As a nurse for a surgeon, it is my duty to prepare patients for the peri-operative experience. It is a stressful time for a patient, and we try to reduce their fears by getting them familiar with what will happen. One of the pre-operative discussions I have with patients involves setting up the expectation that they may wake from surgery with a drain coming out of their abdomen. It is hard for anyone who has not been in the surgical field to wrap their mind around this. I explain what it is, and why it is necessary: to prevent the build-up of fluid under their skin. This sounds scary enough to a lay person that a drain coming out of them is preferable to a belly full of fluid. I explain how to care for it and how to measure output; but it is futile to try to prepare them for the discomfort it will cause or the disruption it will bring to their recovery.
And then I respond to post-operative frustrations. Most often I hear complaints that the drain interferes with sound sleep, which is really all you want when you are in pain. They worry it will get pulled by their clothing, or children, or gravity. They worry it will get infected at the insertion site.
There is not a good way to accurately measure output; we must rely on the patients or caregivers to have had a course in metric measurement of input and outputs. Patients cannot wait to get them out. I get the suspicion that many patients report output by rounding down, just to get the “tail” removed sooner. I hear all too often, “With all the technology, how is there not a better way yet?” It’s a valid question.
Written by Jessica Roberts, RN, BSN