Patients

During Your Stay

Preparing for Spine Surgery at Nebraska Spine Hospital

Spine surgery is a significant event, and we want to provide you with all the information you need to ease your anxieties. As specialists in spine surgery, Nebraska Spine Hospital is designed to facilitate your recovery from start to finish. Our rooms are equipped to allow occupational therapists, physical therapists, and other care providers to assist you right there, making it more convenient for both patients and family members who will support your recovery at home.

Admitting and Pre-Op

  • Check-In: Please check in at the admitting desk in the front lobby at your instructed time.
  • Pre-Operative Area: You will be directed to the pre-operative area, while your family waits in the lobby until you are settled in your room.
  • Medical Review: A nurse will review your medical history, allergies, and current medications. Accurate information is crucial for determining your treatment before, during, and after surgery.
  • Authorization: You will sign an authorization form permitting your surgeon to perform the surgery.
  • IV and Medication: An intravenous infusion (IV) will be started, and medication to help you relax may be administered.
  • Operating Room: You will be transported to the operating room on a stretcher.
  • Family Waiting Area: Your family should proceed to the surgery waiting area and check in.

What to Bring and Tips

  • Brace/Collar: If fitted prior to surgery, bring it with you.
  • CPAP Machine: If you use one, be sure to bring it along.
  • Comfortable Shoes: Non-skid slippers or comfortable shoes are recommended.
  • Clothing: Loose-fitting clothes and your own pajamas for post-surgery comfort after IV and other lines are removed.
  • Personal Hygiene Items: Toothbrush, toothpaste, deodorant, comb, shampoo, etc.
  • Comfort Items: Family pictures, headphones, magazines, books, etc.
  • Contact Information: Phone numbers for family and friends, and pre-paid calling cards for long-distance calls.
  • Home Medications: Bring only the home medications the Nurse Navigator or Pharmacist has instructed you to bring. Note that all medications taken in the hospital will be administered to you by your nurse.
  • Advanced Directive: If you have a living will or durable power of attorney, bring it with you. If you don’t have one but are interested, you can discuss it with the nurse upon arrival.

What to Expect During Your Stay

Surgical Procedure

Your surgery will be performed under general anesthesia, ensuring you are comfortably asleep throughout the procedure. The length of the surgery varies depending on the specific operation being conducted. In some cases, a General Surgeon or another Spine Surgeon may assist your Spine Surgeon.

Rest assured, once the surgery is complete, your Spine Surgeon will personally update your family on your condition and the outcome.

Post Anesthesia Care Unit (PACU)

After your surgery, you will wake up in the Post Anesthesia Care Unit (PACU) where you will begin your recovery journey. Typically, patients remain in the PACU for about 1-2 hours. During this time:

  • Your vital signs (blood pressure, pulse, respiration, and temperature) will be closely monitored.
  • You will be encouraged to take deep breaths and cough to aid in your recovery.
  • You may experience some throat irritation as you wake up.

You will also be connected to various medical equipment such as IVs, a catheter, a wound drain, a blood pressure cuff, and monitors. Don’t be alarmed by any beeping noises—these are normal, and a Nurse will be monitoring all the machines to ensure your safety and comfort.

Transfer

Once you are fully awake, you will be transferred to your hospital room. After a Nurse completes your initial assessment, your family will be allowed to visit you.

Important Need-to-Know Items

Meeting Your Communication Needs

At Nebraska Spine Hospital, we are committed to fostering a setting where patients and staff can share information openly and accurately. Our Language Access department offers in-person and telephonic interpretation services for our limited and non-English speaking patients. Interpretation services and assistive devices are also available for those with vision, hearing, or speech assistance needs. All Language Access services are provided at no cost to our patients.

Providing Services for the Physically Challenged

We strive to ensure that Nebraska Spine Hospital is fully accessible to physically challenged or disabled individuals. We offer accommodations for wheelchair access and assistance for those with vision, hearing, or speech assistance needs at no cost to our patients. Your nurse or healthcare provider can help you obtain assistive devices and provide additional information about services tailored to your specific needs.

