During Your Stay

During Your Stay

Spine surgery and a hospital stay is a major event, therefore want to provide you with as much information as possible to help alleviate your anxieties.

Because spine surgery is all we do, everything about Nebraska Spine Hospital is designed to facilitate the recovery process. Our private rooms allow occupational therapists, physical therapists and others to provide care in the room making it easier on the patient and the family members who will aid in recovery after you return home.

Admitting and Pre-Op

Check in at the admitting desk in the front lobby of the hospital at the time you are instructed to do so.

  • You will be directed to the outpatient surgery pre-operative area.
  • Your family may come with you.
  • A Nurse will review your past medical history, allergies, and current medications with you. Verifying that this information is correct will be important in determining your treatment before, during, and after surgery.
  • You will sign an authorization form permitting your Surgeon to perform surgery at this time.
  • An intravenous infusion (IV) will be started.
  • Medication to help you relax will be given.
  • You will go to the operating room on a cart.
  • Your family should go to the surgery waiting area and check in.

What to Bring and Tips

  • Brace/Collar – If you were fitted for one before surgery
  • If you use a CPAP, bring it with you.
  • Non-skid slippers or comfortable shoes
  • Loose fitting clothes (You may bring your own pajamas to wear once the IV and other lines are removed after surgery.)
  • Personal hygiene items – toothbrush, toothpaste, deodorant, comb, shampoo, etc.
  • Comfort items – family pictures, headphones, magazines, books, etc.
  • Family and friends’ phone numbers and pre-paid calling cards for long distance calls
  • All Home Medications (including prescription, over the counter, vitamins, and herbal supplements) Medications will be used for verification purposes. All medications taken while at the hospital will come from the Pharmacy.
  • Advanced Directive (living will or durable power of attorney) if you have one. If you do not have one and are interested, you may speak with the nurse when you arrive at the hospital.

What to Expect During Your Stay

Surgical Procedure

  • Surgery is done under general anesthetic which means that you will be asleep.
  • Surgery length depends on the procedure being completed.
  • Depending on the surgical procedure, a General Surgeon or another Spine Surgeon may assist your Spine Surgeon.
  • Your Spine Surgeon will talk with your family when surgery is complete.

Post Anesthesia Care Unit (PACU)

  • You will wake up in the PACU for recovery after surgery and remain there for approximately 1-2 hours.
  • Your vital signs will be taken (blood pressure, pulse, respirations, and temperature).
  • You will be asked to take deep breaths and cough.
  • As you wake up, your throat may be irritated.
  • You will be connected to several pieces of equipment (IV’s, catheter, wound drain, blood pressure cuff, and monitors)
  • You may hear beeping noises. Do not be frightened. A Nurse is monitoring all of the machines, so you do not need to worry about them.

Transfer

  • Once you are awake, you will be taken to your hospital room.
  • After a Nurse has completed your initial assessment, your family will be allowed to visit you in your room.
  • Your Doctor will determine whether your first night will be in the Intensive Care Unit (ICU) or on the Spine Unit. Your general physical health, time under anesthesia, and area of surgery are factors which assist this decision.
  • If taken to the ICU, you may stay for several nights depending on your medical status.

Important Need to Know Items

If there is anything we can do to better serve you and your family, please let us know. Your comfort, security and safety during your stay are important to us.

Meeting Your Communication Needs

Nebraska Spine Hospital, LLC strives to provide a setting where patients and staff can share information openly and accurately. Our Language Access department is available to provide in-person or telephonic interpretation services for our limited and non-English speaking patients. Interpretation services and assistive devices are also available for people with vision, hearing or speech assistance needs. All Language Access services will be provided at no cost to patients.

Providing Services for the Physically Challenged

Nebraska Spine Hospital, LLC makes every effort to make sure we are fully accessible to physically challenged or disabled individuals. Accommodations for wheelchair access and assistance for those with vision, hearing or speech assistance needs are offered at no cost to patients. Your nurse or health care provider can help you get assistive devices and can provide you with additional information about services to accommodate your specific needs.

Reviewing Your Medical Records

At the Nebraska Spine Hospital, LLC, patients have the right to ask to see their own medical record. If you would like to see your medical record, please talk with your nurse or other health care provider, who will help you review your medical record to make sure you find the information that you need.

Ensuring Your Safety and the Safety of Those Around You
Overhead Announcements

At times you will hear overhead announcements requiring our staff to respond to pages, emergencies, and severe weather announcements. The safety of our patients and guests is our priority. When an overhead announcement requires patient action, the Nebraska Spine Hospital, LLC staff will assist you.

