To keep you as relaxed as possible we would like you to be at home for as long as possible prior to your surgery. Having a good night’s sleep is more likely in your own bed. We therefore prefer to admit you on the day of your surgery.
On arrival you will go to the Surgical Admissions Lounge (SAL) located in the Treatment Centre.
The arrival time for your admission is on your admission letter. Admission times are normally 07:00 or 10.00 am but you may not go to theatre until later in the day. The theatre scheduler will contact you and confirm this. We will aim to give you an idea of when your surgery is expected and will continue to allow you to drink until two hours prior. There can be a lot of waiting around so bring something to read!.
Once you have arrived, a member of staff will check your details. You will be asked to sit in the waiting room until the nurses are ready to complete your admission.
You will see the consultant and the anaesthetist. This is a good time to ask any outstanding questions you may have. Make a list of these prior to coming into hospital so that you do not forget them. The nurses will undertake any outstanding tests and if you require an enema or suppositories these will be given.
If the surgeon has discussed the possibility of the formation of a stoma, the stoma nurses will see you on the morning og your operation to "site" you for a stoma. These markings are preformed to ensure in the event that formation of a stoma is required, the stoma is sited in the most appropriate area of your abdomen.
You will be asked to put on your hospital gown. Please bring a dressing gown and slippers.
Please bring the following items:
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All medications in their original packaging if possible
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Day clothes - practical shoes. Comfortable, loose clothing is recommended.
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Nightclothes
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Toiletries and a towel.
Your hospital bag should be taken directly to our elective ward as there are no facilities in SAL to keep your belongings.
You will be asked a number of questions on three different occasions. This is the surgical checklist. It is an important safety check to ensure the important information about you and your treatment is correct.
When they are ready for you, if you are able, you will be asked to walk to theatre. If you are unable to walk you will be taken in a wheelchair or on a trolley
When you wake up from surgery you will wake up in the theatre recovery room where the nurse will be able to 1:1 while you are still drowsy.
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You will have Oxygen as you will be sleepy.
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You will be connected to some intravenous fluids
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You may have a PCA (patient controlled analgesia)
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You will have dressings over you wound.
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If applicable you will have a stoma - ileostomy or colostomy
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You may have a drain
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You will have a catheter
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You will be connected to flotrons that inflate up and down to prevent from blood clots.
Once you are stable the staff will then transfer you to the ward. Sometimes after surgery it is necessary for patients to go to the High Dependency Unit (HDU) for closer monitoring. Often the decision is planned and the Anaesthetist will have discussed this prior to surgery, however, there are occasions when an unplanned transfer to HDU is required.
When back to the ward you still may be very sleepy.
It is normal that the ward staff will check your observations (blood pressure, pulse, temperature and oxygen levels) regularly when you first get back to the ward.
The consultant would have written in your notes if you are able to eat and drink so ask the ward staff if you feel thirsty of hungry.
Remember to use your pain button to enable you to move around the best, in and out of bed and ensure your able to take big deep breaths and practice regular breathing exercises.
It may be late before you get back to the ward, this is normal. We will aim to sit you out early the next day after surgery, however there is nothing stopping you sitting out that evening if you wish. Please remember to ask staff for help getting out of bed as you will have lots of attachments.
Each morning you will be reviewed by one of the consultants team - this doesn't necessarily mean the consultant themselves but maybe there registrar or advanced nurse practitioner (ANP). This allows them to see your progress and each day we will aim to remove the number of attachments you have until you are independent.
Remember your ERAS diary! Complete this daily as this will enable to you keep focused, motivated and track your progress.
The colorectal nurses work Monday-Friday and will see you whilst on the ward to ensure your recovery is going as planned.
Your Stay
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For the first day post-op we will assist you with washing and dressing
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Remember to get changed into your clothes or PJ's.
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If you are drinking sufficiently we will aim to take down your Intravenous fluid.
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We will aim to remove your patient controlled analgesia after day 2 or 3 and give you oral analgesia
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After 2 days we will take down your dressing, if clean and dry we will aim to keep exposed so we can see is clean and dry.
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Ask the ward staff if you are able to eat and drink
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You will be seen by a member of the surgical team or Advanced nurse practitioner (ANP) - not necessarily your consultant.
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They physiotherapist will see you daily until they are happy with your walking and breathing exercises
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We encourage you to sit out in chair for as long as you can (at least 6-8 hours)
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You are encouraged to sit out for ALL meals.
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We will monitor your bowel/stoma function
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You will receive daily blood thinning injections - you will complete a 28 day course of these so we will encourage you to give these yourself.
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If applicable we will remove your drain as indicated by the surgical team
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Your catheter will be removed once your are mobile and your bowels are showing signs of working after surgery.
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Rarely some patients will need to go home with a catheter in,
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You will be expected to complete your ERAS diary
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You will regularly practice your incentive spirometry to keep good chest health