I've always wanted to chat about those things in the operating room, and talk about perioperative humanistic care. When it comes to surgery, many patients are stunned and inexplicably panicked. My old lady is, both knee joints have reached the standard of knee replacement, the old man just disagrees, you can still walk, you don't need it, isn't it a matter of human life?And questioned the level of me and my husband. By the way, my husband is an excellent bone and joint surgeon. My own family members are all in this kind of mentality, so you can imagine how stressful other patients are waiting for surgery.
A female patient in her 60s came to have a hysterectomy, and the doctor said that the patient had been taking oral sleeping pills for almost 20 years, and let us go to the consultation. When I visited, there was only one patient, and I was very careful about all aspects of anesthesia. Later, I asked her if she had been taking this sleeping pill for so long, that is, she started taking it in her 40s, and she generally didn't have insomnia at that age, unless there were any special circumstances.
When the old man heard it, the tears of the mother-in-law came out, when the family changed dramatically, her husband died unexpectedly, she went to the night shift three shifts to see the child, she couldn't sleep, only oral sleeping pills to sleep, now the child is older, the economic conditions are not good, and I am afraid of spending money and afraid of suffering. I said that the current medical conditions are better, general anesthesia is not painful, there is an analgesic pump after surgery, and you can also play a nerve block analgesia (TAP), which will not be very painful, and after medical insurance reimbursement, it will not cost much by yourself, and this drug will not have much impact on surgical anesthesia, so there is no need to be afraid. The patient said that after talking to me, he felt a lot more relaxed and less scared. The surgery went smoothly the next day and the patient was satisfied.
There is also a male patient to do lumbar spine surgery, I visited him before the operation, chatted with him, chatted and asked about the usual physical condition, and then chatted with him about the surgical process, what are the risks of general anesthesia, chatted very happily, the operation process of the day was also very smooth, the afternoon operation, it was almost 7 o'clock in the afternoon when I came out of the operating room, and the patient's general condition was okay.
A few hours after returning to the ward, the ward called ** and said that the patient was delirious and restless after surgery, please ask for instructions on what to do, and the night shift doctor was busy with other surgeries, so let me give a little bit of a mida ** and then observe and see. Wait until noon the next day, I was on duty at noon and received ** that I was still delirious and restless, I went to see this situation, and there were more than 10 relatives of good guys, except for the wife and sons, who were full of bedside. The patient was peeing on the bedside after removing the urinary catheter, and the nursing girl secretly pulled me and said that the patient had just lost his temper and asked me to pay attention.
One of the sons told me that his father was hallucinating, that there were birds in the sky, and that he was beating and scolding him. After the patient finished peeing and got into the quilt, I went over to lift the quilt up for the patient (note that the patient has not been wearing any clothes after the operation), and then asked the patient some conditions, the patient said that the pain of the incision is okay, and all aspects are very good, but I felt that I couldn't pee after I came back last night, and I finally urinated out today, and there was no discomfort in others.
In this case, I pulled his son aside and said to him: Let the inconsequential people go and leave the nursing people, such a large group of people surround the old man to watch him pee, can he give you a good face?Can't you say that others can't talk about their own son?A large crowd was chattering and talking about everything, and he wasn't enough to let someone help him pee.
When I went back, the ward didn't call again. If we don't observe carefully and don't understand the actual thoughts of the patient, he may be embarrassed to say it, and he may blindly add sedative drugs, which will affect the patient's postoperative ** and functional exercise.
Patients come to the hospital for surgery and perioperative care is indispensable, not only to go through the process, but also a small detail of our medical staff may be a reassuring pill in the patient's heart. To understand what the patient thinks, do not blindly look at the surface, but combine it with reality, the patient's recent mood swings may be a risk in the process of surgical anesthesia, and there are not only hard instruments in the operating room, but also our warm care.
Zhang Xiaoyan, Department of Anesthesiology and Surgery, First Affiliated Hospital of Shandong Medical College, Linyi City, Shandong Province.
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