Quick question. I just had a foot surgery in day surgery today and was only given versed-so no general anesthesia or anything and the surgery lasted about an hour. They put my tele on with my gown still on, laid blankets over me, gave me the versed/O2 and were already starting to lay my hands down on the outstretched arm boards...which would lead me to believe my gown was left on during the procedure...however, my gown was untied when I woke up afterwards. My question is, what my gown removed? Possibly after I was under? Or was it just untied as a precaution in case I became a code?
Also, I thought they were supposed to protect skin during OR procedures. I came home with two new bruises on the bony prominences of my elbows.
I'm currently just a med/surg nurse and I don't stop with the questions until I find my answers! :chuckle
I'm a 49 year old male and I recently had shoulder surgery and was kind of upset when the nurse opened my gown when standing behind me and then told me to remove my underwear. I told her it wasn't going to happen and hopped up onto the gurney; frankly I saw no reason for that since they would be working on my shoulder and nothing below the waist. She apparently called down to the OR and they said it was fine because I never had to remove them and I woke up with my boxer briefs still on. Afterwards, when I needed to void before I could go home, the nurse followed me into the bathroom, which was helpful because of the nerve block on one side and the IV on the other and I was still kind of groggy. Once she hung up the IV bag, rather than leaving, she reached into my gown and tried to pull my underwear down without so much as asking, which really perturbed me. I grabbed them before they went down and told her that I could handle that and would ask for help if I needed it. She then left me to try to go.
For the most part, the nurses were great, except for these couple of things I felt violated my privacy and were kind of rude. I'm not sure they should have left me alone with a cup of coffee as I was recovering; I guess I was holding on to the cup while it was sitting on the tray and staring into space for a while...good thing I didn't spill....
Specializes in Trauma Surgery, Nursing Management.
We ALWAYS untie the gowns. We don't want anyone laying on the knots. It is also tough to transfer pts comfortably (for them) when the gowns get wrapped up around the neck.
DCINMA-I do shoulder surgery several times a week. Did you have just a scope or did you have an open RCR or a total shoulder replacement? If you only had a scope, I don't see where the need would be to place a foley, which is really the only reason why you shoulda lost the boxers. If it was anything lengthy, that is probably why the nurse asked you to drop trou.
OP, where were your bruises? Elbow? How long was your procedure?
Subacromial decompression only...at the time it was unknown if there was a torn rotator cuff to repair also, but there wasn't. Just a bad bone spur, calcium and inflammed tendons to shave down. The OR apparently were OK with me leaving my shorts on. If a foley had been required, I would have respectfully declined the operation although my (now former unfortunately) girlfriend would have crucified me. I was having enough trouble with the idea of being intubated...I'd never consent to a catheter, especially since I have a hypospadia. I don't allow intimate exams anyway.
I try to preserve my patient's modesty as much as possible, however untying the gown is necessary not only to prevent pressure from knots, but if there is a lot of positioning necessary as well as transferring, I need to see everything in order to prevent harm. Example: residents who forget to unplug Pulse oximeters, IVs that can get tangled around the patient, leads can somehow make it around patients' necks, it's amazing what can happen during a transfer. Also, older school anesthesiologists like to watch the chest rather than the monitor, for them it's more accurate.
Somewhere in a consent for treatment is the option for a foley, hence our facility's rule of no underwear. If for some reason a procedure goes long, you can't risk a distended bladder, it would be bad nursing care. Trust me, going under drapes to put in a foley is the LAST thing we want to do, but if the patient's well being is at risk, under we go.
As for bruises on elbows, I'm not sure how that happened. We either tuck the arms, palms facing thighs and thumbs up or they go on padded armboards palms up.
....... I was having enough trouble with the idea of being intubated...I'd never consent to a catheter, especially since I have a hypospadia. I don't allow intimate exams anyway.
If there's a next time, you might ask your doctor or the anesthesia provider if regional anesthesia might be a viable option. Depending on the type of surgery, many can be done with a regional nerve block and intubation can possibly be avoided - LMA instead on an ET tube is another possible option - ask your doc what might be appropriate for you.....
I'm with you on the foley. I search that out, along with a few other little gems typically buried in the consent form, and cross them out & initial. If they want my consent for the option, they'd better discuss the when/why it might be needed with me in detail ahead of time - otherwise, no consent.
If there's a next time, you might ask your doctor or the anesthesia provider if regional anesthesia might be a viable option. Depending on the type of surgery, many can be done with a regional nerve block and intubation can possibly be avoided - LMA instead on an ET tube is another possible option - ask your doc what might be appropriate for you.....
I'm with you on the foley. I search that out, along with a few other little gems typically buried in the consent form, and cross them out & initial. If they want my consent for the option, they'd better discuss the when/why it might be needed with me in detail ahead of time - otherwise, no consent.
I'm pretty sure that they did use the LMA. I had both an interscalene block and general anesthesia for the operation. I'm hoping there's no next time! But I wouldn't be surprised if I end up with knee or hip work in the next couple years. I was very glad to wake up with my underwear still on and dry and all .... but then it was only a 1 hour or so procedure from what I was told. I would have likely been a hurting puppy if they'd forced a foley on me. I was mad enough at the nurse for trying to pull my underwear down in the bathroom without asking.
It's not unusual for the surgical staff to remove a gown from a patient, depending on the operative site. But I ALWAYS as other nurses, put a new gown on the patient after the procedure. Some gowns may be left on if they do not interfere with the operation. However if there's a lot of blood or irrigation involved then the gown afterwards is covered in that mess and must be changed before the patient leaves for the PACU. Untying gowns is a must to prevent pressure sores from forming when the patient is laying down on the table for so many hours.
dcinma
9 Posts
I'm a 49 year old male and I recently had shoulder surgery and was kind of upset when the nurse opened my gown when standing behind me and then told me to remove my underwear. I told her it wasn't going to happen and hopped up onto the gurney; frankly I saw no reason for that since they would be working on my shoulder and nothing below the waist. She apparently called down to the OR and they said it was fine because I never had to remove them and I woke up with my boxer briefs still on. Afterwards, when I needed to void before I could go home, the nurse followed me into the bathroom, which was helpful because of the nerve block on one side and the IV on the other and I was still kind of groggy. Once she hung up the IV bag, rather than leaving, she reached into my gown and tried to pull my underwear down without so much as asking, which really perturbed me. I grabbed them before they went down and told her that I could handle that and would ask for help if I needed it. She then left me to try to go.
For the most part, the nurses were great, except for these couple of things I felt violated my privacy and were kind of rude. I'm not sure they should have left me alone with a cup of coffee as I was recovering; I guess I was holding on to the cup while it was sitting on the tray and staring into space for a while...good thing I didn't spill....