General Information about the Pre-Admission Center
The primary goal of the Pre-Admission Center (the Center) is to
adequately prepare surgical patients for surgery. The following
procedures help prepare the patient:
- Pre-surgical testing is done to collect critical clinical
information to determine patients readiness for anesthesia and surgical
procedure.
- Patients are assessed and receive planned care based on
physical, spiritual and psychosocial needs.
The Center's job is to prepare the patient and to assure that
the Patients' surgery is not cancelled due to inadequate patient
preparedness.
The pre-admission center is located North of the tower elevators
on the lobby level of Presbyterian Hospital.
The staffing consists of three Registered nurses who work for
Anesthesia Associates of New Mexico. Four hospital Registered nurses, a
lab technician, two unit secretaries and a representative from the
admitting department.
The anesthesia nurse specialists provide early patient problem
identification and ensure that the appropriate clinical data is
available for the peri-operative nurses, anesthesiologists and surgeons
to avoid last minute delays and cancellations of surgical procedures.
They use an algorithmic format to screen and detect high risk patients
so that necessary interventions occur before the day of surgery.
Information is provided regarding medication and NPO status. At all
times, they are in communication with an anesthesiologist regarding any
problems with an EKG, lab results cardiac or pulmonary consultations.
The hospital based nurses interview many patients over the
telephone and decide if the patient needs to come to the department for
further assessment prior to their surgery date. Many of the patients
interviewed over the telephone tend to be young, fit healthy patients
who do not normally need any further assessment. They are also
responsible for pre and post-operative teaching, obtaining surgical
consents and identifying any other surgical problems that may need to be
addressed.
The technician is responsible for collecting blood specimens,
urine specimens and performing EKGS. She also ensures that the
appropriate paperwork goes to the lab with the specimens.
The unit secretaries are available to prepare the charts, enter
the physicians' orders into PACIS and to take the charts to the
surgical pre-operative area the evening prior to the proposed surgery.
The admitting representative is available to verify information
and ensure that admission paperwork is correct, and to collect any
co-pay and copies of insurance details. This saves time for the patient
on the day of surgery.
What to bring to the hospital
You may want to bring a bathrobe, slippers, and personal care items. Be
sure to wear loose comfortable clothes. Please do not bring any
valuables or jewelry with you. If a co-payment or deductible is due, you
will need to bring a check, credit card or sufficient cash for payment
before services are rendered. If you bring a suitcase or overnight bag,
it is best to leave it in your car and have your family bring it up to
your room after your surgery.
Where to go when you come to the hospital
When you arrive at the hospital, you will check in at the In-Patient
Admitting desk in the lobby. It is located across the hallway behind the
Information desk
(Click here for a map).
Once you have
checked in there, you will be directed to the Surgical Pre-Op Area. If
you are coming in the evening before your surgery, you will be directed
to a patient room.
What happens first
When you get to the Surgical Pre-Op Area, the staff will review your
admission information, give you a hospital gown, and start an
intravenous (IV) line. Any "prep" (shave, scrub, etc) that the doctor
has ordered will be done also. The Surgical Pre-Op Area is a very small
area, so you will be allowed just one family member with you in this
area. If you are admitted the evening before surgery, you will bypass
this area.
Just before surgery
When the staff is ready for you, you will be taken to the OR Holding
Area (either from the Surgical Pre-Op Area or from a room upstairs if
you came in the evening before). If your surgery is at 8:00am or
earlier, you will go to the Holding Area at 6:00am. If your surgery is
later in the day, you will be taken to the Holding Area about one hour
before the time of your surgery (major cases such as heart surgery will
be taken two hours before the time of surgery).
The Operating Room Holding Area
In the OR Holding Area, nurses from the Holding Area and the Operating
Room will talk with you. The anesthesiologist who will be taking care of
you during your surgery will talk with you. You may be given IV drugs at
this time. Some drugs might make you sleepy, and some might be
antibiotics.
Where do family and friends wait?
If friends and family want to wait while you are having your surgery,
they may go to the Surgical Waiting Lounge on the Lobby floor. The staff
in the Surgical Pre-Op Area will tell them how to get there. There are
volunteers who will come to the lounge periodically to let your family
know when you are in the Recovery Room.
After surgery
After surgery you may wake up in a room you have not seen before. This
room is called the Post Anesthesia Care Unit (Recovery Room). There is a
nurse close by, so please tell him/her if you need anything. Medication
for pain and nausea (feeling like you need to vomit) will be ordered for
you, so please ask for it. When you have recovered you will be taken to
a room on a nursing unit.
Tubes
When you wake up after surgery you will probably have an IV in your vein
so that you can receive medication and fluids through your vein. You may
also have a catheter (small tube) in your bladder to drain your urine.
If you have extensive surgery you may have other tubes and equipment
attached to you. The nurse will explain what the tubes or equipment are
for and why you need them.
Pain Control
When the anesthetic wears off you may feel pain. Please call the nurse
and ask for pain medication. It is important that you feel as
comfortable as possible. You will need less medication as you begin to
heal. Some doctors order Patient Controlled Analgesia (PCA) for their
patients. If your doctor orders a PCA you will have a button to push to
give yourself the pain medication through your IV. Be sure you
understand how the PCA works; your nurse will explain it to you. If you
do not have relief from the pain, please tell your nurse. Your doctor
may call the Pain Service Team to help you with the pain.
Eating After Surgery
When you first wake up after surgery, you may not be allowed to eat or
drink for some time. When you are fully awake and your digestive system
is working, you will be given liquids. If you are able to tolerate the
liquids, you will gradually progress to solid foods. Be sure to tell the
nurse if you have nausea (feel like you have to vomit) after eating.
Turning, Coughing and Deep Breathing
After surgery, you can help prevent any infection in your lungs by
turning, coughing and deep breathing about every 2 hours until you are
able to get back to your normal activity. The nurse will show you how to
deep breathe and cough in the way which will best help your lungs. If
you have had abdominal surgery, it helps to support your muscles while
you cough by holding your hands or a pillow over your incision. For some
surgeries, coughing is not advised, so follow your nurses' instructions.
Incentive Spirometer
The incentive spirometer is a device to help expand your lungs after
surgery. This will also help prevent any lung infections. To use the
incentive spirometer, first exhale (breathe out) normally, then seal
your lips tightly around the mouthpiece. Next, inhale (breathe in)
slowly to raise the piston in the chamber as high as you can. As you are
inhaling, keep the blue tab on the left between the two lines. This
shows that you are inhaling slowly and deeply enough. After inhaling,
remove the mouthpiece and exhale normally. Rest and repeat.
Discharge Instructions
When you have recovered from surgery and are ready to leave the hospital
you will receive discharge instructions. In general, the following
things are important to know:
- When to see your doctor for follow-up.
- Is there anything you should not do, and if so, for how long?
- Is there any special wound care? Will you need supplies and
where can you get them?
- What should you take for pain? Is there a prescription for
you?