Published Oct 29, 2011
brownbook
3,413 Posts
I get so confused by one doctor's discharge instructions.
It says use ice the first 48 hours after surgery, on the third day use heat.
I'm thinking if their surgery was Monday morning 48 hours later would be Wednesday.
But to my way of thinking the third day after surgery would be Thursday?
There is a gap (in my mind) from Wed. am (48 hours) to Thursday, (third day after surgery).
What am I thinking wrong? Does he want ice Thursday? Or start heat Thursday.
I am way to embarrassed to ask the doctor (or a co-worker) for an explanation about these simple instruction.
Bruce_Wayne, ASN, RN
340 Posts
You're right that it is a little vague, especially if you're thinking of "post-op day 3" which would be 4 days after the surgery.
Given the context I think I think it's pretty safe to assume he/she means to do ice for 48 hours and then do heat.
However, you cannot clarify an order with this website. You have to check with the doctor.
But since this is something that's a few days out, you can wait until the doctor rounds again vs calling him at home. LOL.
Kyrshamarks, BSN, RN
1 Article; 631 Posts
If you got out of surgery at noon on monday,you would start ice right away. You are post op as soon as you are done with or. 48 hours would bed up at noon on wednesday. That his 2 days. The third day starts at noon wendsday. You would stay heat then. A day does not have to start and end at midnight in nursing.
xtxrn, ASN, RN
4,267 Posts
I get so confused by one doctor's discharge instructions. It says use ice the first 48 hours after surgery, on the third day use heat. I'm thinking if their surgery was Monday morning 48 hours later would be Wednesday. But to my way of thinking the third day after surgery would be Thursday? There is a gap (in my mind) from Wed. am (48 hours) to Thursday, (third day after surgery). What am I thinking wrong? Does he want ice Thursday? Or start heat Thursday.I am way to embarrassed to ask the doctor (or a co-worker) for an explanation about these simple instruction.
Out of surgery on Monday...start ice
24 hours= Tuesday....ice
48 hours= Wednesday ....ice
THIRD DAY = Thursday....start heat
This is what I'd sign my name to :)
Thanks to all. I am leaning more towards Wednesday is the third day, count the day of surgery as the first day.
However I will clarify with the doctor since you all agree it can be a little confusing.
joanna73, BSN, RN
4,767 Posts
I would agree with xtxrn. Let's say for example:
Mon till Tues: 24 hrs ice
Tues till Wed 24 hrs ice
Thurs: start heat.
That makes sense.
MunoRN, RN
8,058 Posts
I see what you are saying since 48 hours post-op would end Wednesday morning, yet we usually think of "post-op day 3" as meaning Thursday in this case. But really Monday is the first post-op day, which would make Wednesday the third day.
Ice Monday, Ice Tuesday, Wednesday start heat (Wednesday being day 3).
Our incorrect (and embarrassingly ignorant) use of the term "post-op day x" does confuse things. Despite the rules of very basic math, we commonly refer to the day of surgery as "post-op day 0", even though this is actually post-op day 1. Post-op day 0 would mean the day didn't exist, which isn't possible. If they have surgery on monday that means they are in the post-op state on that day, making it post-op day 1.
MunoRN
Thanks a lot. My feeble brain can grasp the idea that there is no such thing as day zero. The day of surgery is day one!
I love KISS
I see what you are saying since 48 hours post-op would end Wednesday morning, yet we usually think of "post-op day 3" as meaning Thursday in this case. But really Monday is the first post-op day, which would make Wednesday the third day. Ice Monday, Ice Tuesday, Wednesday start heat (Wednesday being day 3).Our incorrect (and embarrassingly ignorant) use of the term "post-op day x" does confuse things. Despite the rules of very basic math, we commonly refer to the day of surgery as "post-op day 0", even though this is actually post-op day 1. Post-op day 0 would mean the day didn't exist, which isn't possible. If they have surgery on monday that means they are in the post-op state on that day, making it post-op day 1.
Very true.
The docs need to write "Ice Q 2 hrs x 15 minutes to ____on Monday and Tuesday , then begin heat on same schedule"......then it's just a matter of getting two more people to take off their shoes and socks, and hole up feet and hands, and start counting fingers and toes