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St. Joseph health! - Summer 2014

Joint Replacement Surgery Hospital Care

Day of joint replacement surgery

On the day you are scheduled for surgery, please arrive at the main entrance of the hospital and check in at the main admitting desk. Bring money for your insurance co-payments, if applicable. Staff will escort you to the surgical admission unit.

Friends and family members can then go to the surgical waiting room. Your surgeon will speak to your family when the procedure is complete. If your family cannot stay in the waiting area, please inform the volunteer or staff member at the desk.

What to expect with joint replacement surgery

In the surgical admitting area, you will be prepared for surgery. This includes starting an IV and scrubbing (and shaving) the operative area as needed. Your operating room nurse and your anesthesiologist will interview you in your cubicle in the surgery unit. They will escort you to the operating room where you will see your surgeon.

Your surgeon will then perform the surgery.

Following surgery, you will be taken to a post-anesthesia care unit (PACU), where you may remain for one to two hours. During this time, pain control will be established, your vital signs will be monitored and an x-ray will be taken of your new joint. You will then be taken to the orthopedic unit, where our total joint nursing staff will have a room ready for you.

Only one or two very close family members or friends should visit you on this day. Most of the discomfort occurs during the first 12 hours following surgery. During this time you may receive pain medication through your IV or PCA (pain pump). You will probably remain in bed except to go to the bathroom. It is very important that you begin ankle pumps on this first day; your nurse will show you how. This will help prevent blood clots from forming in your legs. You should also begin using your incentive spirometer to help fully expand your lungs and keep them clear.

Each day you will receive a newsletter outlining the day’s activities.

 

Post-operative hospital care
Day 1
On Day 1 after surgery, your caregivers will help you get out of bed, bathe and get seated in a chair in your room. You may wear your hospital gown on this day. Your surgeon or physician’s assistant (if applicable) may visit you. The physical therapist will assess your progress and get you walking with either crutches or a walker. IV pain medication will be stopped and you will begin oral medication, as appropriate.

Your therapy will begin in the afternoon. The occupational therapist may begin to teach you ways to dress and bathe while protecting your new knee, including the use of adaptive equipment.

Your care partner or coach is encouraged to be present as much as possible. Visitors are welcome, preferably in the late afternoon or evenings.

Day 2
On Day 2 after surgery, you will get out of bed early and your caregivers will help you bathe and dress. Shorts and tops are usually best; long pants can be restrictive. You will have an individual therapy session in the morning. If you are part of Joint Camp, you along with your group will begin group therapy after lunch.

Your care partner or coach is invited to participate in group therapy; ask your nurse for a more detailed schedule so your coach can be available at the appropriate times. You may begin walking stairs on this day.

You will begin discharge teaching on this day.

Day 3 – discharge
The morning of Day 3 is similar to Day 2. You will be instructed in stair climbing and participate in a group therapy session in the morning, including a game of putt-putt golf for those in Joint Camp. Discharges are planned for 11 a.m., when you will either go home or to a skilled nursing facility’s rehabilitation unit.

Leaving the hospital
The decision to go home or to a rehabilitation unit in a skilled nursing facility will be made collectively by you, the discharge planner, your surgeon, your nurse, your physical therapist, your occupational therapist and your insurance company. We will make every attempt to have this decision finalized in advance, but the decision may be delayed until the day of discharge.

If you are going directly home, you will need to arrange for a responsible person to drive you. Before leaving, you will receive written discharge instructions concerning medications, physical therapy, activity, etc. We will arrange for special equipment, if applicable.

If you are going to a rehabilitation unit in a skilled nursing facility, someone responsible needs to drive you, or we can help you arrange for transportation. Transfer papers will be completed by the nursing staff. Either your primary care physician or a physician from the skilled nursing facility will care for you in consultation with your surgeon. Expect to stay three to ten days, based upon your progress. Upon discharge to home, instructions will be given to you by the skilled nursing facility staff.