Reviewing Your Medical Records

At Nebraska Spine Hospital, patients have the right to review their own medical records. If you would like to access your medical records, please speak with your nurse or healthcare provider, who will guide you through the process.

Ensuring Your Safety and the Safety of Those Around You

Overhead Announcements

Occasionally, you may hear overhead announcements requiring our staff to respond to pages, emergencies, or severe weather alerts. The safety of our patients and guests is our priority. When an overhead announcement requires patient action, our staff will assist you promptly.

Securing Your Personal Property

While we recognize your right to have personal property with you, please note that you are responsible for all items you bring. Nebraska Spine Hospital is not liable for any lost or damaged items. Thus, we recommend leaving expensive items such as jewelry, electronics, and large amounts of cash at home or with a trusted friend or relative during your visit.

If you find any items that may belong to someone else in your room or care area, please inform us. Before you leave, take a moment to check your room or care area to ensure you haven’t forgotten any personal items and haven’t picked up anything that isn’t yours. Please consult with your nurse before taking any medical equipment or supplies home.

If you have special needs regarding your personal property or would like to know if there is a safe place to store your items during your visit, please contact your nurse or healthcare provider.

Ensuring Your Personal Safety

At Nebraska Spine Hospital, the safety of our patients, visitors, and staff is paramount. Therefore, weapons and contraband—including illegal substances, intoxicating beverages, unlabeled medications, and any other items that pose a risk to health and safety—are strictly prohibited across all hospital facilities.

Maintaining a Safe and Healthy Environment

To foster a health-conscious environment, Nebraska Spine Hospital is a tobacco-free campus. We are dedicated to promoting healthy lifestyles that minimize health risks for our patients, visitors, and employees. We kindly ask that you refrain from using tobacco products while on our property.

Use of Cellular Phones, Laptops, and Personal Electronic Devices

Nebraska Spine Hospital strives to create a healing environment for all our patients. Please be mindful of others when using cellular phones, laptops, or other personal electronic devices. In certain areas, you may be asked to turn off these devices. Should you have any questions or need assistance finding an appropriate area for device use, please reach out to your nurse or healthcare provider.

Additionally, some areas of our facilities offer wireless Internet connections. For more information about this service, please contact your nurse or healthcare provider.

Visitor Information

We understand the importance of having loved ones by your side. We recommend limiting the number of visitors and their duration to ensure ample time for rest and therapy.

For safety reasons, we ask that children under the age of 14 spend limited time in the Spine Unit and remain under adult supervision (other than the patient) at all times. No individuals (other than the patient) under the age of 19 will be permitted to spend the night in the hospital. To prevent the spread of illness, please advise friends and family who have been recently exposed to sickness to remain at home.

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: a wound drain to drain fluid from your incision and a 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 allowed ice chips. This cautious approach is necessary because pain medications, anesthesia, and the surgical procedure can slow bowel activity. Introducing food too soon can result in bowel obstruction or ileus (a complete stop of bowel activity). Nurses will monitor your stomach for bowel activity before gradually advancing your diet from clear liquids to soft foods as you are able to tolerate them.

Incision Care

Your incision will initially be covered with a large, thick dressing, which typically remains in place for 24 to 48 hours and is usually removed when the drains are taken out (if present). A thinner dressing will then be applied over the incision, and you may be permitted to shower once this is in place. Your surgeon or nurse will change the dressing as needed.

Tests

While you are hospitalized, follow-up tests may be conducted to monitor your recovery:

  • Blood test: to determine if a blood transfusion is necessary.
  • Spine x-rays: to ensure that the fusion and hardware are correctly positioned.

Bladder Function

The catheter will be removed as soon as possible, based on your mobility. Nursing staff may perform bladder scans 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 to ensure your safety.
  • Back Brace: If prescribed, your brace should be worn as directed by your surgeon.
  • Cervical Collar: If prescribed, your collar should be worn at all times except when showering, shaving, or as directed by your surgeon.

