Over the last ten years or more, aesthetic surgery procedures have increased over 500%. In addition to this unprecedented increase in patient volume, it is also notable that patients are taking more time to educate themselves about plastic surgery.  All surgeons know that a successfully performed procedure can be dramatically and negatively impacted by poorly managed post-operative care and patients are frequently asking important surgical and non-surgical questions about post-operative recovery options.  This interview at Aesthetic Insider™ with Amanda Richey, RN, co-founder of oveRNight RN, a leading post-operative healing company based in San Francisco, CA., and Clinical Coordinator Madeleine Salada, discusses the importance of hiring qualified professional nurses with specific experience caring for plastic surgery patients, as well as patient expectations and frequent problems that may occur during the first 24 hours following any cosmetic surgical procedure. To learn more, visit www.overnightrn.com. 

Amanda Richey RN of oveRNight RN

Amanda, what is oveRNight RN?
oveRNight RN is a company that focuses on pre-operative and post-operative care.  We have a large experienced nursing team that works directly with aesthetic surgeons to provide additional nursing care and recovery to their patients. I found during my time working as a recovery nurse that a lot goes into preparing a patient for surgery, as well as after surgery, and that includes staying with a patient while they recover in the comfort of their own home if necessary. It’s generally easy for a plastic surgery patient to have someone drive them home after their procedure, but they do not always realize how difficult their recovery might be, so sending in an oveRNight RN nurse to care for them during the first 24 hours following a procedure is very beneficial to both the doctor and the patient.

What is the ideal length of time for an oveRNight RN nurse to stay with a patient after surgery?
It all depends upon the extent of the procedure or surgery. Our nurses are available for short stays of four hours for less invasive procedures, all the way up to twenty-four hours or more for facelifts and multiple body procedures.

Amanda and Madeleine, what qualities do you look for when hiring a great RN?
Amanda; It’s important that nurses applying to oveRNight RN have peri-operative experience, by that I meant that they are experienced being around the whole surgical journey including pre-operative and post-operative care. We look for career nurses that are well-rounded in their experience, have critical thinking skills and have dedicated themselves to total patient care.

Madeleine; It’s vital for the nurses that work for oveRNight to have a comprehensive skill set. We have a vetting process based on a high level of expert care, qualifications, experience and integrity. It is also important that they are team players, have experience recovering elective surgery patients and can think on their feet so to speak.

Madeleine, are there any particular or more specific qualities required of an oveRNight RN nurse?
Yes. Most aesthetic surgery procedures are performed in an outpatient setting and the plastic surgery patient is choosing to have surgery. They are not patients that are ill so that makes a big difference because this type of patient does not always realize that there is pain and/or bruising involved and more often than not, are not prepared for any discomfort. Our nurses have to understand the expectations of this type of patient and how best to manage them in order for them to have a safe recovery. Pain levels are especially important to address. It has been our experience that as long as we can set a realistic scope of what’s going to happen, then the patient will have a great understanding of what to expect during their recovery and have a great experience and surgical result. Therefore, patient education is key and we expect our nurses to be able to properly educate and care for the patient both pre-and post-operatively, as well as be equipped to handle an emergency should one arise.

Amanda, do you feel patients are naive when it comes to plastic surgery?
I wouldn’t say naive, more uninformed.  Plastic surgery is not considered as threatening as other necessary surgeries such as brain surgery or heart surgery, therefore many patients don’t really think about pain or potential danger when they book a cosmetic procedure. They just think about looking better. Then, when there is a complication, or infection and pain, they are often upset and surprised.  At oveRNight RN we make sure that all the patients we recover have a good understanding of what to expect before and after surgery. This makes for a much happier and safer recovery.

Is it the doctor’s responsibility to educate a cosmetic surgery patient?
I really believe it is the responsibility of both the doctor and the patient to be as informed as possible when it comes to plastic surgery. As mentioned, cosmetic surgery patients are choosing surgery so it’s up to them to know as much as possible about the possible consequences and concerns prior to undergoing surgery.  Most of the aesthetic surgeons I know do a great job of providing the patient with a variety of educational tools. Also, many of the aesthetic organizations such as the American Society of Plastic Surgery (ASPS), the American Society of Aesthetic Plastic Surgery (ASAPS) and the American Academy of Facial Plastic Surgery (AAFPRS), to name a few, have developed comprehensive educational tools for patients such as what is available on their websites and in brochure form.


Madeleine, do you see any gaps when it comes to patient education?
I wouldn’t necessarily say there are gaps, however, when a patient consults with a doctor for any reason they often get overwhelmed with all the information the doctor provides. This can create a real disconnect as they only hear a portion of the instructions given, then they go home and forget about much of it. This is where a qualified nurse from oveRNight RN can step in and follow up. We make sure that the patient is given the right documentation about their procedure of choice, as well as instructions pre- and post- surgery which includes everything from making sure they have transportation home following surgery, all the way to the necessary ice-packs, pain medication, etc.

How often do you encounter an unprepared patient?
Unfortunately, too often.

What is the number one area that the patient is most unprepared?
Due to the nature of plastic surgery mostly being elective, many patients view it as being easy when in reality surgery is surgery. So they are often inadequately prepared for their post-surgical care and that sometimes includes having someone drive them home, and stay with them for the first 24 hours.

Amanda, what happens when a patient does not have an adult to drive them home following surgery?
In all good conscience, as the recovering nurse, I cannot allow surgery to go forward. This, of course, has huge consequences to both the doctor and the patient. For the doctor, it could cost upwards of $5000 in out-of-pocket surgical facility fees, anesthesia and nursing care fees, etc. For the patient, it can mean loss of time from work, etc.

Potentially, what can go wrong if a patient recovers alone?
Well, anything really. The worst, of course, being incidents of death due to patients being left alone. From time to time, the media reports stories about patients who have had a psychotic reaction to medication and committed suicide, or had other major reactions such as cardiac arrests. Although these events are not the norm, they can happen and this is of course absolutely the time when you want an experienced RN.  There are also many small incidents that can impact and reverse a patient’s recovery such as the patient not following instructions to refrain from strenuous movement and as a result ripping sutures that will then require an urgent, unscheduled visit to the doctor’s practice, even occasionally requiring an additional expensive return to surgery to repair the damage. From my perspective prevention is an important part of recovery.

Does it make sense for a doctor to hire an on-staff recovery nurse that can home with a patient following surgery?
No. Nurses are paid high hourly rates and the doctor would need one on-staff nurse for every patient that they perform surgery on. It is much more cost-effective for them to use the services of oveRNight RN as our per nurse/per patient fees are low in comparison and many of the patients we work with are happy to add this additional cost to their surgical plan as they understand that the continuum of care is important to their overall result.

To learn more about oveRNight RN, visit www.overnightrn.com.

To listen to the oveRNight RN interview at Aesthetic Insider™ Radio, CLICK HERE!


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