WELCOME

Memorial’s mission is to provide you, the patient, with the highest quality healthcare possible. The specially trained, highly skilled team of healthcare professionals on staff makes your care their top priority.

By thoroughly reading this material, you will have taken an important step in guiding your surgical experience.

If after reviewing this information you have questions about any of the topics included, please contact your surgeon’s office or Memorial’s Admission & Testing Center (ATC). If you have any additional questions or concerns, please call the ATC at (618) 257-5460.

Our entire healthcare team—including physicians, nurses, technicians, therapists, volunteers, and administration—thank you for choosing Memorial Hospital for your care.

Mark J. Turner President Preparing for Your Surgery

An entire team of professionals will Perhaps the most important be involved in preparing you for your information you will share is your surgery; this includes physicians, personal health information: nurses, patient care technicians, and • Your medical • The use of tobacco, history, including alcohol, or other office staff. Yet, the most important all other surgeries drugs team member is you. • Allergies to • Pregnancy medicines, foods, • Any chronic medi- and latex Prior to your procedure, be sure to discuss any con- cal problems includ- • General health ing diabetes or high cerns about your surgery with your physician. Your information blood pressure physician can help you understand the risks and benefits involved with your particular procedure. • Recent illness including fever, Remember, it is cold, or rash very important A great deal of information will be required when • Current prescrip- that you take an preparing for your procedure. Providing the most tions and over-the- active role in your accurate and complete information possible will counter medications, healthcare. assist your caregivers in providing safe care. herbals, and vitamins

Informed Consent

Before having your surgery, you will • What are the indications for your This surgery is being performed be asked to indicate that you under­ surgery? Why is this surgery for you, and you should seek necessary? stand the nature of the surgical information necessary to improve procedure to be performed and that • Are there any alternative treat- your understanding. Do not hesitate ments available? you give your permission for the to ask questions. No doctor can • What will be the likely results if surgery. Most surgical procedures guarantee outcomes, because each you do not have the surgery? are not emergencies, so it is very surgery is different depending upon • What are the basic procedures important that you fully understand involved in the surgery? your health status, existing disease, the process. This may appear to be and the response of each patient. • Will any other surgeons be a formality, but, in fact, this should assisting your surgeon during be taken very seriously. Before your your procedure, and what tasks You should feel that your surgery, frankly discuss with your will they perform? questions have been answered surgeon any questions or concerns • What are the risks? before giving permission to that you have, such as: • How is the surgery expected to do the surgery. improve your health or quality of life? • What can be expected during your recovery period? • When can you expect to resume 1 normal activities? Patient Rights Every patient has the right to:

