Ambulating post op day zero - page 4
Hi all! Quick question! So, I work on a surgical floor and I am almost at the two year mark. I had an interesting discussion with a colleague the other day about how she never, ever ambulates her... Read More
Jan 31I work on an orthopedic floor, and generally it is written "progressive mobility" for the patients activity. This means it is up to the nurse's discretion to which "Level" the patient is ready for. The levels include, turn and position, chair position in bed, up to chair for 2 hours, ambulating, and ambulating without supervision. Many of the ortho doctors include " up within two hours of surgery". Unless I think it is a safety issue, I get all my patients up. They have done studies that this is very beneficial to patients.
Feb 1Quote from TenebraeTo be fair, this was a pediatric bariatric unit.... I probably should have included that. I'm sure you still worked your a$$ off! That surgery takes dedication!That wouldnt have worked for me. Unfortunately because I was on the table so long i have aggravated an old tail bone injury and the only positions that didnt leave me in alot of pain were lying down or walking, sitting up in a chair required large amounts of pain relief. Not only that while I was more active than most between walking I still slept alot
I get that there needs to be protocols however there is a danger not every patient is the same and its important to use clinical judgement in each individual is very different.
Feb 1That nurse needs to read up on some best practice. Not every patient fits into this mold. I work cardiac at a nationally ranked medical center and we have CABG/open heart patients up out of bed and walking POD 0 and less than 12 hours after surgery all the time. It's necessary for healing. If a patient who had a left heart cath with a large sheath pulled out of artery can get up after 4-6 hours after, so can someone who has had a relatively minor surgery. Unless the patient has some real reason for not getting up (dizziness, active bleeding, etc.)they need to get their @$$ up and at least sit in the chair in POD 0. These days you're only in the hospital for so long and then you're on your own, you need to know that your patient is going to be strong enough to perform ADLs on their own at home. We have no time to waste.
Feb 4I recently had a knee replacement/partial femur repair for osteonecrosis. The rule was off of stretcher standing and a few steps within two hours of leaving the ER. I needed to urinate and they kept offering the bedpan. Finally PT came, expecting me just to stand and pivot to the chair. I walked to the BR, used and then around the nurse's desk in the PACU twice. No problems.
(people ask me if it hurt a lot. My leg felt so much immediate pain relief after surgery, and the necrosed tissue was removed, post op pain was minor in comparison)