The purpose of surgery is to improve the health of patients. This may be completed as:
- Day Surgery – where you are admitted, have surgery, and are discharged on the same day
- Multi-Day Admission – where you stay for a few days following your surgery for monitoring and recovery before being discharged home or transferred to rehabilitation.
Preadmission phone call
The preadmission phone call provides an opportunity for the hospital to collect information necessary to achieve a positive outcome for patients. We gather information about your previous surgeries, your health history, and any medications you currently take.
The hospital admission is a time to confirm all the information gathered via the preadmission phone call, collect any additional information, and answer any questions you may have.
Diagnostic studies may be conducted prior to your surgery. These will be ordered by your doctor, surgeon, or anaesthetist, to assist them in treating you while you are under anaesthetic. These tests may include blood tests, cardiac monitoring, X-Rays, CT scans or MRI.
The surgical experience involves moving through three different areas:
- Pre-operative (before surgery)
- Operative (during surgery)
- Post-operative (after surgery)
Each of these areas fulfills specific actions to achieve the final objective, the provision of safe and high-quality person-centred care.
Pre-operative (before surgery)
The pre-operative stage prepares the patient for surgery. You will move through a couple of different areas including Day of Surgery and Holding Bay, each with their own purpose. If on the day of admission, you are accompanied by family or friends, you will part company when you enter the holding bay. Your wait in the holding bay may be for 30 mins – 2 hrs and a nurse will be looking after you during this time.
The pre-operative surgical team are specialists in their field. Their aim is to identify and reduce the risks patients may encounter when they are in surgery and in their post-operative and recovery phase. This team includes nurses from Pre-Admission, Day of Surgery and Anaesthetics, as well as anaesthetists and surgeons.
Before going into surgery, you may wish to inform or ask the pre-operative team of the following:
- Ensure you have disclosed all medication you are currently taking including creams, balms, and herbal medicines
- Inform your anaesthetist about any unwanted side affects you encountered including nausea, vomiting and uncontrolled pain from any previous surgical procedures. This will help your anaesthetist to plan and prevent these from occurring.
- Ask your anaesthetist about post operative pain relief
Operative (during surgery)
The second stage is the operative period. This is divided into 3 sub-areas – the anaesthetic induction, the surgical phase and anaesthetic recovery.
The anaesthetic induction is done by the anaesthetist with the assistance of the anaesthetic nurse. This usually takes place in the anaesthetic bay just outside of the theatre. The anaesthetist will insert an intravenous (I.V.) line to give you medication in preparation for intubation which usually occurs inside the operating theatre. Most patients do not remember past this point as a result of the anaesthetic medication.
Surgery phase is the surgical procedure itself, which is conducted in the operating theatre and aims to solve the health problem afflicting the patient.
Anaesthetic recovery occurs after surgery. The anaesthetist will extubate patients in the operating theatre. Patients are usually very sleepy after an anaesthetic and are cared for by specialist nurses in the recovery area. Recovery nurses can provide strong pain relief to ensure your pain is under control. The surgeon and anaesthetist usually visit the patient in Recovery, however, patients rarely remember this visit due to the effect of the anaesthesia.
Post-operative (after surgery)
This is the third stage of the surgical process where you will be transferred out of Recovery to the ward for observation, monitoring, and ongoing care. Patients are provided with pain relief, antibiotics, and introduced to food and drink safely. You may need to continue to fast for a further 4 hours after your surgery to allow the bowel to recover from the anaesthetic. This helps prevent nausea and vomiting caused by eating and drinking before the gut is ready.
Discharge is the final hospital stage and aims to ensure patients have all the information and support necessary to care for themselves at home. This includes providing clear follow-up instructions with your surgeon, information to manage your pain, instructions about medications for home and who to contact if you observe a sign or symptom of post-operative complications.
You can refer to the Preparing to go home checklist patient resource tool that was co-designed with consumers to support patients being involved in planning their discharge. This checklist of prompting questions supports patients to gain the information they need to feel confident and informed in time for their discharge.