• Care and comfort that is • The confidentiality of his or her • Know the reasons for any considerate, dignified, and clinical records. proposed change in the respectful regardless of race, Professional Staff responsible • Access information contained in religion, creed, sex, age, handicap, for his/her care. his or her clinical records within a ethnicity, marital status, citizenship reasonable timeframe. The hospital • Know the reasons for his/her status, military service, pregnancy, must not frustrate the legitimate transfer either within or outside or sexual orientation. efforts of individuals to gain access the hospital. • Participate in the development to their own medical records • The relationship(s) of the hospital and implementation of his or her and must actively seek to meet to other persons or organizations plan of care. these requests as quickly as its participating in the provision of recordkeeping system permits. • Or his or her representative his/her care. (as allowed under state law) • Be free from restraints of any • Access to the cost, itemized has the right to make informed form that are not medically when possible, of services decisions regarding his or her care. necessary or are used as a rendered within a reasonable The patient’s rights include being means of coercion, discipline, period of time. informed of his or her health convenience, or retaliation by staff. status, being involved in care Be free from physical • Be informed of the source of planning and treatment, and being or mental abuse and the hospital’s reimbursement able to request or refuse treatment corporal punishment. for his/her services, and of any or services deemed medically Be free from restraint or limitations that may be placed unnecessary or inappropriate. seclusion, of any form, upon his/her care. imposed as a means of • Formulate advance directives coercion, discipline, • Informed of the right to have and to have hospital staff and convenience, or retali- pain treated as effectively ation by staff. practitioners who provide care as possible. in the hospital comply with Restraint or seclusion these directives. may only be imposed to • Be informed of the hospital’s ensure the immediate policies and procedures regarding • Have a family member or physical safety of the patient, visitation rights of patients, a staff member, or others representative of his or her choice including those setting forth any and must be discontinued at and his or her own physician the earliest possible time. clinically necessary or reasonable notified promptly of his or her restriction or limitation that the admission to the hospital. • Be fully informed of and to hospital may need to place on consent or refuse to participate such rights and the reason for • Personal privacy. in any unusual, experimental, the clinical restriction or limitation. • Receive care in a safe setting. or research project without A hospital must meet the compromising his/her access following requirements: • Be free from all forms of abuse to services. or harassment. Inform each patient • Know the professional status (or support person, where appropriate) of his or her of any person providing his/her visitation rights, including 2 care/services. any clinical restriction or privileges on the basis of race, • Voice a complaint and/or limitation on such rights, color, national origin, religion, grievance related to care or when he or she is informed sex, gender identity, sexual billing practices by contacting of his or her other rights orientation, or disability. under this section. the Caregiver, Department Ensure that all visitors en- Manager, Financial Counselor, Inform each patient (or sup- joy full and equal visita- port person, where appropri- tion privileges consistent or Patient Advocate. A written ate) of the right, subject to with patient preferences. submission of complaint may be his or her consent, to receive mailed to Memorial. The patient the visitors whom he or she • The patient’s family has the right or his/her representative may designates, including, but of informed consent for donation not limited to, a spouse, a contact the Illinois Department of of organs and tissues. domestic partner (including a Public Health at 1-800-252-4343 or same-sex domestic partner), • Consultation with the Ethics 1-800-547-0466 if hearing impaired. another family member, or a friend, and his or her right to Committee for assistance in withdraw or deny such consent decision-making support of ethical at any time. Not restrict, limit, concerns. Caregivers may initiate or otherwise deny visitation an Ethics Consult upon request. Your Procedure Day

Before arriving • Shower or bathe with antiseptic • Bring your glasses, dentures, hearing solution as instructed or with aids, and C-Pap machine (if you use at Memorial on antibacterial soap. one at night) on the procedure day. the day of your • Do not eat or drink (as instructed • Bring all your medications in prop- procedure, there by the anesthesiologist). erly labeled containers.

are certain things • Take your medications as instructed • Do not bring any valuables (money, you should do by the ATC staff. wallet, purse, jewelry). to prepare: • Wear loose, comfortable clothing. Be sure to arrive at Memorial at the • Remove all makeup, including time indicated by the ATC nurse or as lipstick, mascara, and nail polish. directed by your physician.

• Remove all jewelry and contact lenses.

• A parent or legal guardian if patient Family and/or friends may wait with Remember is under 18 years of age. you in your room until your procedure. to bring: • Someone to accompany you, so Please limit the number of family and they can drive you home. friends to two or three.

• A copy of your Advanced Directive or Living Will, if you have one, to be While you are having your procedure, placed in your permanent medical your family and friends may wait in the record. Outpatient Surgery Visitor’s Lounge. If • Your insurance card and driver’s your family and friends leave this area, it is license (if you have not been pre- important to inform the staff at the desk. registered). Wireless Internet is available in the Outpatient Surgery Visitor’s Lounge. 3 Complimentary Shuttle drop-off/pick-up locations include: Parking Lot The Orthopedic and Entrance A Memorial Care Center Neurosciences Center (Serving Medical Shuttle Office Center One, Main Entrance Entrance B Outpatient Surgery For the convenience of patients (Serving Medical Center, Cardiac and visitors, a complimentary Office Center Two Cath Lab, and GI parking lot shuttle is available and The Breast Health Endoscopy Center) Monday through Friday from Center of Excellence) 6:30 a.m. to 8:30 p.m. The shuttle runs a continuous Entrance D route through the north parking (Serving the South and lots — making six stops — at the Center Towers, Surgi- designated shelters. cal Waiting Lobby, and Sleep Disorders Center) Check In Prior to Procedure

