Working on the surgical floor provides an opportunity for nurses to provide primary care to patients. As a student nurse, I was paired with a nursing assistant to help in taking vital signs and monitoring daily weights. At times, I was required to assist in the personal care of the patients, like bathing them. A more notable experience was when I was required to monitor a male patient, John, aged 54, who had undergone a major elective abdominal surgery. The patient was expected to spend the next seven days in the hospital to be monitored as he makes progress toward recovery. On the third day, John was experiencing discomfort and moderate pain. At the same time, he had trouble sleeping the previous night, which prompted him to ask questions about his state and recovery process. These questions seemed to be pointing to concerns and anxiety about potential complications.
Due to the major surgery, John was experiencing moderate pain and discomfort, which required immediate intervention. With my knowledge of non-pharmacological interventions, I worked towards ensuring that his bed was comfortable and provided instructions for deep breathing exercises. In consultation with the nurse, I also administered pain medication as prescribed and then regularly checked in to assess the pain level while documenting his response to the prior interventions.
On the other hand, when I reflected on John’s constant inquiry, I learned that he was emotionally distressed because he did not understand the post-operative recovery process sufficiently. At the same time, I thought of John’s psychological needs at the time (the lack of sleep and anxiety), which dictated the next nursing course of action.
It is not strange that medical procedures provoke anxiety because psychological distress is real in surgical patients (Sveinsdóttir et al., 2020). Nursing care in patient’s recovery after a major surgery aims to safely deliver them to their families and back to society to live a normal life. Through efficient care within the hospital setting and discharge education, nurses can achieve quality.
A literature search has revealed that anxiety and depression among surgical patients are common because some of them are experiencing such for the first time. Sometimes, the pain and discomfort are caused by anxiety, where these patients constantly think of their recovery and fear complications. However, anxiety is low in most patients as they receive sufficient nursing care and emotional support. At the same time, such a major operation is complex for their comprehension, and they may not have received sufficient education or support regarding their recovery expectations, potential side effects, or normal post-surgical experiences. Therefore, it becomes important for nurses to address emotional well-being at the same time they are catering to physical health progress because both psychological and physical health needs impact each other.
A study by Villa et al. (2020) has also shown that stress from worrying about recovery can lead to postoperative complications. Again, stress affects the quality of life of patients in the short and long term; i.e., even after making a recovery, they may be psychologically connected to that one time they feared for their lives. Thus, psychological interventions interacting with the pathophysiology surrounding surgical stress response should be inquired into in areas of the perception of pain, innate immunity, and patients’ mood.
Nursing prioritizes ensuring patient comfort while they recover. After ensuring that the patient is free of any factor that could affect their recovery, nurses move to assess the patients’ other factors. A look and the biopsychological model, scholars argue that biological, social, and psychological factors interact with one another and do act on a person’s health on their own (Kusnanto, Agustian, and Hilmanto, 2018). Assuming the major surgery is part of the biological factor, the patient will need a social support system to ensure that their psychological needs are catered to.
As a nurse, I ensured that I provided support as I could by answering questions John had, and provided pain management and comfort measures. This experience was particularly enriching because I got the opportunity to understand the multi-dimensional nature of patient care and recovery. While some may think of post-op recovery as the wait for the patient’s wound to heal to get discharged, it is more complex because independence is an amalgamation of both the physical and psychological wellness of a patient. If one aspect of care is addressed while ignoring the other, it could lead to long-term health consequences.
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This experience is helpful to me because of my future practice goals. I want to be dedicated to helping patients get back to society with the best experience, something that will reflect on the whole nursing practice. I intend to use my listening and empath skills to care for patients while reinforcing my experience in monitoring their vital signs and recovery state.
Significant learning issues for other student nurses could arise from failure to recognize distress and to communicate it. Nurse receptors and supervisors should help students nurse learn about professional intimacy as described in CNO (2019), which will help in recognizing psychological and social needs. I, too, faced challenges from professional intimacy by not getting social support for the patient because he did not have a close family staying behind to check on him. However, since I had the mastery of checking and monitoring vital signs, I would say I encountered problems related to it. In future, I intend to work towards comprehensive patient education, active listening, and involving the patient’s support system in the recovery process.
Kusnanto, H., Agustian, D., & Hilmanto, D. (2018). Biopsychosocial model of illnesses in primary care: A hermeneutic literature review. Journal of family medicine and primary care, 7(3), 497–500. https://doi.org/10.4103/jfmpc.jfmpc_145_17
Sveinsdóttir, H., Zoëga, S., Ingadóttir, B., & Blöndal, K. (2020). Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 months postsurgery: A questionnaire study. Nursing Open, 8(1), 210–223. https://doi.org/10.1002/nop2.620
Villa, G., Lanini, I., Amass, T., Bocciero, V., Scirè Calabrisotto, C., Chelazzi, C., … & Lauro Grotto, R. (2020). Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioperative medicine, 9(1), 1-8. https://doi.org/10.1186/s13741-020-00169-x