Therapies and Post-Operative Care Instructions

If Ordered by Your Doctor:

Occupational Therapy

Occupational Therapy will assist you with dressing, showering, using adaptive aides, and transferring (moving from one place to another).

Physical Therapy

Physical Therapy will guide you on transferring, walking, performing exercises, and moving while adhering to spine precautions.

Mobility and Positioning

Your Nurses and Therapists will provide instructions on your precautions and movement strategies following surgery. These techniques are also beneficial to practice before surgery.

Spine Precautions

  • No bending, lifting, twisting, or arching
  • Log rolling
  • Transfers
  • Sitting posture
  • Positioning in bed

Day of Surgery

  • Maintain proper spinal alignment while in bed.
  • Lumbar Fusion Patients: You will be assisted to turn onto either side of your back approximately every 2 to 3 hours.
  • Cervical Fusion Patients: Use no more than one thin pillow under your head to maintain proper spinal alignment. Nursing Staff can assist with 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.
  • Activities may include dangling at the edge of the bed or sitting up in a chair, both with the assistance of Nursing Staff or Therapy.

Day After Surgery

  • You will use the restroom with the help of your Nurse or Therapist.
  • You will spend time up in a chair.
  • You will walk with the assistance of a Physical Therapist. Tubes and monitors will be discontinued as appropriate.

Nursing Care

Initial Assessment

Upon your arrival in the room, our nursing staff will conduct a thorough assessment. This includes checking your vital signs, dressings, circulation, and sensation in your arms and legs, and evaluating your pain levels. To ensure proper evaluation, you may need to be repositioned.

Monitoring and Exercises

Our nurses will guide you through coughing, deep breathing, and simple leg exercises to aid recovery. These activities will be performed frequently at first and then gradually reduced over time.

You may be connected to an oximeter via a finger clip to monitor your blood oxygen levels. This device is highly sensitive and may occasionally alarm due to movements or changes in body temperature and pressure.

Preventing Blood Clots

When you are bedridden, your leg muscles are less active in promoting blood return to the heart, increasing the risk of clots. Leg exercises and foot or leg pumps can help prevent blood pooling and clot formation. These pumps are machine-operated and attached to the end of your bed.

If necessary, you may receive blood thinners until your discharge.

Sensation (Feeling)

If you experienced numbness or tingling in your limbs before surgery, please inform your nurse about your normal sensations. It’s crucial to report any changes in these sensations post-surgery.

Pulmonary (Lung) Hygiene

Exercise and movement are essential to clear anesthetic from your system and prevent complications like pneumonia. Walking helps expand your lungs, but when you’re in bed, gravity hinders this process.

Post-surgery, you will be encouraged to take deep breaths and cough to aid lung expansion. You will also learn to use an Incentive Spirometer—a plastic device that promotes deep breathing. Use it every hour, taking 10 deep breaths each time. Although it may be uncomfortable, it is necessary to avoid lung issues. If you have difficulty with the Spirometer, additional breathing treatments may be prescribed.

Pain Control

Pain levels vary among individuals following surgery. Our goal is to manage your pain to an acceptable level, enabling you to perform essential recovery activities.

We will ask you to rate your pain using a 0 to 10 Numeric Pain Intensity Scale, where 0 indicates no pain, and 10 signifies the worst pain imaginable. Alternative methods, including word descriptions or facial expressions, may also be used to help communicate your pain levels.

Pain medication may be administered in several ways:

  • Patient Controlled Analgesia (PCA): A machine that delivers medication through an IV. You will have a button to control the medication according to your pain level. For safety, only you should press the button.
  • Intravenously (IV): Administered by your nurse.
  • Intramuscularly (IM): Given as a shot into a muscle.
  • Orally: Taken by mouth.

 

Your comfort and recovery are our top priorities, and we are here to support you every step of the way.