Enter Building at Entrance A

Before your procedure, you need to check in at the Outpa- tient Surgery Visitor’s Lounge. The easiest way to get there is to park in the A entrance parking lot, enter the hospital through entrance A, and follow the signs to the Outpatient Surgery Visitor’s Lounge.

Memorial uses the Relationship Based All Memorial employees are seen as Care model for the foundation of all caregivers. We recognize that every- of our practice. This means that we are one on our team is vital in order to committed to discovering what provide you exceptional care and compassionate service—whether matters most to you and exceeding they are at the bedside or supporting your needs at every point of care. those at the bedside. Being in the hospital can be a stressful event and we believe through strong human connection you will feel safe and cared for by our staff. Your Surgery

Outpatient Anesthesia Surgical Suites

Surgery At Memorial, your anesthesia is Memorial’s surgical suites are provided by a board-certified anes­ equipped with the latest surgical Go to the Outpatient Surgery Visi­ thesiologist and certified registered technology. Everything has been tor’s Lounge (see map), and check nurse anesthetists (CRNAs) from carefully selected for the ability to in with the receptionist. You will Anesthesia Associates of Belleville. accommodate surgery that is as receive an ID bracelet to wear until These physicians are independent safe as possible. you go home. practitioners and are not Memo­ rial’s employees or agents. Your surgical team will include Most surgical patients will begin highly skilled, specialty-trained indi­ and end their surgical experience in Prior to surgery, you will meet with viduals. Your surgeon will lead team the Outpatient Surgery Center. All your anesthesiologist to discuss members, including registered nurs­ rooms are private and include which type of anesthesia is best es, certified surgical technologists, a television. suited to your individual needs. Your an anesthesiologist, and possibly an anesthesia plan will be discussed RN surgical assistant or physician Here you will be asked to change with you. You should be informed assistant, during your procedure.* into a hospital gown. Personal of the benefits and any risk associ­ belongings will be locked in a locker ated with anesthesia. Be sure to The temperature in the operating until you go home. An intravenous clarify any questions you may have. room may feel cool. Warm blankets (IV) line may be started in an arm There are several different types of will be provided to keep you com­ or hand vein before surgery by a anesthesia: fortable. Prior to your procedure, registered nurse. the nurse will begin to put equip­ • General anesthesia—The ment on you in order to monitor Surgery times are approximate and patient is completely asleep and your vital signs, heart, and lungs. may be earlier or later depending unaware of the surroundings. on the entire surgery schedule. • Regional anesthesia—Medi- * Occasionally, nursing students, allied health professionals in training, or manu- cation that numbs a specific facturer’s representatives may be pres- region of the body is admin- ent. If you prefer that they not be present, istered. One may receive ad- you may indicate that on your Informed for ditional medications for relax- Surgery Consent Form, which you will THANK YOU complete the day of surgery. allowing us to partner ation/sedation in addition to regional anesthesia. with you during this journey of healing. • Local anesthesia—Provides numbness at the specific We will care for you surgical site. with respect and an open heart.

5 Post-Operative Care Immediately after your surgery, you may be taken to the recovery room, also called the Post-Anesthesia Care Unit or PACU. You will be there for approximately one to two hours. After recovery you will be assigned a room in the Outpatient Surgery Center or to a hospital inpatient bed, should you need an extended recovery stay.