Securing Your Personal Property

While Nebraska Spine Hospital, LLC recognizes your right to have your personal property with you, we remind you that you are responsible for all items you bring, and Nebraska Spine Hospital, LLC is not liable if any of these items are lost or damaged. For this reason, we recommend that you leave expensive items such as jewelry, cellular phones, laptop computers or other electronics, large amounts of cash or other high-value items at home, or give them to a trusted friend or relative during your visit.

In addition, let us know if you find anything that may belong to someone else in your room or care area. And before you leave for home, please take a moment to check your room or care area to be sure you have not forgotten any of your personal items, and picked up anything that is not yours. Please check with your nurse before taking any medical equipment or supplies home with you.

If you have any special needs regarding your personal property or if you would like to find out if there is a safe place for you to store your personal items during your visit, please contact your nurse or other health care provider.

Assuring Your Personal Safety

For the safety of you, your family, your friends, other patients, visitors and Nebraska Spine Hospital, LLC staff, weapons and contraband of any kind (for example: illegal substances, intoxicating beverages, unlabeled medications, and any other items which present a danger to the life, health, and/or safety of the patient or others) are prohibited in all Nebraska Spine Hospital, LLC facilities.

Ensuring a Safe and Healthy Environment

To provide a safe and healthy environment, Nebraska Spine Hospital, LLC facility and grounds are tobacco-free. We encourage healthy lifestyles that reduce the health risks for our patients, visitors and employees and ask that you refrain from using tobacco products in the facility or on the property while at Nebraska Spine Hospital, LLC.

The Use of Cellular Phones, Laptop Computers, and Personal Electronic Devices

Nebraska Spine Hospital, LLC is committed to providing a healing environment for our patients. Please be considerate of those around you when you use cellular phones, laptop computers or other personal electronic devices.

On some occasions and in some areas, you may be asked to turn off or not use cellular phones, laptop computers and other personal electronic devices. If you have questions, or if you would like to be directed to an area where you may use these, please contact your nurse or health care provider.

In some areas of our facilities, there may be access to wireless Internet connections. If you need more information about this service, please contact your nurse or health care provider.

Vistor Information

  • There are no set visitor’s hours or visitor limits. But, this is your time for recovery, so you may want to limit the number of visitors and amount of time that they spend in your room to allow for rest and therapies.
  • For your safety and the safety of the children, please limit the time that children under the age of 14 are on the Spine Unit. Children must be supervised by an adult (other than the patient) at all times.
  • If any of your friends or family have recently been exposed to an illness or have been sick, please ask them to stay home to prevent the spread of illness.

Your Hospital Stay

Intravenous Fluids (IV) and Tubes

  • IV fluids are given to help keep you hydrated.
  • Antibiotics are also given by IV to prevent infection (infection is a risk with any surgery).
  • Other tubes may include: wound drain to drain fluid from your incision and Foley catheter to drain your bladder
  • Most tubes are discontinued 24 to 48 hours after surgery depending on your status.

For Your Safety

  • Nurses will frequently ask your name and date of birth throughout your stay to ensure that the proper care and medication are given to you.
  • There will be a call light near the bed and in the bathroom for you to use to request assistance. Please use this button when you need anything.

**DO NOT ATTEMPT TO GET UP ON YOUR OWN**

Diet

  • For the first 12-24 hours (depending on your surgical procedure), you may only be taking a few ice chips by mouth. This is important because pain medications, anesthesia, and the surgical approach tend to slow bowel activity.
  • If you try to digest food before the bowel has returned to normal activity, a bowel obstruction or ileus (complete stopping of bowel activity) may occur.
  • Nurses will listen to your stomach checking for bowel activity.
  • Your diet will be advanced slowly starting on clear liquids and then a soft diet when you can tolerate it.

Incision

  • The incision will be covered with a large, thick dressing.
  • This dressing usually remains on for 24 to 48 hours and is typically removed when the drains are removed (if a drain is in place).
  • A thin dressing will then be placed over the incision.
  • Once the thin dressing is in place, you may be allowed to shower.
  • Your Surgeon or Nurse will change this dressing as needed.

Tests

Follow-up tests will be completed while hospitalized

  • Blood test – to find out if you need a blood transfusion
  • Spine x-rays – to make sure the fusion and hardware are all in the proper place

Bladder Function

  • Your catheter will be removed as soon as possible depending on your level of mobility.
  • Bladder Scans may be completed by Nursing to check bladder function once the catheter is removed.

Activity

  • Bathing – While tubes and monitors are in place, Nursing Staff will assist you with bed baths.
  • Showering – Once you are cleared to shower, your Nurse or Occupational Therapist will assist you with showering to make sure you
    are safe.
  • Back Brace – If ordered, your brace should be worn at all times except when you are in bed.
  • Cervical Collar – If ordered, you collar should be worn at all times except when showering or shaving.

