Surgical nurses typically arrive on the ward just before 7.00am and check our daily patient allocation, working together to provide care with two nurses tending eight to 10 patients.
7.00am
Starting the day with a five-minute huddle gives us time to discuss safety concerns, share important information, before bedside handovers on the ward.
At the bedside
Patients are at the centre of our care and our handover includes them in the conversation. The handover involves:
- introducing ourselves
- checking the patient’s identity
- what they are in hospital for
- talking about relevant history
- what has happened during their stay
- the plan for the day ahead
- any discharge preparations needed.
While we’re there we will check the oxygen and suction safety equipment, medication charts, observation charts, care plans, and risk assessments — discussing any variances or identified problems.
After handover, we begin our daily nursing care. We provide quality care tending to each patient carefully, assessing the differing needs of each with some requiring more care than others. Generally we will:- conduct head-to-toe assessments
- check vital signs, wound dressings, and assess/remove drains and catheters
- administer patient medicine, if needed
- update patient journey boards in room (communication tool)
- help patients get to the bathroom, sit up or get out of bed
- assist patients to order their breakfast.
Ordering meals
Meals are an important part of every patients’ stay and recovery. Hotel-style, room service dining is available to patients in some St John of God Health Care hospitals, including St John of God Bendigo Hospital, with others to come soon. Room service allows patients to order and eat what they want, when they want, with our comprehensive menu offering breakfast, morning tea, lunch, afternoon tea and dinner.
Nurses explain this process, assist where required and ensure our patients receive their ordered meals.
9.30am
We swap with other nurses to take a short break, ensuring we keep each other updated with our patient’s status. It’s important for us to look after ourselves so we can provide the best quality care
After breakfast, it’s time to help patients with their daily activities. This may mean brushing teeth, making beds, assisting with showering and being mobile. Often physiotherapists need to assess patients, particularly our orthopaedic ones, before they can get out of bed.
We aim to have all of our patients up and out of bed, even for a short time as soon as possible after surgery.
Discharge time
Patients who have had their surgery and are ready to go home will be placed on our discharge list, ready for departure by 10.00am.
We coordinate any discharge medications needed with the pharmacy team, who will deliver it and provide any required information.
During this time we:
- schedule follow up appointments
- complete paperwork
- provide care instructions
- let patients know how to seek help should they need it.
When the patient has all the equipment they need, we call for a porter to assist them getting out of the hospital.
The rounds
We then attend to each of our patients to make sure they are comfortable and free from pain, and ensure they have their nurse call bell within reach. We do this every hour for the duration of the shift.
We can also assist with ordering lunch, or additional snacks, if needed.
After lunch is served, we administer any medications that are due and continue on with other tasks requiring completion.
At 12.30pm we start taking our lunch breaks, again communicating and swapping with other nurses on shift.
After lunch
Our post-operative patients from PACU (post-anaesthetic recovery unit) have usually started coming back to the ward by this time. Operating theatres start at 8.00am and go through until 6.00pm, sometimes after hours for urgent cases.
On return to the ward, we do routine post-anaesthetic observations on our patients, frequently for four hours. We do a full assessment and ensure wound dressings, drains and IV lines are clear. We orientate our patients to the ward, educate them on how to order a meal, and call their loved ones to let them know they are on the ward.
We also make sure our patients receive a post-operative wash and are able to go to the toilet.
Handover
Handover to nurses on the evening shift is at 2.30pm. Sometimes during our PM shift huddle, we have in-service education or clinical updates provided by hospital educators, other departments or external providers (or sometimes each other!).
Before we finish, we do a drug count of the Schedule 8 and 11 medications (controlled medications that require a prescription).
Disclaimer:
It’s important to note that the times and duties I’ve mentioned in this blog relate to my experience at St John of God Bendigo Hospital. Timings may vary from hospital-to-hospital, depending on various factors.
I work with a great team at St John of God Bendigo Hospital, and I genuinely love coming to work every day to care for patients in our community.
