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Subject: What If She THINKS She's Doing What Is Necessary? Author: Gall Bladder Guy [ Next Thread | Previous Thread | Next Message | Previous Message ] Date Posted: 16:42:25 10/29/09 Thu In reply to: Carol 's message, "Unnecessary exposure" on 16:45:20 10/21/09 Wed Back in the 80s, I had my gall bladder removed the old way, with an incision just below my right rib-cage. These days they use laparoscopy, and only two holes are made and no incision is required. Almost no shaving is NECESSARY. The night before, I was shaved from the shoulders down to the top of my knee-caps, except for my armpits, by a girl who looked to be no more than twenty. It was arousing, of course, and I assumed she shaved what was NECESSARY. One week later, I was in my surgeon's office for my follow-up visit and she asked me how I was feeling. I told her I was doing fine with my recovery, except for the awful itch which was driving me crazy. Puzzled, she asked me to show her what was itching, so I lowered my pants. She was surprised when she saw how bald I was down there, and how irritated the whole area was as the hair started to grow back. She said, "Wow, someone got carried away with the razor!" She told me all that was NECESSARY was that my hair be removed from my nipple-line to just below my navel. Clearly, there was a mix-up. The young aide somehow thought my shave had to be much more extensive than NECESSARY. But it was me who paid the price, the itching, for her error. In all fairness to the girl, when I asked a nurse about this years later she told me aides are not the decision-makers. Her supervisor, usually an OR supervisor-nurse, assigns these jobs and tells the aide exactly what parts are to be shaved. So the girl was only doing what her boss told her was NECESSARY. We'll never know why she had the girl shave me so much more than the doctor expected. [ Next Thread | Previous Thread | Next Message | Previous Message ]

Replies:

[> [> Subject: The Young Lady Followed The Procedure Manual Author: Barbara [Edit] Date Posted: 17:06:03 10/29/09 Thu Every facility has a procedure manual that the follow. In the case of surgical preps, they don't customize each shave in the manual. The preps are divided into broad categories, like, abdominal, chest, flank, back, lower limb, upper limb, head & neck, genitalia, and so forth. You probably won't get to see a manual, but in one of the big book stores, in the nursing section, you may find a training book for aides or nursing assistants. In there, look up surgical, or pre-op surgical care. There you will see a line-diagram with the areas to be prepped shaded in. The diagram for "abdominal" shows the entire area from just under the armpits to the middle of the thighs. That's what the aide who shaved him was undoubtedly sent in to do an "abdominal" prep. She shaved exactly what the manual told her should be shaved, so she did it correctly. If a doctor wants a different area prepped, he or she is supposed to issue specific instructions to over-ride the manual. Otherwise, the manual's diagrams are followed. The man's doctor should have made her preferences clear. There was no mix-up. The aide did what was required of her. [ Post a Reply to This Message ]

[> [> [> Subject: Re: The Young Lady Followed The Procedure Manual Author: old med staff [Edit] Date Posted: 12:00:22 10/30/09 Fri I agree with Barbara. I used to be an orderly in the early 1970s & had to do the preps for all of the male patients. I still remember a few of them. The abdominal prep (mentioned by Barbara) was from the nipples to mid-thigh. The chest prep was from top of neck to start of pubic hair. The pelvic prep was from belly button to mid-thigh including scrotum. The rectal prep was from the small of the back to mid-thigh including all hair around the anus (rough going if the patient had hemorrhoids protruding outside.) There was a TUR prep that was the pelvic and the rectal prep combined. Then, there were bone preps that not only included shaving, but also washing are with anti-bacterial soap, drying with steril towels, and then wrapping the are with sterile towels. Shaving of the head for brain surgery was done in the O.R. at time of surgery. Anything different from above had to be part of the doctor's prep order. For example, the doc may order only an area the size of a half-dollar be shaved around a cyst on the side of the head. [ Post a Reply to This Message ]

[> [> [> [> Subject: Thanks For Confirming What I Said About Preps Author: Barbara [Edit] Date Posted: 12:16:51 10/30/09 Fri old med Staff, I appreciate your taking the time to confirm for the doubters what I said about how preps are ordered. Maybe, with two of us describing how it works, they will accept what we both independently said. You also confirmed what I said about the fact that the manual's prescribed method can be adjusted if the surgeon takes the time to specify something different. It works both ways. Sometimes a surgeon wants less of a prep than the manual dictates, but sometimes the surgeon wants more. There was a surgeon I recall who wanted the entire body shaved, except for the head, not just the chest prep, for any of his thoracic operations. The doctor who told the man that "someone got carried away" was the one who made the error. The surgeon should have changed the prep order if she wanted less than the full abdominal prep of the patient. The girl did the standard abdominal prep. She was not told anything different. [ Post a Reply to This Message ]