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You hi. My name is flavio de souza. Im a clinical facilitator for utsa utsa in this scenario.
Im facilitating gloria. As she completes a preoperative checklist for patient hi. My name is gloria gomez.
Im a second year nursing student in this scenario. I will be playing a role as a first year notes instead a patient is going to have a shoulder surgery tonight. And i will be checking the pre operation checklist and tom williams was playing soccer.
This morning part of the competition. Im doing pretty well. I was thinking about going for first grade one day then someone just trips.
Me i go down hard and i hit my shoulder and i mean the ambulance. I end up in a hospital. Tell me a broken it and its a bad one and i need a surgery on it to get it fixed.
Its a disaster. Ive missed a game. Im probably gonna miss the rest of the season.
Im worried its not even going to heal right and maybe thats the end of it for me well. I dont want to be in hospital. I just want to go home hi.
Gloria. How are you going hey very. Well.
Thanks. How are you im good. Thank.
You what are you doing today. Who are you looking after um. I have three patients at the moment.
I got one which is more interesting because hes going to surgery today catherine. What surgery is he going for hes going to live. Its a shoulder.
Its a shoulder. So i saw jane okay. So what are you doing for him.
Well. I have to do the preoperative checklist. And yeah.
Im not sure im not pretty sure if i cant do it by myself you did it with me a couple of times before and you did really well you asked the right questions. And you were able to explain everything to the patient. I think you can do it by yourself.
And then we can discuss it later on. Oh yeah. Did you have any questions yes.
I actually i got in. I got one question sometimes the last time when we did it yes with a woman yeah. It is easier to ask if yeah she have makeup on or she doesnt yeah.
But hes a man yeah. And i dont know if actually come ask him see some things are quite obvious we can assess it for ourselves. If hes got makeup on or not if not you can take it as he doesnt have all right yeah.
Hey. But those that you cant see you need to ask him. Okay.
Things that you cant see yeah. Okay. Oh.
Thats fine. Okay okay. Oh.
Okay. Ill see you later. Okay bye bye thanks hello mr.
Williams. My name is gloria gomez. Im a nursing student first year from utsa.
Im here at the moment for doing the preoccupation checklist for you as long as i know you were playing that you will be you will be in a surgery. Today yes. They told me do you have any other question about this surgery or is it everything clear for you when are we gonna get almost it ive been here all day waiting as long as i know just let me check your surgeon is going to be at 6 pm.
Today um. So at the moment now im going to do a preoperative checklist. Which is going to be a little bit of questions and sometimes they are going to be uncomfortable for you but just three a thing that im going to do all these in order to have a good outcome.
In your search. Okay um. Let me check you um eight please and have your full name please.
Tom williams. Youve laid the first still the first of the first nineteen ninety like it was the last time. You asked yeah.
I know its a little bit boring when the when someone asked you every five minutes youve date of birth. But it is very important for us to always verify that we are working and we are doing the procedures with the right patient yeah. Its something that we have to do and i know youre knowing everyone.
But if its for your own good okay so do you have aim what time. Did you have your last food at breakfast this morning. Yes first um.
What time it was it would be nine nine what about your last ring well i was drinking water at a game thatd be 11. I reckon okay as long as i see you dont have classes what about contact lenses. Do you have any oh glances okay here needs no no good it sorry about this question.
But do you have any artificial limbs or proteases. No any danger. No no okay have your boyss whats your ring.
Have you passed you ring today yeah. This morning this morning. Okay im going to just to check if if you have prepared you check your operation side.
Im not going to do it any painful thing for you im going to try to do everything very slowly. Im like very careful of everything okay im just going to have a look at this mac mm hm thats perfect okay thank you um they have any jewelry rings um can i have to have a look of your nails. You have any nail polish.
No no thats fine. Im okay have you had your own shower. Today.
Ive had my shower. Okay. Thats pretty much it do you have any comments.
Any question. Many choirs dont when do i get to go home. Oh.
Thats a thats a tough question now. Im not able to answer it to you as long. They only think i can tell you now is your surgery is going to be at six and you will be in recovery for up to all night and yep.
The doctor is coming tomorrow to check how is everything going. And he will be able to tell you what time are you going home or you you are not leaving tomorrow. Okay.
They have any other question. Why do i have to get a surgery. Im broken up the fall.
I just put it in a cast. I was it i know i know this is a little bit tough and you had a fracture before and it was fake heal just with cast. But this structure is a little bit more complex.
So you need to really be fixed. And the only way to fix. This is not a cast it is a surgery so thats why the research is going to be will be here.
When you come back from the surgery will be always looking after you you will be fine. You will be no in the best hands. Always and yeah.
Well be doing the face our best for you all the time yep do you have any other question. Thats fine so they have your pass are there okay. And also im afraid you cant have anything to drink or to eat until six oclock.
What not even a glass of water not even a glass of water. Im so sorry about that that is because when you will be exposed to a surgery. Which is with general anesthetic.
So you will be all your muscles will be relaxed. So that all the because of your muscles are relaxed also your epiglottis is going to be relaxed. The epiglottis is the muscle.
Which is the in charge is like a lets say its like a cup like a top. Which which doesnt allow the food to go through the airways. So you can have like a choke or any other risk injured surgery.
While you are there thats why we are being advised to to let you know that you are not able to have any drink or any food at all until 6 00. Im so sorry about that i know its a little bit complicated. But if you feel uncomfortable your mouth is dry.
I will be happy to bring you some mouthwash so thats been fun you will be fine. Okay okay so if you have any question anything just let me know okay okay bye. Gloria.
How did you go. I was watching you from. There.
Oh yeah. I think i did well yeah well im not quite sure. But yeah.
What do you think it did well. What um yes. I think the most challenging aspect in this in this situation.
It was to deal with this patient. Which was in a very bad mood mm hmm. So i didnt know what to do how to talk to him how to empathize with him because he was a little bit dry like i think you did quite well in the situation that you were in and saying that you were doing it for the first time.
I think you did well but as you keep doing it you will develop more therapeutic communication skills. And youll be able to help him come out with how his feeling by just empathizing with him and ask him saying. Oh i understand youre feeling really bad today.
And you know. But you did quite well there what what else did you have any problems with actually um. I think i did well asking of questions but i didnt know how to ask him about limbs artificial limbs dentures and yes um which is a little bit like yeah intimidating the patient.
He maybe. He failed that i will keep it that i was intimidating him asking him for danger zone. Maybe practices.
So yeah. See some questions can be quite uncomfortable. But theyre very important to ask because the patients safety depends on them for example dentures.
He if he has a small denture just a single tooth danger they can be very dangerous because the patient can either swallow. It or they can get into the lungs so its really important that you ask the questions and as you keep doing it you will develop that skill to us in in a in a more appropriate manner yeah i got everything here i checked good youve got the x rays and you know checked everything. Yeah.
That looks good and just forgot to ask him about the personal belongings also i am cooking came back again asked him. And i did everything but we have foretold it to do it so did you go back and get that js id clarified ok good lets go through the paperwork. Weve got labels.
There thats good and thats your checklist thats good now make sure all the documentation is right mm hmm and thats the consent good all right okay good. I think you can keep doing. It.
Now. So you can check all your pre op patients before they go to the theatres. I just wanted to ask you something yeah.
I dont i dont know if it is quite normal to find that kind of patience because some i felt just so yeah look um. I dont think see its not nothing to do with you most often it is the situation that they are in and they are feeling either angry or sorry for themselves. And it is um.
How that is how they react. I think you did quite well. And its nothing to do with the way you behaved or anything that you did oh thats a good relief.
Thank you you you .
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