Surgical Services Unit
Thank you for choosing Speare Memorial Hospital’s Surgical Services Unit at which to have your surgery or procedure. This site is meant to help you understand and become comfortable with the process leading up to and following your surgery. It is important that you understand each step in the process from the time your physician determines that surgery or endoscopy is the best option until you are discharged.
The Surgical Services Unit cares for patients prior to, during, and after surgical and endoscopic procedures. The unit consists of seven private ambulatory care rooms, two post-anesthesia (recovery) bays, two operating rooms, and one endoscopy room. All operating rooms are equipped with state of the art surgical and emergency equipment. Surgical Services cares for pediatric, adolescent, adult and geriatric patients.
- General surgery
The Surgical Services staff is committed to providing you with the highest quality patient care available. Nursing care in the Surgical Services Unit is guided by the recommended practice standards set out by the Association of periOperative Registered Nurses (AORN) www.aorn.org and the Association of PeriAnesthesia Nurses (ASPAN) www.aspan.org as well as by the Centers for Medicare & Medicaid Services (CMS) www.cms.gov Conditions of Participation.
- Your surgeon’s office will schedule your surgical procedure. At the same time the surgeon’s office will schedule you for a 30 minute nursing telephone interview or a 1 ½ to 2 hour face-to-face appointment in the Pre-op Testing Center at Speare Memorial Hospital. Whether you have a telephone interview or a face to face interview is dependent upon what type of surgical procedure you are having and your past medical history. Either of these appointments will be made approximately two weeks prior to your surgery date. A pre-operative questionnaire is available to help you with the nursing interview. Whether you have a telephone interview or a face to face interview these are the questions that will be asked of you. If you have a telephone interview please set aside this scheduled 30 minutes without interruptions
- We also suggest that prior to either of these appointments you write down any questions you may have.
- Once your surgery is scheduled please arrange for someone to bring you home on either the day of your surgery or day of discharge. You must have a responsible adult (not a taxi) drive you home and we strongly recommend that someone stay with you until at least the following morning.
During either appointment (telephone interview or face to face interview) you can expect:
- A nurse to ask you about your past medical and surgical history
- To be asked the name and dosage of all medication you are taking, including prescription, non-prescription, over the counter medications, and aspirin. You should also provide the name and dosage of any vitamins, herbals and diet supplements. Please have your medications or a list of medications that you take, including times, and dosages for each.
- To be asked if you have any allergies and what the reaction is.
- To review customized instructions regarding what medication to take or stop prior to surgery.
- To provide name and telephone number of your primary care physician and specialist.
- To be asked about a Living Will, Durable Power of Attorney for Healthcare (DPOAH), and/or guardian papers if applicable. Please bring copies of these documents if applicable.
- To have the opportunity to ask questions and have your questions answered. Feel free to ask any questions or express any concerns you may have.
If you are scheduled for a face to face interview you can also expect in addition to the above:
- To be in the Testing Center for 1 ½ – 2 hours.
- To meet with an Anesthesia provider.
- To meet with Rehabilitation and/or Case Management as necessary.
- To have required pre-operative testing, if not already complete: labs, EKG, x-ray, etc.
If you have an appointment at the Pre-Op Testing Center, come to the main entrance of the hospital and go to Outpatient Registration. The Pre-Op Registered Nurse will come and get you.
- Standard pre-operative instructions should have been reviewed with you by a nurse. Follow instructions reviewed with you by the nurse and also those provided to you by your surgeon’s office.
- Follow instructions provided to you in regards to your medication. Certain medication will interfere with your surgical care and must be stopped, or your surgery may be cancelled.
- Notify your surgeon of any change in your physical condition, such as a cold or sore throat.
- If you have not received these instructions or have any additional questions, please call the Surgical Services Unit603-238-2234 between 7 am and 3 pm.
Evening Before Surgery
- Follow the instructions provided to you by your surgeon and the pre-op testing nurse.
- Follow instructions regarding not eating and drinking prior to surgery. Your surgery may be cancelled if you eat or drink. This includes not having gum or hard candy. Exceptions only include if you were instructed to take any medication(s). These medications should be taken with a small sip of water.
- Try to get a good night’s sleep.
- If you were instructed by your surgeon to take any medication the day of surgery, do so with a small sip of water.
- Your arrival time for Surgery is Approximately one hour Prior to the Surgical Start Time, unless told differently. Allow extra time for traffic and parking. Surgery may be cancelled or delayed if you are late.
- Please bring as few personal items as possible to the hospital. Leave valuables and jewelry at home as the hospital will not be held responsible for lost or stolen items.
- Please remove nail polish (clear is fine). Do not apply lotion, cream, deodorant or make-up on the day of surgery.
- Wear comfortable clothing.
- Please park in the main parking lot on Hospital Road. Proceed through the main entrance and proceed to your right to the Registration area.
- You will register at the Registration Department. Please have your insurance card and identification with you. Upon completion of the registration process, you will then proceed to Surgical Services.
- You will be met by a receptionist or nurse and be escorted to a private room. You will be asked to change into a hospital gown. A patient belongings bag will be provided to put your clothes in.
- For your safety, you will be frequently asked your name and date of birth. An identification bracelet will be placed on your wrist as well as an allergy bracelet if appropriate. You will also be asked to confirm what you are going to have done for a procedure.
- A short pre-operative interview will be done by a nurse to make sure that your health history has not changed since the time of your telephone or face to face interview.
