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M A R C H 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
John D. Kelly IV, MD
CUTTING REMARKS
Don't You Just Hate Confusing Post-Op Orders?
The clearer that I can make my discharge instructions, the better.
I
'm blessed with
very thorough
PACU nurses,
but not even the
most conscientious
nurse can over-
come my confusing
post-op orders.
Here are 4 exam-
ples that clearly
illustrate my point.
• Can I put weight on
this leg?
After
speaking to families
and delineating post-op care, invariably I'll be in a case and receive
a call to my OR from the PACU inquiring whether Mrs. Jones is "toe
touch" or "non-weight bearing." Yikes! Whether someone is non-
weight bearing or toe touching has no clinical relevance. The same
stress is realized on the joint. It may appear important, but it is not.
My bad for not making this clear. I have amended my orders now
to say: "Under no circumstance can you put any weight on that leg
… for fear of incarceration!"
• When can I remove the dressing?
There's no real hard science
regarding dressing duration and its effects on infection rate. Yet, I
receive scores of phone calls from nurses and patients alike about
when they can remove bandages. There's no magical formula for
DID I MUMBLE? What part of my post-op orders don't you
understand?
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