ERAS = Enhanced Recovery After Surgery
After my C section in 2012, I experienced some but not all of the "enhanced recovery after surgery" recommendations at the hospital.
1. Nursing care
Daily CHG Bath: sponge bath with antibacterial wipes--thank goodness they didn't do this to me--it's probably a new guideline to kill germs and make people cold.
Incentive Spirometer: never saw one of these suckers until nursing school, where I also learned I'm supposed to suck air in through it, not blow, to make the blue thingy go up.
Incentive Spirometer, use 10 times /hr
Day 0 take out nasogastric tube: didn't have one
Day 1 take out urinary catheter: I was so sad when they took mine out, because not only did I have to get out of bed now, I was pretty sure my bladder didn't work anymore since it hardly worked during pregnancy.
2. IV
Saline lock IV when tolerating clear liquids: I have zero recollection of what was going on with my IV.
3. Pain Management
Day 0 IV/epidural if needed: I had a morphine pump initially, but they took that away and threatened a cardiology consult because my heart rate was in the 40s (normal is 60-100).
Day 1 IV and oral meds: I was in so much pain I was in spasms and crying. IV toradol helped--still remember how it felt going in--cold, pain-relieving.
After Day 2 oral pain meds only: House, MD is a liar becuase Vicodin barely took the edge off and made me nauseous but Vicodin and Motrin were all I could get from the pharmacy for home, even though my uneven C-section scar was oozing grape jelly and hurting (not as much as my spirit, which was gone).
4. Post-op nutrition
Day 0 gum, ice chips, water: after the surgery even though I was parched they would not give me water, only ice chips, which if anyone knows about Chinese medicine, is literally the worst thing you can give someone who is weak from just being cut open, giving birth, etc. Kill all my chi, why don't you.
Day 1 full liquid diet, no carbonated drink / Day 2 soft, chopped diet / Day 3 regular diet: they advanced me pretty fast since I wasn't choking on food.
5. Early mobilization
Day 0 walk at least 150 ft: when they took out my catheter I was forced to walk my broken body to the bathroom, which I kept to a minimum, definitely <150 feet.
Day 1 walk at least 300 ft (a little more than one lap around the floor): I was in a ton of pain, and when asked to go walk around the hallway for my own good (mobility is medicine, lol), I said, "No."
Day 2 walk at least 500 ft (2 laps): still no. I was barely 30 and probably not going to get a blood clot, nauseous, in pain, and didn't feel like leaving the baby alone in the room (plus she was pretty much on me continuously).
However hard people say nursing is, I don't believe it's harder than being the patient, especially if the patient has to "work through the pain" after an ortho proecdure or feed and take care of a newborn (again, what's up with that?)
1. Nursing care
Daily CHG Bath: sponge bath with antibacterial wipes--thank goodness they didn't do this to me--it's probably a new guideline to kill germs and make people cold.
Incentive Spirometer: never saw one of these suckers until nursing school, where I also learned I'm supposed to suck air in through it, not blow, to make the blue thingy go up.
Incentive Spirometer, use 10 times /hr
Day 0 take out nasogastric tube: didn't have one
Day 1 take out urinary catheter: I was so sad when they took mine out, because not only did I have to get out of bed now, I was pretty sure my bladder didn't work anymore since it hardly worked during pregnancy.
2. IV
Saline lock IV when tolerating clear liquids: I have zero recollection of what was going on with my IV.
3. Pain Management
Day 0 IV/epidural if needed: I had a morphine pump initially, but they took that away and threatened a cardiology consult because my heart rate was in the 40s (normal is 60-100).
Day 1 IV and oral meds: I was in so much pain I was in spasms and crying. IV toradol helped--still remember how it felt going in--cold, pain-relieving.
After Day 2 oral pain meds only: House, MD is a liar becuase Vicodin barely took the edge off and made me nauseous but Vicodin and Motrin were all I could get from the pharmacy for home, even though my uneven C-section scar was oozing grape jelly and hurting (not as much as my spirit, which was gone).
4. Post-op nutrition
Day 0 gum, ice chips, water: after the surgery even though I was parched they would not give me water, only ice chips, which if anyone knows about Chinese medicine, is literally the worst thing you can give someone who is weak from just being cut open, giving birth, etc. Kill all my chi, why don't you.
Day 1 full liquid diet, no carbonated drink / Day 2 soft, chopped diet / Day 3 regular diet: they advanced me pretty fast since I wasn't choking on food.
5. Early mobilization
Day 0 walk at least 150 ft: when they took out my catheter I was forced to walk my broken body to the bathroom, which I kept to a minimum, definitely <150 feet.
Day 1 walk at least 300 ft (a little more than one lap around the floor): I was in a ton of pain, and when asked to go walk around the hallway for my own good (mobility is medicine, lol), I said, "No."
Day 2 walk at least 500 ft (2 laps): still no. I was barely 30 and probably not going to get a blood clot, nauseous, in pain, and didn't feel like leaving the baby alone in the room (plus she was pretty much on me continuously).
However hard people say nursing is, I don't believe it's harder than being the patient, especially if the patient has to "work through the pain" after an ortho proecdure or feed and take care of a newborn (again, what's up with that?)
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