Surgery in the morning then home for tea!

Hazel Dineen and Anne McBrien, Day Procedure Unit    Picture: Ronan McGrade

Hazel Dineen and Anne McBrien, Day Procedure Unit Picture: Ronan McGrade


GOING “under the knife” can seem like a traumatic experience, but one trip to the South West Acute Hospital’s nurse-led day procedures unit (DPU) would allay the fears of even the most anxious patients. 
Advances in modern medicine and 21st century technology mean surgery, in many cases, is no longer the disruptive and lengthy experience of days gone by. In many cases, patients are able to call in the morning, have their surgery, and make it home in time for tea. Add to that a staff that goes above and beyond to ensure patients and their families are as relaxed and as comfortable as possible, and you have a hospital experience those in generations past couldn’t even imagine. 
DPU nurse Anne McBrien, who first embarked on her vocation of nursing in 1970, said she “could write a book” on the changes she’d seen down through her years of nursing, with some of the biggest changes coming in day surgery. 
“In times past, patients would have to remain in hospital for ranges of 10-14 days following surgery,” said Anne, explaining many of those surgeries now only involved a day trip to hospital. “Today, day surgery has brought many changes for patients and health care providers. It’s cost effective, reduces waiting times and improves hospital bed efficiency.”
Anne, who lives in Derrylin, explained the DPU covered a range of surgical procedures, from vascular and venous surgery, to special needs dental and general surgery. It’s not just surgery services either, the unit can carry out further investigations and treatments including lung and liver biopsies, blood and iron transfusions, cardiac echoes, and paediatric MRI scans. 
“We work closely with our consultant radiologist and radiographers, medical consultants and doctors, and link with other regional hospitals and consultants,” she continued. “This means it is accessible and patients do not have to travel to other hospitals for these types of investigations and procedures.”
While the state-of-the-art facility is light years ahead of the old Erne Hospital in terms of equipment and technology, one thing the unit has retained is the patient-focused ethos of its nursing and surgical team. 
Anne, who said she’d “never lose sight of the memory” of first driving up to the SWAH which was “like an airport”, said the nursing staff, working as part of a multi-disciplinary team that includes consultants and surgeons, provided “holistic patient-centred care” where “the safety of the patient is paramount.” 
 “I am a firm believer that preparation is the key to successful surgery,” she said, outlining the process patients go though at the DPU from admission to the procedure itself. 
“During this time, I make time for conversation which establishes an initial rapport, not just for the patients but also offers support for family members. I believe effective communication is of utmost importance to keep patients informed, especially in times of great anxiety, as poor communication can lead to emotional exhaustion and undue stress. 
“Patients are admitted at 8am for morning surgery, and 11am for afternoon surgery. For some patients, this could be their first visit so I believe information provided should be easily understood and concise. Particularly in relation to the order of our theatre list, the environment in which our patients are cared for. When the patient is ready for theatre I will take them to first stage recovery followed by the second stage recovery where I will provided care until their discharge.”
Theatre nurse Hazel Dineen plays another role in the nursing team’s holistic approach to care, caring for patients immediately before, during and after surgery. She too strives to make it as comfortable experience as possible. 
“I deal with patients in a very stressful situation,” said Hazel. “Most patients haven’t been in theatre before, even if they have been it’s been stressful. It’s fear of the unknown with lots of patients.”
Hazel said surgery involved various stages of patient care: “You’re dealing with a very nervous anxious patient beforehand and you’re reassuring that patient as they go in. You want that patient to be very calm, you want them to feel very comfortable and you want them to feel that they’re safe in your care. That’s very important for a patient going through surgery to feel that. 
“Then you move on from that because the patient’s asleep to dealing with the unconscious patient. As a theatre nurse you’re very aware of the needs of that patient, such as the positioning of their airways and so on.
“Afterwards, a patient has just had a lot of drugs and they’ve been asleep. You want them to be safe. People can be disorientated as well, so you want to orientate your patient and let them know they’re finished with their procedure.”
Hazel said the DPU actually used different drugs to those used for in-patient theatre, explaining how these drugs helped keep the patients asleep and pain free, but meant they were fit enough to be discharged the same day. 
“Day centre patients are, on the whole, fit and healthy patients,” she said. “Day surgery is all about the patients coming in the morning, having their surgery or their procedure done, and going home in the afternoon.”
She added: “Years ago patients would’ve stayed in bed for days, now we want patients to get up and mobilised. If you’re a fit and healthy person coming in to have your surgery we want you to go home as that fit and healthy person. We don’t want you to stay in hospital when you don’t need to.”
Hazel, who has been living in Enniskillen for 20 years and was also a nurse at the old Erne, said the technology at SWAH was state-of-the-art, which helped with day procedures such as key-hole surgery. For example, theatre has multiple screens that can be pulled down to assist surgeons. 
“I’m not sure people fully understand they wonderful facility that we have,” she said, who added staff from other hospitals across the UK, Ireland and beyond often visited to view the hospital’s facilities. “It’s quite amazing.”

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