From Operating Room Number Eight to Recovery Number Nine

I had waited all semester for this day. I could hardly sleep the night before due to the anticipation. I was to visit Middle Tennessee Medical Center and follow a patient throughout the phases of surgery including preoperative, intraoperative and postoperative. I found each phase to be equally hectic, technical and important for the safety of the patient.

The patient that I followed throughout her operative experience was no stranger to surgery. She was a twenty-three-year old woman with a history of three prior surgeries: two cesarean sections, tubal ligation and on this day was scheduled for a laparoscopic cholecystectomy due to cholelithiasis and cholecystitis. The patient had complaints of pain in the epigastric region ranging from crampy to sharp and radiating to the back. Prior to surgery the patient stated she had high hopes that this surgery would cure her pain.

When I arrived at 6:35 a.m., the patient was already in the holding area with an intravenous catheter inserted, warming blankets on, identification band in place on her right wrist, and a signed consent in the chart. The nurses in the holding area had already qu

The patient¯s pain level is one of the primary concerns and can be a controlling factor in the patient¯s health. °Neglected pain erodes a patient¯s trust in the health care system, and it can lead to further health setbacks. Appropriate pain management can bring about quicker recoveries, shorter hospital stays, fewer readmissions, and improved quality of life± (Mayer, Torma, Byock, Norris, 2001, pg. 44). The patient determined a pain level of four by rating it on a scale of 0-10 (0 being no pain at all and 10 being the worst pain imaginable). No additional pain medication was given at that time.

Walton, J. (2001). Helping high-risk surgical patients beat the odds. Nursing 2001, 31(3), 58. Retrieved August 20, 2002 from the World Wide Web: http://www.nursingcenter.com/prodev/ce_article.asp?tid=53483

As time was drawing nearer to enter the operating room the activity began to pick up. A new set of vital signs were obtained and her blood pressure was 108/61, a tympanic temperature of 97.8 ¢ªF, heart rate of 82 and respiratory rate of 16. The Anesthesiologist came and assessed the intravenous site and lines, spoke to the patient a second time regarding anesthesia and then administered two additional milligrams of Versed. Donned with mask, head and shoe covers, the circulating nurse allowed me to push the gurney to the operating room while she helped guide me down the halls and through double doors using caution around corners. To safeguard the patient we made sure the bedrails were up at all times and a nurse followed along one side of the gurney during transport.

The intravenous catheter was a 20 gauge located in the left hand and was being infused with lactated ringer¯s intravenous fluid. Also infusing via piggyback was Ancef 1 gram, a first generation Cephalosporin antiinfective used as a surgical prophylaxis against postoperative infection. In addition to Ancef, the nurse in the holding area gave the patient four other medications including Zantac 50 milligrams (mg) given preoperatively to prevent pulmonary aspiration of acid during anesthesia, Reglan 10 mg given prophylacticly for postoperative nausea and vomiting, Robinal 0.2 mg given to reduce salivary, tracheobronchial, pharyngeal and gastric secretions and Versed 2 mg given to reduce anxiety and to facilitate anesthesia to increase ease of sedation. The line was flushed with normal saline before and after the infusion of the Zantac due to its incompatibility to the other medications. Unlike how I was taught, I noticed the nurse not once wiped the port on the intravenous tubing with alcohol before administering the medication nor did she wipe the vial top before drawing up the medication. When I asked her about this, she gave me a °look± and said the holding area was considered a clean area and they push so many medications and have had no complications.

Some common words found in the essay are:
Versed Donned, Medical Center, Demerol Vital, Byock Norris, Wide Web, References Kreger, Recovery Nine, Retrieved August, oxygen saturation, operating table, blood pressure, day surgery, heart rate, vital signs, Retrieved November, Journal Nursing, circulating nurse, world wide web, safety patient, 2002 world, world wide, 2002 world wide, mayer torma byock, byock norris 2001, torma byock norris,
Approximate Word count = 2378
Approximate Pages = 10 (250 words per page double spaced)