Pain Relief Talking About • What makes the pain worse? Is it worse when I lay down, You have the right to: Pain Relief stand up, walk, sit in a chair, read, sleep, eat, get dressed, • Facts and answers to your • Tell your doctor or nurse that move in a certain way? questions about pain and you are in pain. • Does the pain stop you when you pain relief. • Keep a diary with notes lie down, stand up, walk, sit in a • A sense your report of pain is about when and where your chair, read, sleep, eat, bathe, get believed by your doctor or nurse. pain happens. • A feeling the staff cares about dressed, move in a certain way? your pain. Here are some questions that • A quick response from your nurse you might try to answer when How to measure pain: or doctor when you report pain. One way to measure pain is to use you talk to your doctor or nurse 02468 10 • The best pain relief treatments about pain: a “pain scale.” One type of pain on hand. • Where is the pain located? Chest, scale asks you to pick a number NO HURfromT HURTS0 to A 10HURTS to A measureHURTS EVEN howHURTS A HURTS shoulder, neck, back, arm, leg, LITTLE BIT LITTLE MORE MORE WHOLE LOT WORST Ways you can help: foot, hand, head, or other. strong the pain is. Another scale • Ask your doctor or nurse what • How would you describe the pain? uses faces, from happy to sad, that to expect. Sharp, dull, aching, throbbing, pins match how the pain feels. Nurses • Talk about pain relief choices with and needles, or other. and doctors may also ask you your doctor or nurse. • Does the pain come and go, to describe your pain. No matter • Work with your doctor or nurse to or is it there all the time? which scale you use, give the best make a pain relief plan. • What makes the pain better? answer, so the treatment can help. • Ask for pain relief as soon as the Is it better when I lay down, pain begins. stand up, walk, sit in a chair, Below are two pain scales: • Help doctors and nurses measure sleep, eat, read, move in a 02468 10 your pain. certain way? • Tell your doctor or nurse about any NO HURT HURTS A HURTS A HURTS EVEN HURTS A HURTS pain that will not go away. LITTLE BIT LITTLE MORE MORE WHOLE LOT WORST

0 1 2 3456789 10 NO WORST PAIN POSSIBLE PAIN 6

0 1 2 3456789 10 NO WORST PAIN POSSIBLE PAIN Measures to Pain relief: Incision and • Medicines: Infants and children Relieve Pain are given almost the same Dressing Care medicines for pain as adults, • Medicines Your incision area will be cleaned just in different dosages. • A change in your position and properly dressed after surgery. • Being held or rocked • Balms Before you leave the hospital, a • A favorite blanket • Massages, back rubs healthcare team member will show • Teddy bears or other soft toys • Heat or cold packs you how to provide care for the to cuddle • A soothing bath area. Be sure you understand the • Pacifiers • Music to help you relax instruction sheet you are given. • Mobiles • Meditation • Music, lullabies • Something to distract you, • Toys, TV, games, or other things such as a game, puzzles, that might distract your child TV program, reading • Sucrose liquid Talk with your nurse or doctor about other ways to relieve pain. Recovery Communicate

