Here’s another excerpt from my little book of Home Nursing. It details the preparation of the patient for surgery…
“On the day before the operation the nurse should ask the surgeon how he wishes the patient to be prepared. If no specific instructions are given the patient should if possible be kept quiet the previous day: he should take only light food, have a warm bath and an aperient in the evening. On the day of the operation he may, if the operation is not to be performed too early, and with the surgeon’s permission, have a light breakfast of tea, with toast and butter, and, three hours before the operation, a cup of tea or bovril.
His preparation begins with a simple enema first thing in the morning. Then he may have a warm bath or be well sponged down. The area of the operation must now be sterilized by shaving and then cleansing thoroughly with either soap or spirit soap, which must be washed off with hot water; the skin must again be washed with hot biniodide of mercury solution, and covered with a compress of lint or gauze wrung out of the same solution: or, after drying, the skin may be painted over with mild tincture of iodine, allowed to dry and covered with a dry sterile towel.
Before the operation artificial teeth, hair-pins, jewellery, etc., must be removed, and if the hair is long in a woman it should be plaited in two plaits tied at the ends. The patient must put on warm flannel clothes which can be removed easily, and long woollen stockings.”
Now that’s what you call pre-operative care. These days, patients are admitted to hospital on the day of surgery and the pre-op preparation is left almost entirely to the patient. I can remember once getting it completely wrong and I paid the price.
I had a young baby at the time and instead of resting the day before my surgery, I rushed around putting preparations in place for during my absence. The following moring I insisted on getting myself to the hospital so that my husband could stay at home to look after our baby. Having fasted from the night before, I travelled by train to the hospital and arrived feeling totally parched and exhausted. I had a particularly difficult post-operative recovery from the anaesthetic on that occasion and it taught me a lesson. In today’s world of conveyor belt medicine, it’s really important to rest the day before surgery so as to optimise your powers of recovery. Allow yourself to be pampered!
UPDATE: I’ve just spotted this letter to the Irish Times from a Consultant in Emergency Medicine, which fits in nicely with the ‘ patient care’ theme of this post.
“And the Minister should focus on the universal need for a familiar smiling face. Let us have carers who have the time to care and the moral support of a loved one in our hour of need. Health economists may have factored these basics out in their many dubious prescriptions, but Mother Nature has not”.
Walk in, walk out surgery, with neither preparation nor follow up, seems very common. I still have twinges around a three inch scar left from the removal of a lipoma the size of a saucer last October. Not much to be done about it now.
I remember before going for an op, way back, I had to have three (3) baths before surgery! AND before you ask I was not dirty since I already had a bath before I left home!
Ian – ‘Day surgery’ looks like being the way of the future. This works well when/if we have a good primary care community system to back it up!
The operation I referred to was not day-surgery and I was in theatre within an hour of arriving at the hospital. I now always make sure to rest-up immediately prior to surgery.
Grannymar – I always knew you were ‘durty’!
Was it your mind they were trying to fix? 😉
It’s hard to believe there were ever days like that, now, isn’t it. My first ever hospital stay was like that – and that was back in the “dark ages” – hmm, more like the more enlightened ages if you ask me!
My last hospital stint was a walk in/walk out day thing – it was a bit alarming to be honest – and without the support at home, it wasn’t much fun either. And therein lies a huge part of the problem.
AV – You’re on the ball as always. Rapid turn-around surgery works well when there are services in place to support the patient at home. Hospitals are no longer the ‘safest’ place to be post-operatively due to the emergence of superbugs but unfortunately, care in the community has not kept pace with the demands of fast hospital turn-around and patients suffer as a result.
Actually Steph apart from the ‘enema’ and day of rest, the prep doesn’t seem to have changed much. Although I shaved myself by choice and was given a delightful pair of inflatable pressure hose prior to the op rather than woolly stockings!
Baino – I’ve noticed big changes over the last ten years in the pre-op care of patients and it’s not all for the better. I’m in favour of patients being admitted to hospital on the day of surgery but I feel that this should be optional for certain patients, and it’s not generally. I’m an old-hand, as you know, at hospitals but for many people it’s a terrifying experience and they should be allowed an opportunity to acclimatise before going under the knife. In private hospitals, there is a greater tendency to admit patients the day before surgery but for all the wrong reasons. An extra night, earns extra bucks!
Once while boy wonder was in Temple st for dialysis with a nurse escort – I did my usual run around town like a mad thing to get my drivers licence renewed, bring back library books and oh yes get that niggling ache seen to by the GP. I scheduled everything to the second – luckily the GP was the final stop at midday; as I was on the table at 2pm having an ovarian cyst removed with the appendix thrown in as part of their two for one special that day! I couldn’t get in touch with Rory’s nurse as they’d already borded the Galway flight! Luckily I’d left a key out, as the other Kidney was away! That was a scheduling nightmare! Boy did I feel rough for a few weeks after that one. Niggling pains are now dealt with post haste – you live and learn!!
Ann – You are seriously at risk here of stealing my thunder in terms of unusual medical emergencies 😉
I love the 2 for 1 deal!