(646) 838-6020 info@nancemd.com

Board-certified and expert orthopedic hand and upper extremity surgery, Dr. Erin Nance, speaks to Up Journey about What to Say to Someone Before Surgery.

She is quoted saying:

Undergoing surgery is a significant life event for patients, whether it is a simple carpal tunnel release or a knee replacement. The goal of the pre-operative discussion is to lay out the options, describe the risks and benefits, and help set the expectations for post-surgical recovery to help your patient remain calm and confident. Informed patients are satisfied patients.

Here are some helpful tips to guide patients through the pre-operative surgical discussion.

Discuss the options

A patient should know what are their surgical and nonsurgical options. There may be different ways to perform surgery (open versus arthroscopic).

Is the surgery time-sensitive or can it be scheduled at a later, more convenient time? Our job as surgeons is to present the full spectrum of options and then make a recommendation in the best interest of the patient.

Describe the benefits

Patients need to know how the surgery will positively impact their life. Whether it is to alleviate pain, remove a suspicious mass or is a preventative surgery, patients should know what is the goal of surgery and how will they will benefit from the surgery.

Explain the risks

Taking the time to thoroughly explain the risks of a particular surgery is critical to a patient’s full understanding of surgery and is part of the informed consent process.

There is no surgery that is 100% risk-free. Bleeding, blood clots and infection are some of the more common complications that can occur and should be discussed prior to surgery. There are also more specific risks depending on the type of surgery being performed.

For example, if a patient is undergoing a distal biceps repair, I will quote the current literature and explain that in 3% of cases there is the risk of developing a posterior interosseous nerve palsy.

Just before surgery, a patient will be asked to sign the official consent form which states they understand the risks and benefits of undergoing the procedure.

Layout the scene

A patient should know what will be happening to them on the day of surgery.

Are they going to a hospital or an ambulatory surgery center? Will they go home after surgery or will they be expected to stay in the hospital for a few days? Will they be having general anesthesia or sedation medication? This will help the patient feel more comfortable once they arrive at the surgery center.

Set the expectations

Often times the perception of a successful surgery depends on if a patient’s expectations were met. For example, if a patient breaks their wrist, undergoes surgery and then develops some post-operative stiffness in their wrist, they may be disappointed, even though their wrist went on to heal and they are back to their pre-injury function.

If preoperatively a discussion was had explaining how after trauma and surgery the joint may become stiffer, requiring post-operative physical therapy and understanding that they may never reach a full symmetrical range of motion, then a small deficit in the range of motion after surgery is seen as a normal and common consequence of surgery.

Ask them if they have any questions

This is a discussion. A patient’s questions and concerns should be fully addressed before proceeding with surgery.

I will often ask my patients, “Is there anything I talked about that you didn’t understand?” or “Tell me what concerns you still have about the procedure.”

Patients should leave the office feeling confident that they have made the right decision for themselves.

Read the original article on Up Journey.