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Hello, my name's Arthur Stephen and I’m one of the consultant Orthopaedic Surgeons
in the Trauma and Orthopaedic Department at the Derby Hospitals.
We've made this DVD to help give you extra information about your forthcoming hip surgery.
You'll soon be having your hip operation and it's very important that you read the book
that you've been given. We would also like to help you prepare for
the operation and your recovery afterwards by showing you the departments, what happens
there, the staff that would be involved, and some of the care you'll have before during
and after you stay in Hospital.
Pre Op Area.
You'll be asked to attend the preoperative assessment department.
Some patients, but not all, see an anaesthetist here and the surgeons; but all patients are
seen by the specialist nurses in the department. Here your general health will be assessed,
the nurses will records your details, tell you about the surgery and your pain relief
afterwards. They will take blood from you, answer your
questions and perform tests like an ECG. These are all routine tests and investigations
ready for your operation.
Hello, my name is Marie Boam I'm a care assistant and I work within the preoperative assessment
unit. My job is to do all your tests and assessments
before your operation. Some patients are asked to go to the therapy
department to be assessed by an occupational therapist who will decide with you what equipment
or help you might need at home after your operation.
The occupational therapist will also advise you on what you can and cannot do after your
operation.
Hello, I'm Julie Corby one of the occupational therapists.
You might be seen by an occupational therapist at your pre op assessment and perhaps at the
prehabilitation hip class, and certainly during your stay in hospital.
It's our job to make sure that you can manage your every day routine with your new hip.
Pre Habilitation Class.
Some patients, but not all, will have an appointment for a separate pre habilitation class.
If you're asked to come to this clinic the physiotherapist will show you how to use walking
aids, how to get in and out of bed, and will watch you practice.
You'll be given the crutches to take home and use before your operation and you'll bring
these into hospital with you. Being able to use these aids well and being
familiar with them is a very important part of making a speedy recovery.
At the pre habilitation class a physiotherapist will teach you some very basic hip exercises.
It's a good idea to practice these exercises before you come into to have your surgery,
as you will need to perform them everyday once you've had the operation.
I'm going to use Hilda now to demonstrate some of these exercises.
If you come across to the table Hilda and just hold on with your fingers.
When you're performing these exercises It's important that you're holding something safe
and secure just in case you were to feel a little bit wobbly and the exercises are only
for the operated side, so the side that will be having the surgery.
What I want you to try and do is keep your knee nice and straight and first of all we're
going to lift you to the operated leg out to the side away from you as far as you can
comfortably and then bring it back down again. We should aim to try and do it at least a
set of ten of these, within your comfort levels. Okay, so just have a go at doing a few.
Well done, and the main thing to be careful of is that you don't tip over, every time
that you're lifting you leg keep your body nice and central.
Well Done. Often before the surgery you loose the ability
to stand nice and straight and also to move your hip into what we call extension and so
this is an exercise is to make sure that we stretching out all of the muscles at the front
the leg. What I'd like you to do was to take your operated
leg back behind you and then back to the floor. Well done, and again while doing this one
try not to do dip forwards, but keep your body nice and straight.
Well done, that's great.
Also at this class the occupational therapist will explain the hip precautions you'll need
to follow after your operation.
You will also be seen by an orthopaedic outreach nurse who will talk to about your care, going
home, and will answer any questions you might have.
Hello my name's Judy Berry, I'm a member of the orthopaedic outreach nursing team.
We may come and visit you at home or we may give you a phone call once you've had your
operation done and you've left hospital.
Admissions Area.
You will come to an admission area on the day of the operation.
Nurses will check all your details, record your temperature and blood pressure, your
pulse and help you to get ready for the surgery.
Hello, I'm Jane Archer; I'm one of the ward sisters on the orthopaedic admissions unit.
And you’ll see myself or one of my colleagues when you're admitted to hospital, and we will
prepare you all ready for surgery.
The doctor will mark your skin to highlight the area of operation.
You might also be seen by the anaesthetist at that juncture.
"Right Hip, is that correct?" "That's correct.”
" Okay, right, now we had a good chat and went over things and do you have any questions
whatsoever that you want to ask me?"
"I don't think so, I think you explained it quite well to me, I don't think there’s
anything really."
"Okay, fantastic so the final thing to do really is that we need to draw an arrow, so
if you just stand up.” “I'm afraid it has to be a large arrow.”
"That's alright." "Okay, I shall see you a bit later; you can
have a seat again now." "Thank you very much, bye."
Theatre Department.
When it is time for your operation a porter will take you on a trolley or in a chair to
the operating theatre department. The receiving nurse will check with your details
with you again, and you will then go through to the anaesthetic room where the anaesthetist
will talk to you and give you medication.
"Hi, Mr Riley, Hello again.”
