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By Stephen W. Earnhart, RN, CRNA, MA
CEO, Earnhart & Associates, Austin, TX
Ordinary people do not understand what surgeons do every day. They do not see other people’s guts and blood, see them naked and completely reliant upon drugs, hooked to machines to keep them alive and bring them back from the seeming brink. The general public may be terrified of what we see every day. That terror is completely normal to laypeople, and we must become more adept at recognizing it, minimizing it, and dealing with it. Most of us fear the unknown. What happens in surgery to millions of people every day is unknown, ergo, terrifying. From the simplest procedure to the most complex operation, it is difficult for the layperson to understand. Let us all try to help our patients deal with it by reviewing what you already know and hopefully follow.
• Educate patients. Use your website to give patients a tour of your facility. Create a staff member video that walks through the registration desk with a simulated patient. Explain what happens there, how long it takes, who will greet patients, what they need to have with them, and what forms they need to sign (and what those forms mean). Do not ambush your patients with these unknowns when they walk in your facility for a procedure.
From there, the video could guide patients into pre-op where a staff member explains the process. This would include who the patients will meet, what the staff will ask them, and what clothes need to come off (many patients are afraid they have to take off their underwear; some do, some do not — explain that). Use the video to inform patients they will meet someone from anesthesia, that a nurse will ask them questions, and that their surgeon will review the procedure, including marking the surgical spot on the body. Let patients know they will have an opportunity to use the bathroom before the procedure if they need it (a serious concern for older patients). Also, inform patients that it is not uncommon for them to be in pre-op for a period until their room is ready.
In the video, include footage of a stretcher wheeling into the operating room. Describe the temperature (cold, but patients can have a warm blanket if they want). Film the operating room with masked and gowned staff moving around and instruments clanging in the background. Explain to patients that they most likely will see the same anesthesia provider they saw in pre-op.
Near the end of the video, include footage of staff wheeling a faux patient into PACU. Briefly explain that once they arrive, a new team of professionals will attend to patients and prepare them to go home. Let them know their loved ones will be able to join them there and learn how to help them when they arrive home.
If you cannot put this video on your website, consider playing it on a loop on the TV in your waiting area. If you cannot do that, consider asking patients to come to the facility a few days before surgery. Introduce patients to the staff and provide as much information about the door-to-door experience as possible. You also can direct patients to YouTube to watch the video, or you can send a link to the video by email or text. The technology is there — take advantage of it.
• Your facility. Ensure the driving directions to your facility are clear. Nothing raises patient anxiety more than getting lost and frustrated by poor directions.
Make sure the waiting room drips with a sense of security by keeping it neat, clean, smelling fresh, and staffed with receptive, smiling faces. At the end of each day, a staff member should walk through the waiting room to ensure it is in order for the next morning.
Minimize the patient’s arrival time before surgery. No one wants to feel their time is wasted and disrespected by waiting an unreasonable length of time. A benchmark goal from arrival to OR should be 45 minutes.
• Discharge. The patient and their accompanying family or friends cannot wait to leave. In their haste to escape, recognize patients will hear or retain little of what you tell them. Give them detailed written information that includes a phone number they can call to ask questions after they get home. Hopefully, someone from your facility will follow up with a phone call that day (ideally) or within a few days after discharge.
Patients talk about their experiences to other people and on social media. Be sure you look your best when they speak of you.
(Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Address: 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. Email: firstname.lastname@example.org. Web: www.earnhart.com. Instagram: Earnhart.Associates.)
Financial Disclosure: Nurse Planner Kay Ball, PhD, RN, CNOR, CMLSO, FAAN (Nurse Planner), reports she is on the speakers bureau for AORN and Ethicon USA and is a consultant for Mobile Instrument Service and Repair. Editor Jonathan Springston, Editor Jill Drachenberg, Author Melinda Young, Author Stephen W. Earnhart, RN, CRNA, MA, Physician Editor Steven A. Gunderson, DO, FACA, DABA, CASC, RN, CRNA, MA, Consulting Editor Mark Mayo, CASC, MS, Editorial Group Manager Leslie Coplin, and Accreditations Manager Amy M. Johnson, MSN, RN, CPN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.