Roselyn Raj is the nurse manager of theatre recovery at Mater Private Hospital, Cork. She recently experienced a role reversal when she underwent an operation herself.
This gave her a valuable insight into the anxiety that often accompanies a surgical procedure.
“I had a very simple operation.
Being a nurse, I convinced myself ‘it’s going to be okay’, but while waiting on the ward my heart started pounding.
I said to myself ‘don’t be anxious, you know what’s happening and all will be fine’, however it really made me think about how others without my inside knowledge may well feel.
“That experience filled me with great empathy and renewed determination to make all my patients’ experiences of surgery as positive as possible.
“At Mater Private, we provide surgical interventions of a varied nature and the very mention of the word ‘surgery’ does cause some anxiety. Whether it is a small procedure or a bigger elective operation, the theatre environment is a place filled with unknown fears.”
What is the effect of anxiety?
“It is normal to be anxious on the day or two before surgery, however, this undue stress can cause many repercussions, during and after surgery,” says Raj.
“Prior to surgery, stress or anxiety can cause a pounding heart, nausea, shortness of breath and even sleep problems. This especially aggravates pre-existing conditions like diabetes and high blood pressure.
“The sensation of pain might be increased after surgery and wound healing can be delayed. Smoking is universally known to raise blood pressure and cause narrowing of arteries. Add in surgical anxiety and people who smoke tend to smoke even more.
"This can compromise the wound healing and recovery from the anaesthetic. Thus, assistance to stop or cut down is important, if possible weeks before the surgery. This is something I really recommend you discuss with your family doctor.”
What can we do about surgical anxiety?
“Surgical anxiety is similar to Flight-and-fight reaction where our brain prepares for unexpected or new circumstances,”says Raj.
“A clearer understanding of what might be expected or encountered in the peri-operative area can help alleviate this.
"Relaxation therapy can be useful for overly anxious patients. For very nervous patients a mild sedatives prior to surgery can be helpful too.
"At Mater Private we meet as many patients as possible, days before surgery, to go through the operation so they can be well informed before they give consent.
"This is the patient’s opportunity to discuss concerns and ask questions with the team, including nurses, physiotherapists and anaesthetists.
What is the peri-operative phase?
“Our operating theatres have a pre-operative reception where patients are greeted and checks are done — again,” says Raj.
“Then a few minutes are spent in the waiting area before being taken into the anaesthetic room. This room is similar to the actual operating theatre and the patient is prepared for anaesthesia.
"Monitors are attached and a few minutes are spent talking to the anaesthetic nurse and the anaesthetist before being taken inside the operating theatre.
“After surgery, the patient is taken into the recovery room to wake gently.
“Many patients talk about pleasant dreams and many wake-up with ‘Is it over?’ or ‘That wasn’t so bad’. When patients are fully recovered, which usually takes about 30-60 minutes, they return to their private room or the day ward and when allowable have some long awaited refreshments.
“Talk to your doctors and nurses, express your fears and anxiety. We do understand especially from our own experiences and we want to make the whole experience as anxiety free as possible.”
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