The surgical experience begins with  patients being greeted by the staff members of the Ambulatory Care Unit. Here the patient is prepared for surgery. Johnnies replace the patient’s clothes, vital signs are taken and surgical procedures and consents are confirmed. As part of preparation for surgery, a nursing assessment is performed and warm intravenous fluids are begun. The patient is pre-warmed also with a warming blanket/warmer to help prevent surgical hypothermia.

When the OR  is ready, the circulating nurse walks to the Ambulatory Department to interview the patient. Prior to this, the circulating nurse, along with the scrub technician, have been preparing the OR suite for the patient. Supplies have been opened sterilely and instruments readied. The OR table has also been pre-warmed to make the patient’s transition to the Operating Room a warm one.

Once in the OR, the patient is secured with a safety belt and a warming blanket is applied to the patient and the process of preparing anesthesia begins. About this time, the circulating nurse, the anesthesiologist and the surgeon hold a “Time Out”. At this time the patient is re-identified, the procedure is announced and confirmed and right and left sides are verified. Once this is done, surgery can proceed. During surgery the patient is continually being warmed and monitored by the anesthesia team.

When surgery is over, the circulating nurse calls report to the Post Anesthesia Care Unit (PACU). The patient is transported to this area via bed or stretcher. Here the patient is carefully monitored and vital signs taken frequently. The patient is encouraged to deep breathe and cough. Pain is carefully  monitored at this time and appropriate pain medication is given to insure the patient is comfortable. When the patient meets certain criteria, the patient is discharged from the PACU. The patient, if going home the same day, will be taken to the Ambulatory Care Unit or if staying in the hospital, will be taken to a patient room on the second floor.

In the Ambulatory Care Unit, the patient’s vial signs are again monitored. Pain levels are also carefully monitored during this time. Once the patient meets discharge criteria, discharge instructions are given to the patient/family/and or significant other. Instructions are given verbally and are also written. The patient is then walked or wheeled out to their vehicle.