A Day In The OR

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.