Nursing Postoperative Patient

Because most operations today are performed in hospitals, it is well for family members to know how best to aid the recovery of their convalescing relatives. Undue visiting should be discouraged. The frequent recital of a person’ s own operation and details of hospitalization can help to depress and confuse the individual recovering from surgery.

Visiting just to “chit chat” in the hospital should be kept to a minimum. Well wishers should either send cards or reserve their condolences for later. A devoted family member or trained nurse, however, can be of incalculable value to the convalescing surgical patient. Immediately after major surgery the incision should be cooled with an ice pack applied over the dressing.

This will reduce swelling (edema fluid), lessen the likelihood of bleeding, and modify impressively the pain responses. Avoid excessive movement of the involved area, while maintaining activity in remote portions of the body. And especially encourage deep breathing. This will aid the rapid emergence from anesthesia, while minimizing the sensation of severe pain.

After the initial recovery phase is ended, moist warm compresses can be applied over most incisions, except in areas where the blood supply is compromised or at the distal extremities. In the latter case cold packs may be used. Over the chest and abdomen, however, frequent applications of moist warm packs, such as fomentations or electric heating devices will significantly reduce the pain, while promoting rapid healing of the involved area.

At this stage the healing processes will occur more rapidly in the presence of warmth, since all enzyme reactions as well as the growth of new cells are speeded up by mild heat. Usually the moist hot pack can be applied every three to four hours, enabling the convalescing patient to relax in between, gaining the necessary rest that promotes recovery.

From the very first, the incision should be protected from undue moisture and kept clean and dry. Daily changes of the sterile gauze dressing are helpful in allowing air to reach the incision and dry the sutured area. Adequate fluid intake is important. After abdominal surgery intravenous feedings are often used until the intestinal tone returns.

This manifests itself by the passage of gas, and a sensation of hunger. One can hear “bowel sounds” when listening to the abdomen with a stethoscope. At this stage, the patient may be given sips of water or ice chips. If these create no problem, clear liquids such as herb teas, apple juice, vegetable jello, grape juice, and vegetable broth may be added.

After a meal or two in which these clear liquids are well tolerated, the diet can be enriched with the addition of creamed soups, diluted cereals, other fruit juices, milk, or pudding. As rapidly as possible, the diet should be advanced to foods that can be thoroughly masticated, always prepared as attractively as possible.

This variety of natural foods can promote tissue healing and emotional satisfaction in the most positive way. If the patient is in the average community hospital, it is advisable to supplement his diet with some form of whole grain cereal, such as homemade crackers, as well as extra amounts of fresh fruits, dry fruits, or nuts.

These should be kept, of course, in plastic containers to avoid attracting roaches, rodents or flies. Nevertheless, the addition of some whole grains and fresh fruit to the average hospital dietary will help provide the extra vitamins and minerals that are essential to a prompt recovery. Consultation with a dietitian and permission from a physician may be necessary.

The natural foods will help to accelerate the healing process and improve the nutritional value of the highly refined “popular” diet usually served in public medical institutions. An individual who requires prolonged feedings with intravenous fluids should ask his physician about the addition of vitamins, as this often neglected measure can be helpful in meeting nutritional needs during a critical illness.

Simple hygienic measures which will aid in convalescence from surgery are adequate water drinking, exposure to sunlight daily, and availability of fresh air in the sick room. All of these are hard to find in large hospitals. It may demand the selection of a facility for major surgery that recognizes these essentials and provides them.

It is very important to obtain adequate rest at night, and this should be insisted upon. Not uncommonly, hospitals perform at night many routine tasks that do nothing but disturb a patient. An atmosphere of tranquility should be insisted upon. Bedside telephones and the frequent taking of unnecessary vital signs may be intrusions into your peaceful rest that promotes a rapid recovery.

It is wise to avoid much television viewing. This distraction puts the mind in “neutral” (or reverse), and stifles creative thought patterns and positive emotions that aid in recovery. Windows with an outdoor view and a stream of fresh air that can enter without hindrance will make convalescence pleasant.

Where hospitals do not provide these essentials, early discharge should be advocated, securing the appropriate nursing care in a more home-like setting. Finally, it must be recognized that exercise is not detrimental to the convalescing surgical patient. Early ambulation will help prevent such complications as pneumonia and clots in the veins.

It also aids the general circulation. Activity establishes a feeling of well being that promotes recovery in the most unequivocal way. A short walk within the room, down the corridor, or even, with appropriate clothing, in the out-of-doors, will aid healing for surgical patients in record time.

I have seen in my institution patients recovering from surgery of the gallbladder, female organs, or orthopedic procedures taking deep breathing exercises, stretching the limbs, and ambulating considerable distances in the first few days. Complications are almost nonexistent in these patients.

Cheerful mental attitudes, good nutrition, and fresh air combined with physical exercise support a rapid recovery. The gastrointestinal and digestive tone in such cases usually returns earlier, too.