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Mary Dedeen Andrada, |
"Explanation" and "teaching" are the key words in the preparation for transplant surgery. The more your nurse can teach you during the pre-operative phase, and the more you are able to learn and understand, the more we can, together, alleviate your uneasiness or fear.
As a nurse, I do all that I can to improve your pre-operative experience. For example, I:
-Provide answers to questions and expectations related to the surgery process.
-Help you and your caregiver(s) actively participate in planning the entire transplant.
-Continuously educate both you and your family regarding long term health care practices after transplantation.
Understanding Anxiety
It is natural to harbor anxiety as you prepare to undergo a change in the way your body functions and prepare for the effects of the physical recovery from surgery. As a nurse, I try to understand this anxiety, its cause and its management in order to allay any potential fears.
Managing Anxiety-Part I: Overcoming fear of the unknown
The most common cause of pre-operative anxiety is fear of the unknown. By clearly explaining what will take place to both patient and family, providing emotional support and facilitating the scheduled surgery as planned, your nurse is instrumental in helping you conquer this fear. Your nurse should be able to explain every procedure to you (see box below), and you are encouraged to ask many questions about them as well.
Managing Anxiety- Part II: Overcoming other fears
By answering questions and through open discussions, a nurse can also address other causes of anxiety, such as fear of death or disability, fear of pain, fear of poor prognosis and fear of rejection. For example, I once had a patient who was afraid that he would have to undergo a colostomy when none had been planned or even remotely considered by his healthcare team. He had been too uncomfortable to discuss this with his doctor. However, through our frequent conversations, his anxiety was uncovered. We had a thorough discussion about it, and he soon understood that this was not a part of treatment.
A nurse is also there to help you and your caregiver(s) actively participate in the process and understand your long-term role. Pre-operatively, she will emphasize the importance of taking your medications on a daily basis, maintaining your routine laboratory work up and continuing your commitment to follow up with your doctor. Should any issue arise, the transplant team is available 24 hours a day, 7 days a week. For example, if you are having problems with your medications schedule, your nurse can work with you to simplify or change your medications routine to make it easier for you to adhere to it. The medications, labwork and continuing communication are matters within your control. Your committment to maintaing these will help you catch a potential episode of rejection or prevent damage to your new organ.
Summary
As your nurse explains the preparation for transplant, you should feel your comfort and security increase, and your initial uneasiness decrease. By maintaining open communication with your healthcare providers and working as a team, a successful transplant and recovery are easier to attain.
As a patient, you should be given a realistic appraisal of the events to come so as to reduce your pre-operative and post-operative anxieties. Your nurse knows that there are some procedures that you may want explained. She will discuss the following points with you and encourage you to ask many questions: 1. The general meaning of x-rays, cardiology work up and other referrals and clearances needed, laboratory work, the exact method of performing these tests, and the approximate amount of discomfort that you should expect. 2. A general idea as to your expected pre-operative course. 3. The meaning of each medication administered before, during, and after the operation. 4. The meaning of each nursing procedure carried out during your entire course of hospitalization. 5. The operative procedure and what you can expect post-operatively. |
- Mary Dedeen Andrada, R.N., B.S.N.
