if the patient is in pain or uncomfortable then

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

Hinkle, Janice L., Kerry Cheever. Hinkle & Cheever: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Edition. CoursePoint, 11/2013. VitalBook file.

During my rotation in the operating room at Community medical center, I observed the preoperative, intraoperative, and postoperative care for a patient who underwent a laparoscopic hysterectomy. I believe that an appropriate preoperative plan of care for this patient would have included a full physical exam and an interview for patient history, a pelvic exam to look over and understand the nature of the patient’s complications, blood testing including a CBC and WBC to note any signs of infection or contraindications for the procedure, and a urine test to rule out any urinary tract infections or pregnancy. It would be important to interview the patient and ask questions to determine how the patient is feeling about their procedure and to better assist with any anxiety or pain they may be dealing with preoperatively. It is important to consult with the patient well before the procedure to ensure that she knows to refrain from smoking for at least 8 weeks before the procedure because this reduces the risks of complications such as infections, issues with blood pressure, heart rate, blood flow, and respirations when under anesthesia, and promoting overall health and risks associated with smoking after the procedure. (ASAHQ) It is also important to educate the patient to consume no food or drinks after midnight the night before the scheduled procedure. (Health Communities) During my rotation I observed that the patient did indeed have labs drawn and a urine test run. Her lab

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional

The orientation process for new hires lasts six weeks. The new nurse attends nursing orientation for one week and then is assign a preceptor on the unit for each shift. The DPCS introduces the new employee to their preceptor. This nurse works three weeks on the day shift, one week on the evening shift and one week on the night shift working with both medically acute rehabilitation patients and surgical patients. Nurses receive extra days of their orientation with patients that the nurse has limited clinical experience such as a nurse with postoperative experience will work more with the medically acute rehabilitation patients to practice new skills. For new graduates their orientation is individualize and can last from 8-16 weeks.