Pre-OP Patient Interview

[mondragon]

OR Nurses,can you share your Pre-OP patient interview routine? Do you tell the patient the room will be cold ? Do you tell the patient you will be placing leads and/or monitors on them (even though anesthesia or the CRNA already educated the patient about the monitors)? What do you routinely review with the patient ? I am aware of the consent,blood consent,allergies,etc. But I would appreciate if anyone can share your entire routine,interaction with the patient and patient education that you do routinely.thanks.

[IsseyM]

Head to toe basically. I start out with any neurological stuff, previous head injuries, seizures, strokes, deficits. ENT problems. Thyroid issues. Heart problems, pacemaker, HTN, Cholesterol. Lung problems, asthma, COPD, smoker. Abdominal stuff, diabetes, kidney, reproductive organs. Any previous surgeries, metal in body. Take medications for anything. Do they use drugs. Last time NPO, last void. If they will need a catheter I explain about that. And I do mention cold room and how they have to move from stretcher to OR bed but will be covered up with warm blankets. I used to explain hooking up leads not anymore. Then I complete interview with if they have family & if they have any questions. Is this what you're looking for? I'm sure i forgot somethings. LoL. I know some nurses that hardly do a preop interview. Some only ask procedure, allergies, metal in body, last NPO, last void while some do a full blown interview covering more than necessary.

[RNOTODAY, BSN, RN]

introduce myself, check id band, ask them to verify their procedure, npo status, any metal in body, any dentures, contact lenses or piercings that need to come out, ask them who will be waiting for them or is their a number they want the doc to have to call after surgery, sometimes i give a quick run down of what to expect inside the OR---monitors, stickers, etc....give them my best estimate of how long it will take for them to get back to the room to get started, of course, first thing i do is check for h&p and consent (but that doesnt involve them)... and of course i ask if they have any allergies, if so what does said allergy cause them....i explain they will see me in the or, i will just have a mask up like everyone else

pretty much it!!!! i (we) dont get into complete assessments, i dont ask if they do drugs, or what meds they are on at home, that is anesthesias domain.....

lots of times if it is on the fly, ie: i had no time to do an interview in holding...its just basics...allergies, npo, metal in body, dentures/peircings /contact lenses, have them verify procedure....and thats it...alll while helping them onto the OR table!!!

[mondragon]

Thank you Issy and RNotoday,it is very helpful to me.Sometimes I forget to ask about the contacts.I'm trying to establish a routine so I decrease my chances of forgetting something,and I wanted to see if I'm covering the areas that seasoned nurses are covering.Thanks so much.

[jeckrn, BSN, RN]

for the most part I ask the same but a couple that I also ask since I work in a military hospital is if they have PTSD, anxiety etc. along with if they have been in combat. I also have them explain the procedure in their own words to see if they understand what the procedure is to include is it going to be open or a lap.

[canesdukegirl, BSN, RN]

I introduce myself, and tell them that I am going to ask them the same questions that they have already been asked by other staff members. I explain that we do this as a safety measure, not because we don't know what is going on. (I had one irate patient who just wanted to get on with the show already, and he said, "Daggum, do NONE of you people read my chart? I am starting to get nervous because everyone keeps asking me the same questions over and over. Do y'all not know what is going on or what?") It always helps the pt to know WHY you are asking the same set of questions. If I didn't know anything about the medical field, I would be nervous too!

Then I check their band with my paperwork, check their consents/H&Ps/etc. I run through the same list that RNO listed in her answer above. If I notice that a pt is especially nervous, I will tell them a funny story related to my question list. For example, I ask if the pt has any piercings that need to come out. Some pts look at me sideways when I ask this question, so I tell them about the 70 year old lady that came through years ago who stuck her pierced tongue out and then said, "You mean this thing needs to come out?" That will usually get a chuckle.

I then tell them briefly about what to expect when they get back to the OR. I tell them that the OR is cold, and tends to be loud like a kitchen because there is nothing to absorb noise. I tell them that the anesthesia care provider will likely give them some meds through their IV to help them relax right before they are taken back. I tell them that there will be 4-5 people in the room when they arrive to the OR and that we are all there to take care of them.

When they get to the OR, I ask them jokingly if the anesthesia care provider slipped them a few martinis. They usually laugh. Then I get a warm blanket for them and tell them that the monitor leads are COLD! I don't leave their side once they are on the OR bed. I explain what is happening every step of the way and tell them that they probably won't remember even coming back to the OR. Once the pt is intubated, I can go about my regular circulating duties.

Hope this helps some.