Writing a Care Plan: Things to Consider

Today I finally sat down to begin drafting my hospital care plan for my surgery. Like a woman going into have a baby has a birth plan, so will I for my surgery, in order to ensure that next time won’t be as chaotic or distressing as last time.

It really got me to thinking – what went wrong last time? What went well? What did I struggle with?

Well! Last time I had a heating blanket left on me so long that I sweated through my clothing and bedding and had to change my clothes 2 hours after getting into the ward. I also had my catheter left in for ages. And they wouldn’t empty the bag before I mobilised so I was using a zimmer and carry 2 litres of my own pee. And I wasn’t given adequate pain relief. I could go on. I will not.

I really thought about what I’d like them to know and I broke it down into a few sections.

1) My medical history – cliffnotes such as allergies, previous surgeries, previous issues

2) My pre-op care – I am an incredibly sickly patient and so I have asked for my nausea to be preemptively managed.

3) My immediate post-op care – for example, I won’t want to eat but I’ll likely be gagging for a coffee. I also noted that it would be helpful to have someone there to reassure me when I wake up as I have been known to wake up quite frightened.

4) My care on the ward in the early days such as what to do if they need consent for something and I am out of it on pain meds, my laxative preferences (because high dose opiates bung me up) and apologising for the fact I’m an arsehole when I’m spaced on meds. Oh and making sure they get that damn catheter out as soon as I can mobilise. I’ve also asked that they allow/disallow certain people to ask for updates.

5) My care in the event my admission lasts 3 days or more such as preparing for discharge, managing visits with Jack, and that I would like a copy of my x-ray and my discharge meds to be in a dosette box for the first weeks while the pain is really bad. I have also given advance consent for all of my post op care to be discussed with Bryan so he can best support me.

I have also just remembered – I would like my post operative physiotherapy to be overseen or executed by Dave Hopper from the pain management team. He knows me well, and knows my capabilities, limitations, and mindset having worked with me since early 2016.

I am sure I will add/remove/edit certain parts as time goes on, but this was my general gist of how I want things to go. I was really upset after my last surgery and I don’t wish to feel that way again. It’s also quite important for the staff to understand that this is a rough plan and if they can’t follow certain things, that’s ok. I can only hope that they are able to follow my wishes and help me have the best possible experience. Orthopaedic surgery is hard enough!!

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