When I heard the title of my postoperative nursing placement it did not excite me, to me “low dependency” suggested a slow area, but I was completely wrong.
Postoperative care is vital in ensuring surgical patients are medically and holistically ready for safe discharge. For student nurses, these placements are an opportunity to develop essential nursing skills in oxygen therapy, pain control, hypovolemic shock and other surgical complications.
My postoperative nursing experience was on a low dependency unit for patients undergoing a range of surgical procedures, from cholecystectomies to teeth extraction.
The first week on the ward allowed my nursing “vision” to progress and develop, as not only was I helping patients during their admission; I was also helping families prepare for discharge. The placement allowed me to meet patients’ medical, psychological and social needs throughout my time there.
As the weeks progressed, I could feel myself changing from a student worried about everything, to a practitioner who understood their patients’ needs. I knew my confidence was growing and that my nursing skills were enhancing.
This was my first placement, and from it I built the core nursing attributes that I needed to progress in my course. I would advise any student starting their first placement to make the most of what is available; this is where you start to learn the skills you carry from placement to placement.
My initial assumption that this was a slow, less exciting area just shows that you should never dismiss a placement until you have arrived and experienced it for yourself. This type of nursing can be daunting for student nurses, especially the idea of pain management, but postoperative nursing is a key part of a nurse’s repertoire of skills, as even medical areas experience postoperative complications.
From my experience, I have developed a POST-OP tool to help other student nurses grasp the basics of post-operative care:
Pain = Is pain being managed adequately? Are you using WHO analgesic ladder for guidance? Do you understand the side effects and contraindications of the medications? Do you understand what is causing the patient’s pain and their individualised coping strategies?
Observations = Are you monitoring vital signs continuously according to the post-operative care plan? Do you know what the baseline values should be and the local escalation process?
Safety = Are vital signs in safe limits for patient? Is there any haemorrhaging or unexplained fluid loss? Are drains, catheters and pumps working sufficiently? Are there any signs of surgical site infection?
Timing = Have medications been given at the right time? Does the patient need food and fluids at certain times? Does the patient need sitting up or mobilising at a specific time after the procedure?
Ongoing care = Are you monitoring fluid regime and dressings? Have you followed the care plan? Have you used your own clinical judgement with assessments to produce individualised care?
Plan = Has the post-operative care plan been followed? Does the plan need altering? Are there any complications?
I hope this tool will allow student nurses to feel more comfortable observing and monitoring patients’ needs. Post-operative nursing opens your eyes to the wonders of healthcare in the 21st century.
Callum Metcalfe is a second year student nurse studying Adult nursing at University of East Anglia