Preparing for Inpatient Surgery
Welcome to UW Hospital and Clinics
On behalf of the University of Wisconsin Hospital and Clinics, we extend a warm welcome. Our goal is to work together with you so that your surgery goes well and your recovery at home progresses smoothly.
As you plan for your surgery, you might find the contents of this booklet helpful in getting ready. This booklet has general information about getting ready for surgery. Your doctors and nurses will talk with you about your own surgery. A nurse will also go over this booklet with you and answer your questions.
A nurse will help you prepare for surgery. The anesthesia staff will also see you before surgery. They will talk with you about anesthesia choices and what to expect during and after surgery. You will have an intravenous (IV) catheter inserted in your hand or arm. You may also receive medicine to help you relax.
Some key things to help you prepare for surgery are
- At some point (often 8 hours or more before your surgery), you will be asked to stop drinking and eating. This includes chewing gum, candy, or chewing tobacco. Other diet restrictions depend on your age, time and type of surgery, health status, and type of anesthesia.
- You might reduce the risks of anesthesia by not smoking or at least cutting back. You may want to discuss this with your nurses or surgeon. The building and grounds of UW Hospital are smoke-free.
- When brushing your teeth the morning of surgery, rinse but do not swallow. If you are given medicine, use just a small amount of water to swallow the pills.
- Your surgeon may ask you to stop taking "blood thinning" medicines before surgery. You may be asked to stop taking medicines that contain aspirin, naproxen, ketoprofen, and ibuprofen. This includes: Excedrin®, Ascriptin®, Ecotrin®®, Advil®, Motrin®, Nuprin®, Orudis®, and Aleve®. Other “blood thinners” like Coumadin® and warfarin may also be stopped. Acetaminophen (Tylenol®) may be used for general discomfort.
- Before surgery, you will be asked to shower or scrub with an antibacterial soap such as Hibiclens®. Please remove make-up and nail polish.
- Remove all jewelry and wedding rings. For safekeeping, please send them home or ask your nurse to place them in the hospital safe.
- Send large sums of money and credit cards home. You can keep a small sum to pay for small expenses.
- One parking pass for your family can be picked up at the Hospital Admissions Desk inside the Main Hospital Entrance. This will provide free parking during your hospital stay. The person at the desk can also help you with keeping your car in the parking ramp during your stay. The phone number for the Patient Information Desk is (608) 263-8590.
- If your family is coming from out of town, they may find it handy to stay in Madison. A Housing Accommodations Coordinator, (608) 263-0315, can give your family a list of nearby motels and arrange for their stay at a discount rate.
- When you return home, it may take a few days or weeks for you to resume your normal routine (such as work, child care, laundry, shopping). The length of time you need to recover will vary and depends on the type of surgery you had. During your hospital stay, nurses and doctors will talk with you about caring for yourself at home. You may need to make special plans for someone to stay with you for a few days.
- Please review any information you receive about your surgery. Be sure to ask your doctors and nurses about getting back to work and other activities.
Making Choices about your Health Care
Federal law requires hospitals to inform you of your right to complete an advance medical directive. The admissions staff will give you written information about The Living Will or Durable Power of Attorney for Health Care. These legal forms state your wishes about your health care and ask you to name a friend or relative to make health care decisions for you if you become unable to do so. If you have already filled out one of these forms, let us know.
Anyone who is age 18 or older and of sound mind may write an advance medical directive (AMD). It is your choice. If you need help to complete the form or have questions, call the Patient Relations office at (608) 263-8009.
Spiritual Care
Some people like to have their own clergy visit them. If you would like a chaplain from Spiritual Care Services to see you, call them at (608) 263-8574 or ask your nurse to help arrange for their services.
Going to the Operating Room
Once the time of your surgery has been set, your nurse can tell your family the best time to visit with you before you leave for the operating room (OR). You should know your scheduled surgery time in the late afternoon on the day before surgery. Family members may stay with you in your hospital room until you are taken to the OR. At that time, family and friends will be sent to the Surgical Waiting Area (see below).
