Admission

On the day of your admission, please report to main reception. You will be asked to check your registration form, confirming personal details. Once this has been completed, you will be admitted to the hospital. The ward receptionist or a nurse from the ward will collect you from reception and take you to your room. The room layout and facilities will be explained to you and you will be asked to change into the theatre gown provided. The nursing staff will admit you, recording your vital signs (temperature, pulse, blood pressure and respirations) and confirming that there are no changes to your medical history since you had your pre-op assessment appointment. As part of your preparation for theatre, the nursing staff will provide you with elastic compression stockings to prevent blood clots forming in the veins in your legs. Your consultant will see you on the ward before the operation, to complete your consent form with you and to put a mark on the leg that will be operated on. The anaesthetist in charge of your care will see you and explain the anaesthetic to you. When they are ready for you in theatre – a nurse will either walk you or take you in a wheel chair.

Theatre

Your nurse will stay with you in the anaesthetic room. On arrival in the anaesthetic room, the nurse assisting the anaesthetist will perform the same checks as the ward staff did on your admission and will attach all the normal monitoring to you, recording your vital signs again. The anaesthetist will insert a small plastic tube (cannula) in your arm or the back of your hand which will be used to administer drugs. The anaesthetist will then anaesthetise you – this will normally be a spinal anaesthetic. In rare cases they will do a general anaesthetic.

Recovery

You will be awake when you are taken to the recovery room and you will be on your hospital bed. The recovery staff will keep you there until they are happy that you are stable and comfortable. The ward nurse will collect you and take you back to your room.

Post-Operative Care on the Ward

On your return to the ward the nursing staff will make sure you are comfortable and continue to monitor your vital signs regularly. You may be given oxygen via a mask, depending on your oxygen levels and instructions from the anaesthetist. You will have a drip in your arm to build up your fluid levels and may or may not have a catheter into your bladder. Provided that you are not feeling sick you may be given something to eat and drink. You will have Flowtron Boots (foot pumps) on both feet to promote good circulation and will continue to wear the elastic stockings to prevent blood clots. Your pain will be managed with painkillers in tablet or liquid form.

If you have had a knee replacement, to aid a quick recovery, the physiotherapist will see you soon after your operation, assisting you to get out of bed and to walk with the aid of crutches/walking frame. The physiotherapist will also commence an Ice machine/pack that same day. The purpose of this is to apply continuous cold compressions to the knee to help reduce swelling and pain.

Day one after the surgery

The nurses will assist you to have a wash, either in bed or sitting out in the chair. They will change your elastic stockings and if you prefer you may wear your own clothes during the day and nightwear at night. Your pain will be controlled with regular painkillers and you will be given a dose of blood-thinning medication. This will be either by injection or tablet form and this will be given to you on a daily basis. During the next few days the nursing staff will teach you how to self-administer this blood-thinning medication (if this is prescribed by your Consultant), because you will have to continue injecting yourself when you are discharged. Depending on the type of surgery you had and your consultant’s preference, it may vary how long you will need to have these injections/tablets following your discharge. The drip and drain will be removed and a blood sample will be taken to check your kidney function and iron levels. The nurses will continue to monitor your vital signs and wound site and the dressings will only be changed if necessary. You may experience some dizziness when getting out of bed for the first time. These symptoms are normal and can be expected after having a spinal/general anaesthetic. The physiotherapist and the ward nurse will assist you to get out of bed and encourage you to walk a short distance and to sit in a chair.

The rest of your stay in hospital

Your catheter will be removed on the first or second day after your surgery provided that you are able to mobilise to the bathroom with some assistance. You will be given assistance to have a wash and during the next few days, as your mobility improves, you may be able to get into a shower with assistance. The elastic stockings will be changed daily. The nurses will continue to give you regular painkillers and you will receive the blood-thinning medication on a daily basis. The nurses will monitor your vital signs and the dressing will only be changed if necessary. Your walking will improve daily and the physiotherapist will see you twice a day to assess your progress. The physiotherapist will go through the exercises with you, until you are confident to try them on your own. They will also give you advice on how to manage at home and establish what equipment you will need to take home. Before discharge, you will practise the stairs with guidance from the physiotherapy team on the technique most applicable to your home environment.

Your consultant will review you daily and will, in conjunction with the physiotherapist and nursing team, decide about your discharge date. By now you should be able to walk independently with crutches, wash and dress with minimal or no help and be ready to go home. Most patients are ready to go home by day 5. We aim to discharge patients in the morning before 11 am. Please make arrangements where possible for someone to come to escort you home.

The nursing staff will advise you on pain control and continued use of the blood thinning medication, and supplies will be given to you prior to discharge. You will be given follow up outpatient appointments to see the clinic nurse for a wound check, the physiotherapist and a review with your consultant.