The instructions you are given by and ask questions To the Parents of your surgeon and care team have of your care team Pediatric Patients been carefully calculated to aid in your recovery. You can assist in the regarding how ​Rights to pain relief: speed of recovery by doing certain you feel. Your child has the same right breathing and moving exercises in to pain relief as grownups. As a the recovery room. parent, you can play a big part in helping your child. You will be asked to breathe deeply and cough to help clear ​How to talk about pain: your lungs, aid circulation, ​​Tell the nurse if you think your and help prevent pneumonia. child is in pain. A hint may be if your child acts differently than It is important that your circulation usual. Also, tell the nurse about and body functions return to normal any words your child might say after your surgery. You can help or other ways they might express these processes by moving around, pain. This will be helpful to your sitting up in a chair, and even walk­ child’s nurse and doctor. ing, as indicated by your surgeon and healthcare team. Your child’s nurse will watch for changes that might be a clue that they are in pain. If your child is old ​Sources for Pain Section enough, the nurse may ask him/ ​The patients’ bill of rights for pain management, ​2000. Purdue Pharma L P, Norwalk, CT 06850-3590. Portions reproduced by permission. her to look at a group of faces that ​Peak Development for Nursing Assistants© ​— Acute and Chronic Pain. Peak Development Resource, LLC. measure pain. Sept. 2003; 3: No. 9. McCaffery M, Pasero C: ​Pain: Clinical manual, ​p. 67, 1999, Mosby, Inc. Duplicated by permission. Wong-Baker FACES Pain Rating Scale from Wong D L, Hockenberr-Eaton M, Wilson D, Winkelstein M L, Schwartz P: ​ ​ Wong’s Essentials of Pediatric Nursing,​ ed. 6, St. Louis, 2001, p. 1301. Copyrighted by Mosby, Inc. Reprinted by permission. 7 Going Home If you will be going home the same day as your surgery, you will return to the post-operative area in the Outpatient Surgery Center after the recovery room. Your healthcare team will do everything possible to facilitate your discharge. Please plan to spend most of the day at the hospital.

You will be given a list of post- At home it is important to be alert for un­ operative instructions. It is impor­ usual symptoms. You need to contact your tant that you fully understand them. surgeon/physician if you are experiencing Please ask questions if any of the any of the following: instructions are unclear. You may • Fever above 101.5˚ F want to ask specifically about some • Increased redness, swelling, and pain or all of the following: at incision site • Medications • Incision discharge that smells bad • Staples, stitches, and incision care • Incision opens or incision bleeding • Bathing and/or showering that seems to be more than should be expected • Pain and pain control • Side effects from your medication • Proper eating • Intolerable pain • Physical activity and exercise • Driving • Resuming sexual relations

Follow-Up Care Follow-up care, which is usually arranged with your Please call Memorial’s Outpatient Surgery Center surgeon’s office, is important to monitor your recovery. with any questions at (618) 257-5830, Monday through Friday 6:00 a.m.-8:30 p.m., or go to the The Outpatient Surgery Center staff will call the next busi­ nearest emergency department if you are unable to ness day after your procedure to see how you’re feeling. reach your physician or the Outpatient Surgery Center. Let the staff know if you are having any problems after your surgery, such as nausea, vomiting, or a fever. SURGEON ______The staff makes two attempts to try to contact you following your procedure. The staff will not leave a CONTACT INFORMATION message on your answering machine or voicemail ______unless we have permission.

Physicians treating patients at Memorial are independent practitioners. They are members of Memorial’s medical staff. They are not Memorial’s employees or agents. Understandably, Memorial does not control and is not responsible for their medical treatment decision. The information contained in this booklet is not intended to replace professional medical advice.

8 Our Brand Promise to You... Thank you for choosing Memorial Hospital.

e are committed to providing you and your family with Wexceptional healthcare and compassionate service.

You may receive a patient experience survey either in the mail or via email about your visit. We strive for excellence…your feedback is very important to us.

If there is someone who gave you exceptional service, please share that as well! Memorial has received MAGNET® status— the ultimate benchmark for measuring quality of care.

What does that mean for you? • We’re focused on excellent patient outcomes and experiences, like shorter hospital stays.

• MAGNET status attracts the best nurses in the field to care for you.

• Our Care Management Team coordinates your care among your physician, nurses, and anyone else directly involved in your treatment to address your unique needs.

• We provide you with superior education on disease process, medications, and more.

• Experts available for consultation are also outstanding resources for you.

• MAGNET hospitals nationwide have lower mortality rates. Memorial Hospital is the only hospital in the Metro East recognized with MAGNET status.

The Magnet Recognition Program®, ANCC Magnet Recognition®, Magnet® names and logos are registered trademarks of the American Nurses Credentialing Center. Journey to Magnet Excellence™, and National Magnet Conference® are trademarks of the American Nurses Credentialing Center. All rights reserved.

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