A nurse will be with you during your operation. The nurse will answer any questions you have. She will help make sure that you are comfortable and explain what is going on around you.
Once you enter the OR, staff will be wearing masks and surgical hats. They will help you to move onto a narrow, firm bed. The nurse will place a safety belt, like a seat belt, across your legs for your protection. You will feel the nurse or anesthesiologist putting the blood pressure cuff on your arm. Sticky patches will be put on your chest to monitor your heartbeat. Tape or a clip will be placed on your finger to check the oxygen in your blood. The room will be brightly lit.
Surgical Waiting Area
The amount of time you spend in the OR depends on your type of surgery. The nursing unit staff will direct your family to the Surgical Waiting Area (C5/2, just past the D elevator lobby on the 2nd floor). In the waiting area, coffee, tea, magazines, TVs, and computers are there for your use from 7:30 am until 6:30 p.m. Monday through Friday. When your family arrives at the waiting area, a disc pager will be given to the main contact for the patient in surgery. Updates will be given when the incision is made and every 2 hours until the surgery is done. The doctor will come to the waiting area or call to inform family about the patient’s surgery.
Recovery Room (Post-Anesthesia Care Unit)
After surgery, you will be taken to the Recovery Room. The nurses will check your blood pressure and help you to wake up from the anesthetic. Nearly all patients have oxygen when they first arrive. Often it is given by mask. If you are bothered by having something over your face, please let the nurse know. Oxygen can be given by a tube under your nose. Once you are awake, it is often removed.
You will have a small clip or tape placed on your finger, toe, or earlobe to check your pulse and the amount of oxygen in your bloodstream. This clip or tape will be removed before you leave. You will have a blood pressure cuff on your arm. This cuff will tighten for a few seconds every 10-15 minutes so the nurse can record your blood pressure. You will have your temperature taken under your arm rather than under your tongue.
If your temperature is low or you feel cold, a heated blanket or heat lamp can be used to warm you. You may notice beeps from the equipment in the room.
Pain after surgery is common. We want you to be comfortable. Please let the staff know if you need medicine to relieve the pain. Although you may have told a number of staff about your allergies, you might be asked again. This is to make sure that you are not given a medicine that might cause you to react. Feeling sick to your stomach (nausea) and vomiting can also occur after surgery. If you are nauseated, let your nurse know. Medicines can be given to help you feel less sick.
When you feel the need to pass urine, please do not try to get out of bed. For your safety, ask for help. The nurse will give you a bedpan or urinal. Some patients have a catheter in place to drain the bladder.
The time you spend in the Recovery Room might be a few hours. Family and friends are not allowed in this area. Once you are settled in your room, they may join you. Some patients might be transferred to an Intensive Care Unit (ICU) for special care. The staff will tell your family and friends about the visiting hours.
After Surgery
Once you are back in your room, nursing staff will check you often. How things progress depend on the type of anesthesia and surgery. You might have a number of tubes, drains or equipment such as
- An IV (intravenous catheter) in your hand or arm to provide fluids and medicines until you are able to drink fluids well.
- A face mask or tube under your nose to supply oxygen.
- A tube to drain urine from your bladder. You may feel the urge to urinate even though your bladder is empty.
- An NG (nasogastric) tube through your nose into your stomach to help prevent nausea and vomiting.
- Wound drains to help your incision heal.
- Leg wraps that inflate and deflate and/or elastic stockings to improve blood flow in your legs while you are less active.
A nurse will explain how these items work and how long they will be in place. Your case manager or primary nurse works with you and your family, doctors and other care givers to help you get better. The case manager will help plan your care and answer your questions from admission to discharge.
You cannot eat right after surgery because eating may cause nausea or make you vomit. At first, you will receive ice chips. As your system allows, your diet will progress from clear liquids (juice or broth) to full liquids (milk or ice cream) to solid foods.
Soon after surgery, the nursing staff helps you turn in bed often and do leg exercises. Nursing staff must be with you the first time you get up. Some people may need help for a few days. Although you may feel weak and sore, it's vital that you get out of bed and walk as much as you are allowed. Walking helps to decrease lung problems and prevent blood clots in your legs.
