Ambulating post op day zero

Nurses General Nursing

Published

  1. Do you ambulate your patients POD 0 or 1?

    • 19
      POD 0
    • 2
      POD 1
    • 44
      Depends on the situation
    • 0
      Neither

65 members have participated

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 patient's post op day zero because of their increased risk for bleeding. She said it does not matter what the procedure was it is a big no-no.

But, I have used my nursing discretion all this time and if the patient is ordered "activity as tolerated", pain is well controlled, and what not then I get them to ambulate. Usually just a few steps or even standing up at the side of the bed. And I take into consideration their procedure, if it was something like a TURP, then yeah get walking. A cystectomy, well no I will probably wait until POD 1 to ambulate.

Any thoughts?

Specializes in NICU.

When I worked on a surgical floor, depending on the surgery and the stability of the patient we would AT LEAST get them dangling at the side of the bed on POD#0. We did encourage walking to the bathroom with help on POD0 as well again depending on their stability. She's worried about bleeding? I wouldn't be - I'd be worried about a thrombus or PE from lying in bed too long post op. The sooner they're up the better.

0 Votes
Specializes in Cardiac ICU.

Hahaha! I thought the title said "AMPUTATING post op day zero"....I was gonna say, that's gonna be an awkward conversation to have with the patient. "Sir, good news, surgery went fine, you should expect to heal up nicely. Now, if you're ready, we'll wheel you on back to the OR and just take that leg off for ya, and get you on outa here, what'da say?"

0 Votes
Specializes in IMCU, Oncology.

That is a old school of thought. When I worked on a surgical floor, patients were up within hours of surgery if it was safe to do so.

As a nurse, this would be a good time to review some recent research/studies on this subject.

0 Votes

I 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.

0 Votes
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.

To 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!

0 Votes

That 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.

0 Votes

I 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)

0 Votes
+ Add a Comment