Therapies

If ordered by your Doctor:

  • Occupational Therapy will work with you on dressing, showering, adaptive aides, and transferring (getting from one place to another).
  • Physical Therapy will work with you on transferring, walking, exercises, and how to move within your spine precautions

Mobility and Positioning

Your Nurses and Therapists will instruct you on your precautions and moving after surgery, but these are good things to practice before surgery as well.

  • Spine Precautions – no bending, lifting, twisting, or arching
  • Log Rolling
  • Transfers
  • Sitting Posture
  • Positioning in Bed

Day of Surgery

  • When in bed, spinal alignment needs to be maintained.
  • For lumbar fusion patients, you will be assisted to turn to either side or your back about every 2-3 hours.
  • For cervical fusion patients, no more than 1 thin pillow should be placed under your head to maintain proper spinal alignment.
  • Your Nursing Staff can assist you in positioning pillows behind your back and between your legs for comfort when lying on your side.
  • Do not attempt to sit up or get out of bed without assistance.
  • Activity may include dangling at the edge of the bed or sitting up in a chair with the assistance of Nursing Staff or Therapy.

Day After Surgery

  • You will be getting up to the bedside toilet with the help of your Nurse or Therapists.
  • You will be up in the chair.
  • You will get up and walk with the help of a Physical Therapist. Tubes and Monitors will be discontinued as appropriate.

We expect that you will achieve all necessary goals within the following time periods associated with each procedure. These are general guidelines, but each patient’s length of stay at the hospital may vary.

  • Laminectomy/Laminotomy/Decompression: outpatient to 1 night
  • Discectomy: outpatient to 1 night
  • Cervical Spine Fusion: 1 night
  • ALIF: 1 to 2 nights
  • Disc Replacement: 2 nights
  • TLIF: 3 nights
  • Anterior and Posterior Fusion: 4 nights

Nursing Care

  • Once in your room, a nurse will check your vital signs, dressings, circulation, sensation (feeling) in your arms and legs, and assess your pain. You may need to be turned, so that the nurse can see your dressing.
  • The nurse will have you cough and deep breathe as well as have you do some simple leg exercises.
  • The monitoring and exercises will be done frequently at first and then gradually decrease over time.
  • You may be connected to an Oximeter by a clip on your finger. This measures the oxygen level in your blood, and the reading is monitored by your nurse and Respiratory Therapist. This machine is very sensitive and may alarm due to arm movement, body temperature, and pressure.

Preventing Blood Clots

When you lie in bed, the muscles in your legs do not work to assist in returning blood to your heart.

  • Leg exercises can help to prevent blood pooling and clot formation.
  • Foot or leg pumps also assist in this process – The pumps are inflated and deflated by a machine at the end of the bed.
  • Your doctor may order compression stockings for blood clot prevention as well.
  • When the foot or leg pumps have been removed, you may be started on a blood thinner shot. The shot will be given in your stomach 2 times per day until you go home.

Sensation (Feeling)

  • If you had numbness or tingling in your arms or legs prior to surgery, let your nurse know what was normal for you.
  • Also let the nurse know of any changes after surgery such as an increase or decrease in the numbness or tingling area.

Pulmonary (Lung) Hygiene

  • Exercise helps to clear your body of anesthetic and prevents complications like pneumonia.
  • When up and walking, gravity assists you to take in air and expand the air pockets in the lungs to their full size. But, when you are in bed, gravity works against this process.
  • After surgery, you will be asked to take deep breaths and cough to assist in expanding your lungs.
  • You will also be taught by a Respiratory Therapist to use an Incentive Spirometer which is a plastic device used to encourage you to take a deep breath in.
  • Use the Spirometer every hour and take 10 deep breaths each time. It may be uncomfortable, but it is necessary to prevent lung complications.
  • If you are having trouble using the Spirometer, another type of breathing treatment may be ordered.

Pain Control

Everyone has different levels of pain after surgery, and no two people experience pain the same way.

  • Pain should be expected following surgery.
  • Your nurse will work with you to achieve an acceptable level of pain management in order to perform the necessary functions during the recovery process.
  • Your nurse will ask you to rate the amount of pain you have by using a 0 to 10 Numeric Pain Intensity Scale.
  • 0 is considered no pain and 10 is considered the worst pain you can imagine. If the numbers are difficult to use, the words listed or the faces may be helpful.

Pain Medications will be given in one or more of the following ways:

  • Epidural – tube with medication placed in your back during surgery by your Surgeon
  • Patient Controlled Analgesia (PCA) – This is a machine that is used to give pain medications through an IV. You will be given a button that is attached to the machine, so you can give this medication to yourself depending on your level of pain. For your safety, family or friends should not push the button for you.
  • Through an IV given by your nurse
  • IM (a shot into the muscle)
  • Orally (by mouth)

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