110 2017 Davinci Robot Set Up 2
Featured Story Written by Shelby Quintana

A Day In The OR

Surgery can be a frightening thought and it is normal for surgical patients to experience nervousness. The Surgical Center at Ivinson Memorial Hospital aims to ease the nerves of our patients by providing compassionate care throughout every step in their surgical experience. This is an inside look of a day in our surgery center.

Before enter­ing the oper­at­ing room or even putting on a hos­pi­tal gown, sur­gi­cal patients receive a call from Jenn Jensen. 

Jenn is Ivinson’s OR Sched­uler, tasked with cre­at­ing the mas­ter sched­ule for our oper­at­ing rooms. She spends most of her day on the phone, prepar­ing sur­gi­cal patients for their pread­mis­sion interviews.

The pread­mis­sion inter­view pro­vides patients with an expla­na­tion of their sur­gi­cal process. A health­care provider will ask patients specifics about their med­ical his­to­ry includ­ing aller­gies and med­ica­tions they are tak­ing. Addi­tion­al­ly, this inter­view is an oppor­tu­ni­ty for patients to ask any ques­tions about get­ting ready for their surgery or any spe­cial needs they might have. 

The goal is to have the pread­mis­sion inter­view about two weeks out from their surgery,” explains Jenn. Dur­ing this ini­tial phone call, she explains the time frame and pro­vides an overview of patients’ interviews. 

In addi­tion to patients, Jenn reg­u­lar­ly com­mu­ni­cates with sur­gi­cal staff through­out her day to devel­op the planned surgery sched­ule. This process begins with the doc­tor book­ing a day for surgery. 

The com­put­er sys­tem aver­ages how long I need to book the OR,” explains Jenn. This aver­age time includes every­thing- from in room to out of room, includ­ing cleanup. The time is a flu­id num­ber because it is a cur­rent aver­age from past surg­eries.” The com­put­er includes fac­tors such as the pro­ce­dure and the sur­geon to esti­mate how long to book the OR.

Ivin­son Memo­r­i­al Hos­pi­tal is proud to offer sur­gi­cal resources to the Laramie com­mu­ni­ty by allow­ing all sur­geons with hos­pi­tal priv­i­leges per­form in our ORs. Jenn reg­u­lar­ly works with these vis­it­ing providers by sched­ul­ing their elec­tive surg­eries as well. 


Behind the Surgery Depart­ment Doors 

While Jenn devel­ops the sched­ule for elec­tive pro­ce­dures, Keeshia Salazar, OR Coor­di­na­tor, blocks out time for emer­gent oper­a­tions. Referred to as Add-ons,” these surg­eries are booked for patients in an urgent med­ical con­di­tion. Emer­gent surg­eries could include appen­dici­tis or trau­ma cas­es. I sched­ule add-ons on a same-day or next-day basis,” says Keeshia. It depends on the case.” 

Whether under­go­ing emer­gent or elec­tive surgery, each sur­gi­cal patient has a sur­gi­cal team com­posed of sur­geons, anes­the­si­ol­o­gists, nurse anes­thetists, pre-oper­a­tive nurs­es, oper­at­ing room nurs­es, post anes­the­sia care (PACU) nurs­es and var­i­ous oth­er health­care pro­fes­sion­als. Ivinson’s sur­gi­cal teams work with state-of-the-art tech­nol­o­gy in our Cys­to room, an Endoscopy room and the da Vin­ci Sur­gi­cal Robot to offer a vast num­ber of sur­gi­cal procedures. 

As the OR Coor­di­na­tor, Keeshia is in charge of coor­di­nat­ing all team mem­bers through­out each sur­gi­cal process. 

I’m like the cruise direc­tor,” says Keeshia. 

In the Oper­at­ing Room

An addi­tion­al team Keeshia is tasked with coor­di­nat­ing is the Ster­ile Pro­cess­ing Depart­ment (SPD). Staff in the SPD play a cru­cial role in Ivinson’s surgery cen­ter, prep­ping, clean­ing and ster­il­iz­ing the oper­at­ing rooms and sur­gi­cal instru­men­ta­tion. Mem­bers of Ivinson’s SPD under­go exten­sive hands-on train­ing and must receive cer­ti­fi­ca­tion after 18 months on the job. 

SPD is in the OR before and after pro­ce­dures,” says Eric Harns­berg­er, sur­gi­cal tech­nol­o­gist. They are in charge of ster­il­iz­ing, wash­ing, pack­ing and orga­niz­ing the instru­men­ta­tion used in surg­eries in addi­tion to car­ing for the oper­at­ing rooms.” 

Pre­vi­ous­ly, Eric was a mem­ber of our SPD. Now, as a sur­gi­cal tech­nol­o­gist, he helps pro­vide care to patients by assist­ing sur­geons in the oper­at­ing room dur­ing procedures. 

He devel­ops close work­ing rela­tion­ships with sur­geons, hand­ing them instru­ments dur­ing their oper­a­tions. Sur­gi­cal tech­nol­o­gists must know the process for surg­eries, as the goal is to pro­vide instru­men­ta­tion before sur­geons ask. Sur­geons don’t want to talk about the pro­ce­dure dur­ing surgery,” says Eric. 

Each sur­geon has a dif­fer­ent pref­er­ence for the set-up of the oper­at­ing room and dif­fer­ent names for all of the instru­ments,” says Eric. He works with all sur­geons at Ivin­son, assist­ing with ortho­pe­dic, urol­o­gy, gen­er­al surgery, OB/GYN, gas­trol­o­gy and ENT care. 

The PACU

Depend­ing on the type of anes­the­sia patients received, some sur­gi­cal patients are trans­port­ed out of the OR and into the PACU (post anes­the­sia care unit). This is a crit­i­cal area that focus­es on mak­ing the patient’s tran­si­tion out of the oper­at­ing room as com­fort­able and safe as pos­si­ble. While in the PACU, nurs­es care­ful­ly mon­i­tor patients’ vital signs as they awake from an anes­thetized state. 

It depends on the surgery and the patient, but usu­al­ly patients are in the PACU for about an hour,” says Mar­i­lyn Krysl, a reg­is­tered nurse in Ivinson’s PACU. This is not a long-term area.” 

Mar­i­lyn works direct­ly with sur­gi­cal patients, prac­tic­ing a stir-up” reg­i­men to help patients awak­en from anes­the­sia and pre­vent com­pli­ca­tions. Dur­ing this reg­i­men, she will ask patients to take deep breaths, cough or encour­age them to make small movements. 

When patients are more con­scious, PACU nurs­es are also tasked with pro­vid­ing post-oper­a­tive instruc­tions. We do a lot of teach­ing,” says Mar­i­lyn. We teach them how to care for their sur­gi­cal wounds, explain their med­ica­tions and tell them when to see or fol­low-up with their doctor.” 

Before going home, patients must know how to care for them­selves. PACU nurs­es overview the type of activ­i­ties patients can per­form, what they are allowed to eat, how to man­age their pain among oth­er impor­tant dis­charge instructions. 

The Heal­ing Process 

From our OR Sched­uler to our PACU nurs­es, all employ­ees in the Surgery Cen­ter at Ivin­son Memo­r­i­al Hos­pi­tal work to pro­vide each patient with the best qual­i­ty of sur­gi­cal care with a high lev­el of safe­ty. Our employ­ees in the surgery cen­ter ensure patients are com­fort­able through­out their sur­gi­cal expe­ri­ence by pro­vid­ing edu­ca­tion in a com­pas­sion­ate envi­ron­ment. Through sur­gi­cal meth­ods, we aim to make a pos­i­tive impact in our patients’ lives.

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