A little later the nurse comes back to see how the patient is doing. Then, the nurse discusses her findings with her colleagues at shift change: most workplaces call it “kardex”- it’s a review of patient status and plans for the new staff to be briefed on their clients. The head nurse is director of the meeting.
Health professional : Mrs. Jones, we will remove your intravenous line so you should try and drink a few glasses of water in the next little while to help your body get back to its normal functioning level. You need to keep up with those fluids! You’ll be able to walk freely. Would you like some water or juice?
Patient: Oh no. I feel that if I drink anything, I will throw up!
Health professional : Are you nauseated? That is sometimes a side effect of the anesthesia. Can I bring you some ice chips? It sometimes helps to settle the stomach. Would you like to try?
Patient: OK. That would be fine.
Health professional : In the meantime, I will place this kidney bowl on your table in case you feel nauseated. Your call bell is easy to reach. Would you like a moist cloth on your forehead?
Patient: No. I’d like to sleep now.
Health professional : Before I go, I need to check the incision site to see if everything is going well.
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Health professional : Mrs. Jones shows ineffective breathing patterns. In the next few hours, if we don’t see any change, I will mention it to the staff doctor and we may have to start oxygen. The patient does not report any pain at the moment but the anesthetic has not worn off; she knows to call when the pain starts bothering her.
Other professional : Oh yes, that’s the patient they tried the new anesthetic with—do you see a difference compared to our other patients?
Health professional : well she said she felt nauseated; my guess is that it’s due to the anesthesia. Let’s monitor this closely.
We’ll make a note of the fluids she is taking in; she might need to be reminded or prompted to drink more. We’ll have to put her back on IV if she starts to dehydrate.
Head nurse: Anything else to note?
Health professional : I inspected the incision site and there is a lot a swelling; more than what we usually see in our other patients. I wonder if it’s an allergic reaction or if something else is going on. Maybe you should take a look. You might want to mention it in the doctor’s rounds too. I left a note on the chart.
Head nurse : Good observation. I will take a quick peak before the shift ends and let you know.
Teacher: How do you think Mrs. Jones is recovering after her surgery?
Student: Well, she still seems nervous and she doesn’t seem to be feeling well. She really needs to drink but she won’t because she feels nauseous.
Teacher: That’s right. Keeping hydrated helps with recovery after a surgery. Ice chips can help at the beginning but the patient will have to drink or else she won’t start recover.
Student: In the meeting they seem to be worried about her.
Teacher: Yes, if she doesn’t drinks fluids, they will need to put her back on IV so she doesn’t get dehydrated. What else are they worried about?
Student: Oh they saw the incision site was swollen. It didn’t seem to be healing, as it should be.
Teacher: Exactly. That’s why these meetings at shift change really help the nurses to understand the patients they are caring for and their needs.