- If you require anesthesia services an Anesthesia Department representative will meet with you to discuss the right type of anesthesia for you. The decision for your anesthesia will be between you, your doctor and your anesthesia provider. More information regarding anesthesia can be found under Frequently Asked Questions (FAQ’s).
- An intravenous (IV) is started by the pre-operative nurse or anesthesia provider. Your surgeon visits with you to review your medical history, answer questions, and to mark your surgical site if appropriate.
- You may be asked to remove dentures, partial plates, bridges, hearing aides, contact lenses and body piercings.
- Family members or friends in the waiting room may visit. Family will be asked where they will be waiting and/or how they can be contacted so that the Surgical Services staff can provide progress reports and so that the surgeon can speak with the family after the surgery is completed.
- The operating room nurse comes to meet you in your private room, confirms your name, date of birth (with you and against you bracelet), confirms procedure, checks your chart, answers your questions, and proceeds to take you to the operating room or procedure room. You will be asked to put on a Surgical Hat and Mask (if appropriate) prior to going to OR Suite.
- If you are anxious you will probably receive some medication through your IV prior to being wheeled into the Operating Room.
- Providing you with excellent care is our ultimate goal. If at any time you have concerns about your care, let your nurse or the Charge nurse know in order for us to address your concerns before leaving Surgical Services.
In the Operating Room
- The Operating Room staff will be wearing surgical clothes, masks, and hats. The room has bright lights and ‘lots’ of equipment.
- In the operating room you will be asked to move onto the operating room table. The room will feel cold but warm blankets will be provided to keep you warm.
- Your nurse in the operating room is there to care for you and to act as your advocate. He/she will remain with you until your procedure is finished.
- Our goal is to keep our patients and your loved ones informed throughout your surgical experience. Do not hesitate to ask questions at any time.
- If your contact/family member is not able to stay at the hospital during your surgery, please provide us with contact information.
In the Post Anesthesia Care Unit (PACU or Recovery Room)
- Immediately after surgery you will be taken to either the Post-Anesthesia Care Unit (PACU), back to the private room where you started or taken directly to the in-patient unit if you are staying overnight.
- A nurse will take care of you during your emergence from anesthesia. The nurse will monitor your blood pressure, heart rate and breathing as well as your fluid intake and urine output. He/she will frequently check your bandages and will encourage you to take deep breaths and cough to expand your lungs in order to prevent pneumonia. He/she will help you to periodically turn from side to side and move your legs to aid circulation and prevent blood clots.
- You will frequently be asked to rate your pain on a scale of 0 to 10. You will be given pain medication for your comfort as needed. If you are uncomfortable please inform your nurse.
- You will remain in PACU until it is safe for you to be discharged to a post- recovery location.
- The PACU nurse will determine when it is appropriate for you to see your contact person. Immediate family members may visit you in PACU as determined by your PACU nurse.
After the immediate post-operative recovery period, you will transition to one of two areas:
- Back to the private room where you started where you will be reunited with your family, receive home care instructions, and be discharged.
- Inpatient room where you will continue recovery over night.
- Do not make important decisions for the first 24 hours after surgery.
- Do not use non-prescription drugs or drink alcohol for 24 hours after surgery.
- Do not drive or operate dangerous equipment for 24 hours after surgery (longer if directed by your doctor).
- Resume your diet slowly. Start with clear liquids. Avoid eating a large meal until the day after your surgery.
- You will be given discharge instructions prior to discharge from the hospital. Refer to those instructions.
- Contact your doctor if unusual symptoms arise or you are concerned or have questions.
- Ask your nurse or physician if you need to purchase a prescription on the way home. Often times it is possible for a family member to pick up a prescription while you are in surgery so you will not have to stop on the way home.
The Surgical Services phone number is (603) 238-2234.
A. Anesthesia is the process by which a patient is made comfortable during a medical or dental procedure. This is accomplished with the use of medication that allows the patient to sleep or makes a particular part of the body numb.
Q. What types of anesthesia are there?
A. There are three ways in which anesthesia is provided:
General anesthesia- the patient is completely asleep and may need help breathing through the use of a breathing tube.
Regional anesthesia- the patient is sedated and relaxed while local anesthesia (ie. lidocaine) is used to numb part of the body. Examples of regional anesthesia include spinal, epidural, axillary, digital or ankle blocks.
Monitored Anesthesia Care (MAC)- the patient is sedated and relaxed. The surgeon may or may not use small amounts of local anesthesia to make the skin numb.
For more details and information, we invite you to contact our Department of Anesthesia at 603-536-1120 x370 or visit the American Society of Anesthesiologists web site at www.asahq.org/patient Education for more patient information.
Q. Who provides anesthesia?
A. Anesthesia is provided by anesthesiologists (physicians specially trained in anesthesia) and CRNA’s (nurses with special training in anesthesia)
Q. Can I eat before surgery?
A. A fasting period is essential to patient safety. The objective is to empty the stomach so the risk of inhaling stomach contents into the lungs is reduced. Therefore, do not eat, chew (including gum or candy), or drink anything after midnight the night before surgery. For your safety, surgery may be delayed or cancelled if you eat or drink.
Q. Which medications should I take prior to surgery?
A. Taking certain medication on the day of surgery improves your safety as other medication can make your care more difficult. You will be told what medication to take and what not to take.
If you are a diabetic you will also be told what medication to take and what not to take.
Q. Will I receive a meal before going home?
A. It is best to eat lightly for the first several hours following your surgery or procedure in order to prevent nausea/vomiting. Food options in the Surgical Services unit include: muffins, pudding, applesauce, Jell-O, saltines, graham crackers, soda, coffee, and a variety of juices.