The Perioperative Patient for Registered Nurses

Pre-Operative Preparation

Assessments and Evaluations

From the moment a patient meets with a surgeon and the decision is made to proceed with surgery, many assessments, evaluations, and discussions must take place. Some of these include:

Procedures and Prep

Some procedures also require specific pre-procedural preparation. For example:

Bowel Preparation: Often for bowel surgery or GI scopes, patients are required to clear the bowel or GI tract. This could include:

  1. Enema until clear
  2. Solutions such as Colyte
  3. Radiology preparation
  4. Sometimes X-rays or wires must be placed right before a surgical procedure

(Phillips & Hornacky, 2021)

Alleviating Anxiety and Stress Before the Day of Surgery

Patients and their families have anxiety and stress about the unknown aspects of surgery. Through the double doors into the OR, the room is a whole new world that few have had a chance to explore. Many hospital institutions include a discussion of what to expect during the nurse interview. Some facilities even provide videos to help provide a visual of what to expect.

Outpatient – Arrival at the Same Day Admission Unit

All patients coming from home will be asked to register at the same-day surgical admission unit. Upon arrival they will be:

  1. Screened for any breeches to pre-operative preparation instructions (i.e., fasting guidelines, illnesses, etc.).
  2. Registered and provided with a hospital ID band containing their unique identifiers and an allergy bracelet, if applicable. Both should be placed on the patient’s arm (or leg depending on the procedure).
Patients change into a clean hospital gown:
  1. All undergarments should be removed unless directed otherwise by the surgical team.
  2. All jewelry and personal items should be removed.
  3. Any assistive devices such as hearing aids, glasses, prosthetic devices, etc., can remain on the patient until just before heading to the OR room or immediately before anesthesia.
Patients are assessed by the pre-anesthesia nurse who will:
  1. Assess all current vital signs.
  2. Have the patient void to prevent overdistention of the bladder unless the procedure requires a full bladder.
  3. Apply anti-embolic stockings, if required.
  4. Provide any pre-anesthesia medications.
Inpatient – Arrival at the Pre-Operative Holding Area

Like outpatients, surgical patients coming from an inpatient unit arrive in a designated waiting area until the operating room staff are ready to bring them into the OR. The nurse is responsible for completing the pre-surgical prep as ordered by the physician. Many institutions have a pre-surgical checklist to ensure that steps are not missed.