Washington University Orthopedics

Your surgery and hospital stay

You will arrive at the hospital approximately two hours before your scheduled surgery time. Procedures are performed on a “to follow” basis. Occasionally, a procedure scheduled ahead of yours may take longer than expected, so there may be some delay before your surgery. Regardless, it is important that you arrive on time. Sometimes an earlier procedure will cancel and we run ahead of schedule. You should not have anything to eat or drink after midnight the night before surgery. You may be advised to take some of your medications with a sip of water only. The anesthesia staff will discuss this with you at the time of your pre-testing. Upon arrival to the hospital you will go through a check-in process. At the appropriate time you will be brought into a pre-operative holding area. At this point the nurse will see you, review your records, and an IV will be started. A member of the anesthesia team will meet with you to discuss any anesthesia concerns and anesthetic options. Your surgery will be performed under general anesthesia (you will go to sleep.) In addition, the anesthesiologist may recommend a regional block if they think that you are a good candidate. This involves an injection of local anesthetic (numbing medicine) or placement of a catheter near the nerves at the base of the neck. These blocks are generally recommended to help control your pain following surgery. The anesthesiologist will discuss the risks of the block and the decision to perform this is a mutual decision between the patient and the anesthesiologist.

You can anticipate that your surgery will last approximately 2 hours, although this varies depending on the complexity of your surgery. If you have family members with you they will wait for you in the waiting room. Your doctor will speak with them after your surgical procedure to let them know that you are finished. During your surgery, family members should plan on remaining in or near the waiting area in order to be accessible at the completion of the procedure. Belongings will be stored in a locker in the pre-operative area. Please leave valuables at home or with family.

When you wake from surgery you will be located in the post-operative recovery room. Unfortunately family members cannot be present with you at this time as there are many other patients and many nurses in this area. Once you have been stabilized and are comfortable, approximately 1-3 hours after surgery, you will be transferred to the nursing division and you will be able to see your family. The orthopedic floors are 7300 and 7400. Visiting hours are from 11am-9pm, children under 12 are not permitted to the nursing divisions. Most rooms are semi-private, or have 2 beds. If you have a roommate family members will not be allowed to stay the night. You can request a private room for an addition charge, but this cannot be guaranteed due to the changing census of the nursing division. However, the nursing staff will accommodate this request to the best of their ability. If you are interested in requesting a private room please notify your surgeon’s nurse when you schedule surgery so that the request can be made.

You can expect to stay in the hospital for 2 nights. If you are planning to go to an extended care or rehab facility you will likely need to stay 3 nights due to insurance reasons. If you are planning to go to one of these facilities you may want to research facilities in your area prior to surgery. The social work staff will assist with placement once you are in the hospital.

You will have a dressing on your shoulder and your arm will be immobilized in a sling. You will also have a drain in place to collect fluid and blood from the surgery. This will be monitored closely during your hospital stay. It will be removed the morning you are discharged. Other equipment you can expect to have while hospitalized includes: an IV until you are eating, drinking and voiding normally, a cold therapy unit in the place of ice bags, compression and sequential stockings on your legs to prevent blood clots, possibly oxygen tubing according to your needs, and possibly a catheter if you are not able to urinate normally.

As previously noted, you may be given a regional block. This block usually wears off sometime in the night. Your nurse will be offering you pain medication every 4 hours. We recommend that you begin taking the medication when it is offered so that you will have medication in your system when the block wears off. In addition to the routine pain medication you can ask for additional pain medication in IV or pill form if needed. Please ask for additional pain medication when you first begin feeling uncomfortable. You will also have medication for nausea if needed.

Lab work or “blood work” will be done during your stay. By looking at these results decisions are made regarding your care. In order for the lab results to be ready for your doctor in the morning the staff will collect samples from you. This is normally done between 12am and 2am. We apologize for any inconvenience this may cause you.

Depending on your needs you may need a blood transfusion after your surgery. It is requested that you not donate blood for yourself prior to surgery. If a friend or family donated blood prior to your surgery, you will receive that blood. Otherwise you will receive blood from the blood bank. Your doctor or nurse can answer questions you may have about this.

Occupation therapy will see you after your surgery to evaluate your needs, they normally start around 8am. If they feel it necessary a referral will also be made to physical therapy. You will begin doing range of motion for exercises the morning after your surgery. It is recommended to have a family member attend the therapy session, while the therapist instructs you on these exercises.

The day that you are discharged your doctor or a member of the shoulder team will see you early in the morning. Your drain will be pulled at that time and discharge order will be written. Your nurse will go over your discharge instructions before you leave. Normally, patients are able to leave around noon time.

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Your surgery and hospital stay

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