These nursing priorities for post-op patients will help you keep your head and give the best care to your patients.
You are rocking through your shift, feeling awesome because you kind of know what you’re doing now, and your charge nurse comes up to you to say you are getting a patient from the PACU. As soon as she finishes that sentence, the phone rings.
They’re calling report.
CRAP! I’ve never taken care of a fresh post-op! BAAHHH!
Nursing Priorities for Post-Op Patients
Ok calm down, crazy nurse, this is no big deal. You’ve got this! Let’s talk about your nursing priorities for post-op patients.
I’ll list the priorities, in order, so you know what to expect and how to do them.
1. Get everything together
The very first priority should be gathering all your information together.
Look at their labs, know their orders, grab everything you’ll need before they roll on the floor. Be confident when you tell the family to scram while you settle and assess them.
While the family is gone, ask the patient who they want to be their go-to person/emergency contact. It can get kind of dicey if you ask them in front of others. Go get the family from the waiting room, and on the way back, go over your unit rules/contact info/plan of care. Drop them off at the door and go sit down and chart that beautiful assessment you just did.
2. Establish Pain control
After you have all your information, focus on the patient’s pain control.
Make sure you have orders for pain meds, oral and IV.
And Zofran. (pain + pain meds + empty stomach = pukes)
Once they have kept some crackers/clear liquids down, get some oral pain meds in them. If they’re in terrible pain, I give them a dose of IV pain meds at the same time as PO, so by the time the IV wears off, the PO is kicking in.
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Side note, if it takes a sternal rub to wake them up, get the PCA out of their hand and grab some Narcan. Buckle up, because they’re about to be pissed because you just instantly took all of their pain meds away you mean, mean nurse.
3. Care For the Incisions
Next, focus your care on their incisions.
Typically, the surgeon removes the first post-op dressing when they round the next day or whenever they deem appropriate. Chances are if there is drainage they’ll only want you to reinforce the dressing, not tear it down and place a new one. Just assume this unless told otherwise.
When the PACU nurse brings the patient up, look at the dressing together and make sure it looks the same. If there is drainage on the dressing, outline it with a Sharpie. Time/date/initial it as well so you know how much is draining.
4. Prepare For The Poops & Pukes
Remember to advance their diet slowly. Clear liquids until they start passing gas is a good rule of thumb. You want those bowels to start perculatin’ ASAP, so as soon as they’re allowed to get out of bed, they need to get up!
Also, pain meds slow the bowels down. They need the stool softeners, even if they say they don’t. Encourage and educate them on the importance. If a patient stays in bed, takes a bunch of pain meds, and eats a cheeseburger first, they will throw up, be in more pain, and then get an ischemic bowel. And it’s all your fault! Just kidding.. well, only if you documented appropriately…
Nursing Priorities For Post-Op Patients
The more you do it, the easier it will become. I hope these 4 steps helped you understand what to expect and what you should do as their nurse. If you still want more training, I have a master class that is super helpful!
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