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Jun 22, 2018 / Scoliosis & Spine
#SRHaccess Facebook LIVE Recap: Scoliosis FAQs
In honor of Scoliosis Awareness Month, clinical manager Jennifer Bowden, R.N., joined us on Facebook LIVE to discuss the most frequently asked questions about scoliosis. Below is a recap of the conversation.
Watch the live segment.
What is the difference between an ambulatory care and inpatient nurse?
Who do the parents contact if they have questions about surgery?
Watch the live segment.
What is the difference between an ambulatory care and inpatient nurse?
- An ambulatory care nurse, also known as clinic nurse, is the nurse a patient will see when he or she has a clinic visit.
- An inpatient nurse takes care of the patient once out of surgery.
- The patient is seen by their doctor and clinic nurse. They could also be evaluated by a physician’s assistant or fellow/resident.
- If the patient does not have X-rays on file, it is possible that they may be sent to radiology to have those taken.
- The doctor will complete a clinical exam to check for scoliosis.
- Depending on the outcome of the clinical exam, X-rays are checked if there are concerns regarding a potential curve in the back.
- The doctor will give the patient a time frame of when he or she needs to come back for another visit.
Who do the parents contact if they have questions about surgery?
- Clinic nurse
- Families are encouraged to call with any questions they may have at any time.
- Our staff encourage parents/patients to write down any and all questions.
- Patient will be assigned a room on the inpatient unit - parents can wait in that room.
- Surgery waiting area is on the 4th floor – quiet and away from hustle and bustle
- Cafeteria – on the C level by the A elevators
- While the patient is in surgery, the parent/guardian must stay inside the hospital at all times.
- Each parent/guardian is given a pager to be notified/updated regarding the progress of the surgery.
- It takes about an hour to get the patient prepped before surgery actually begins.
- The parent/guardian is updated when the surgery actually begins.
- Updates come every one to two hours
- Parents are notified when the patient is being closed up.
- When the surgery is complete, the surgeon will call and speak to the parent.
- Most spine patients check into the hospital the day before surgery.
- Labs and X-rays are taken, if needed
- Clinical photos are taken so that the patient can remember what he or she looked like before the surgery.
- The patient and their family are able to meet their care team:
- Inpatient nurse
- If needed, a child life specialist and physical/occupational therapist
- OR nurse
- Anesthesiologist
- The patient will be in recovery (PACU) for half an hour to an hour or longer.
- Once the patient is awake and the breathing tube is removed, the parents are called to see their child in recovery.
- Parents are escorted to the patient’s room and the recovery nurse will take the patient to their room.
- Recovery nurse will give the inpatient nurse a report on the child.
- Inpatient nurse
- Patient care techs
- Doctors
- Residents and fellows
- Education on pain takes place before surgery
- Really sore and still after surgery – the nurse teaches the patient how to assess their pain
- No, the patient is fully asleep during surgery.
- Anesthesia is given to the patient to keep them asleep
- The patient's spinal cord wil be monitored throughout the duration of the surgery.
- Physical or occupational therapy can be part of the process after surgery, if needed.
- Nurses help patients get out of bed.
- The nurse will teach the patient how to roll over, prop themselves up and turn over.
- The care taker at home will also be taught how to help the patient get out of bed and move around safely.
- Pain is under control
- Incision looks good
- Patient is up and moving
- Eating and drinking – no vomiting
- Bowel movement in the hospital – biggest problem after this surgery is constipation and gut issues
- Every patient is different
- Take pain medication close to when departing the hospital
- Most patients like to recline in the car seat versus sitting up straight.
- The nurse will help the patient down to the car and will make sure they are safely situated inside the car.
- Every hour to two hours, we recommend the patient to get up and move/change positions.
- No restrictions on the bed setup at home
- If the bed is upstairs, recommend sleeping somewhere downstairs
- No hospital bed is necessary
- Some patients like being in a recliner, instead of lying flat
- Nurses educate parent/guardian on how to change the dressing covering the incision.
- No creams or lotions on the incision until told by your doctor.
- A nurse will provide the parent with supplies to change the dressing.
- No soaking the incision, showers only – do not want the incision under water because it could cause an infection
- After shower, remove the dressing, pat area dry and then apply a new dressing
- Yes, a long and thin scar down the middle of their back.
- If well taken care of, it will flatten out and look like a faint pencil mark down the middle of the patient’s back.
- For at least two years after surgery, it is recommended that the scar be covered with sunscreen or a shirt when out in the sun.