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.

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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.