Coughing and Deep Breathing
Once the breathing tube is out, nurses will ask you to breathe deeply, cough, and use a breathing tool (incentive spirometer). Good breathing helps you to get rid of the anesthesia and prevent pneumonia.
To cough and deep breathe
- Place a pillow over your chest to lessen the pain while coughing.
- Breathe in deeply and slowly through your nose. Hold it.
- Exhale slowly through the mouth.
- Repeat twice more.
- Breathe in again; hold it, and then cough.
To use the Incentive Spirometer
- Exhale and place your lips tightly around the mouthpiece.
- Take a deep breath. Slowly raise the Flow Rate Guide between the arrows.
- Hold the deep breath. Continue to inhale, keeping the guide as high as you can for as long as you can, or as directed by your nurse or respiratory therapist.
- Exhale and relax.
- Repeat 10 times each hour while you are awake.
Pain Control
People used to think that severe pain was something you just had to put up with. That’s no longer true. Today, you can work with your nurses and doctors to prevent or relieve pain. Good pain control helps you to:
- Enjoy greater comfort.
- Heal faster.
- Start walking, breathing and gaining strength more quickly.
- Leave the hospital sooner.
- Have better results and avoid complications.
Drug and non-drug treatments can help prevent and control pain. Don’t worry about getting “hooked” or “addicted” to pain medicines. Studies show that this is very rare unless you already have a problem with drug abuse.
For best results
- Discuss your options with your doctor and nurses. There are many choices from IV medicine to pills. You and your doctor can decide which is best for you.
- Take (or ask for) pain relief drugs when pain first begins. Waiting until your pain becomes severe limits the effectiveness of the medicine. Pain pills take 20-30 minutes to work.
- After surgery, you will be asked to rate your pain using the following scale.
0-10 Number Pain Intensity Scale
________________________________________________________
0 1 2 3 4 5 6 7 8 9 10
No Mild Moderate Severe Worst Pain PainPossible
- The goal should be a level that will allow you to do your deep breathing exercise, walk, and sleep with little pain. Rating your pain helps us to know how well your pain medicines are working.
- Tell the nurse or doctor about any pain that won’t go away. Don’t worry about being a “bother”. Pain can sometimes be a sign of problems.
Pain medicine may cause you to become drowsy, dizzy or lightheaded. Do not drive, use machines or drink alcohol while taking pain pills.
Narcotics can cause constipation. When you go home, be sure to increase your daily water or juice intake to 6-8 (8-ounce) glasses. Increase the fiber in your diet as well.
Going Home
How long you stay in the hospital depends on your type of surgery. Before you leave, we will talk with you about how to care for yourself at home. Please ask a friend or family member to be with you for discharge information. At this time, the nurse will give you supplies you will need at home. You will receive prescriptions for medicines which can be filled here, if your insurance allows, or at a pharmacy of your choice. Bring your insurance card or other information if you plan to fill your prescriptions at the UWHC pharmacy. Please arrange to have a responsible person drive you home and stay with you during your first few days at home. Plan to be discharged by noon.
At UWHC our goal is to give you the best care possible. We hope this booklet has been a helpful start.
You might want to write down any questions and discuss them with your nurses and doctors.
Important Phone Numbers
If you have questions about your surgery or any related service, please call. Our staff is here to help.
Admissions and Insurance Advisors (608) 263-8770
(financial counselors) E5/213
Admissions Office (608) 263-9172
(Insurance Verification)
Business Office (608) 263-4466
General Billing Office (608) 262-2221
General Information (608) 263-6400
Hospital Paging Operator (608) 262-0486
Housing Accommodations (608) 263-0315
Spiritual Care (608) 263-8574
Patient Information (608) 263-8590
(for room number and location)
Patient Relations Office (608) 263-8009
Outpatient Pharmacy (E5/23) (608) 263-1280
Toll-free number 1-800-323-8942
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/09/2009
Copyright © 10/01/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5228
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