"So as I explained to you on the ward, the first thing we're going to do is pop a drip
the back of your hand, ok, we'll pop that in the other side.”
"And we'll swing your legs round and prepare your back, and pop this injection into your
back."
"Ok?"
"Ok."
Hello, my name's Dr Marval and I'm one of the Consultant Anaesthetists.
My role is to assess you for your operation. To obviously perform the anaesthetic and to
look after you during your operation to make sure everything’s nice and stable, and then
make sure pain control and symptoms like nausea are adequately controlled, to allow earlier
mobilisation to optimise your fast recovery.
You will then be wheeled into the operating theatre where the surgeon and theatre nurse
will be waiting for you. Many patients have a spinal anaesthetic where
you are awake but unable to feel any part of the operation at all.
If you wish however you can choose to have some sedation during the procedure so as not
to hear the operation taking place. Before the operation starts a large screen
will be put in place and the staff will work behind this for sterility reasons.
Once you surgery is over you will be taken into the theatre recovery ward.
Theatre Recovery.
You’ll stay in the theatre recovery area for a little while to make sure you are recovering
well from an anaesthetic and surgery, and to make sure the medication given to you is
controlling any pain you may be experiencing.
Extended Recovery Ward Area.
You might then go to orthopaedic extended recovery ward overnight.
Or you may be taken directly to the orthopaedic ward after leaving theatre recovery.
The nursing staff will record your blood pressure, check your wound and give you any intravenous
fluids known as drips you have been prescribed. They'll also make sure that your pain is well
controlled. Later on about six or eight hours or so after
your operation. If you are recovering well the physiotherapists
and perhaps the nurses will help you stand out of bed and take a few steps.
This will be repeated again before night time.
"How do you feel about taking a couple of steps?"
"Alright." "Take a couple of steps forward for me."
"Use your frame first." "That's it, brilliant same again, step into
it.”
Hello my name is Sharon Watters and I'm a staff nurse on the extended recovery ward.
Some, but not one of our patients, come here to recover particularly if they've had a long
anaesthetic or had previous medical problems. One they are medically stable they are transferred
to other orthopaedic wards.
Ward Areas.
On the first day after your operation your temperature and blood pressure will be recorded
regularly, and a doctor will examine you. If you have been in the extended recovery
ward you will be taken to one of the orthopaedic wards to continue your care.
A nurse will help you to wash and will check and dress your wound if required.
A blood test and an x-ray may be taken during this day.
You'll be helped out of bed by nursing or physiotherapy staff or both and you will walk
a short distance. The distance walked and the number of times
you are walked will gradually increase as you improve.
You may be able to go home on the first or second day after operation if your consultant
feels you have progressed well enough. Most patients will go home on the fourth day.
Hello my name's Emma Prince and I'm a staff nurse on one of the orthopaedic wards.
Hip replacement patients often continue their care on these wards until they're ready for
discharge. Often four days sometimes less.
Before you are able to go home the physiotherapist will ensure you are able to walk safely on
the level and on stairs.
An occupational therapist will assess if you can do all you need to do at home like having
a shower and will arrange any equipment or support needed that has not already been provided.
The doctor will make sure that all your medicines are prescribed ready for your discharge home.
The ward staff will arrange an appointment for you if one is needed from a district nurse
or an orthopaedic outreach nurse. Or at your health centre depending on which
is more suitable for you. You'll also be given an outpatient appointment
for about six to eight weeks time postoperatively to see your orthopaedic doctors.
Once you have been given everything you need to take home you will then go to the discharge
lounge to wait for your family or friends to collect you from hospital or to wait for
hospital transport if that was required.
After You Get Home.
Once you are at home you should continue with your exercises and walk as the physiotherapists
have taught you.
You
may be telephoned or visited by one of the orthopaedic outreach nurses after you get
home to check on your progress. You will return to the hospital about six
to eight weeks for your follow-up appointment.
Outpatient Section.
You will come to clinic to see the consultant or one of the team and sometimes an arthroplasty
practitioner. Someone who's special practice is with hip
replacement patients. By this time you should have recovered considerably
from your hip surgery and be enjoying an improved pain-free mobility.
Hi, I'm Claire Stevens I'm the Arthroplasty practitioner, I'm also an occupational therapist
by background. My special interest is in the long term function
of people who have joint replacements and you might see me when you come back to clinic
for your first post op check. We can have a good chat about how you've been
doing, and make sure you get to return to all the things that you want to do after your
hip replacement.
Thank you for watching this film. We hope you found the information useful but
should you have any questions please ask the staff at any of the department areas that
you will be attending before your operation or ask the staff on the wards once you are
admitted. Please bring the DVD back to the ward when
you are admitted and give it a member of staff so that it can be past to another patient.
I wish you a speedy recovery.