Even though cosmetic surgery is elective, the need to prepare for the post-operative healing journey is as critical as it is with any other surgical procedure. Medical experts agree that undergoing cosmetic surgery is not “a walk in the park” and should be taken very seriously to make sure that there are no issues with post-operative recovery, as well as to ensure optimal healing. In this exclusive interview with Aesthetic Insider™, Amanda Richey, RN and Michael Freyer, co-founders of oveRNight RN a leading post-operative healing company, discuss the importance of professional round-the-clock nursing care for the first 24 hours following any cosmetic surgical procedure. While only a small percentage of patients may experience a minor or major issue following cosmetic surgery, how that medical problem is managed is crucial to the patient’s overall health, as well as to the ultimate surgical result. This interview discusses the potential complications that can arise in the first 24 hours following surgery, and how the expert nursing team at oveRNight RN are prepared for these and many other clinical challenges. oveRNight RN offers unparalleled aftercare and healing support through its specially trained Enhanced Postoperative Care Nurses to improve surgical outcomes, advance healing progress, and ease the surgical experience for both doctors and patients. To learn more, visit www.overnightrn.com.
Amanda, what inspired you to start oveRNight RN?
I’ve been a surgical nurse for over 10 years primarily in the post-anesthesia recovery unit area. I began my career as a nurse in the US Navy and then worked at UCLA Medical Center, Kaiser, Sutter Health, Stanford and a vast array of highly reputable medical facilities. I found that there was always a common theme at each place I worked – the patient never felt ready to go home without a nurse following their outpatient surgery. Many people come into surgery thinking that the hard part is over when they’ve made it to the surgery center or the hospital where they can relax and let the medical professionals take over. However, I’ve witnessed firsthand, time and time again, that the hard part is actually when it’s time for patients to leave and they feel that they inadequately prepared for this stage of their surgery. I came to learn that whether a patient is undergoing heart surgery or a facelift, surgery is surgery and they need a solid medically supervised after-care plan for at least the first 24 hours.
Why do you think many aesthetic patients are not adequately prepared post-surgery?
I think most patients are prepared for the post-operative healing process and understand what to expect in terms of bruising, swelling, healing, no heavy lifting, light exercise, etc., but many of them underestimate the importance of having qualified expert care during the first 24 hours as they are coming out of anesthesia. We all know that anesthesia can bring nausea, vomiting and pain, but there are also many other things that could occur during that first 24 hour period that can lead to major complications if an experienced medical professional is not on hand. In the case of cosmetic surgery, many patients go home with a friend or family member who will take very good care of them but may not know how to handle a hematoma should one occur, or whether drains placed after a facelift are draining at the correct rate. I’ve seen what began as a minor wound irritation turn into a major infection because the caregiver or patient did not know what to look for in terms of the progression of the infection. Most non-medically trained people have a hard time discerning what is expected and what is not. They may see fluid, blood, or puss coming out of an incision and feel the need to do something about it. Sometimes our bodies naturally produce a clear, reddish fluid or serosanguineous drainage and swelling and knowing if that is normal, or that it is an indication of an infection or hematoma is really something only a trained, experienced nurse or doctor can diagnose.
Have patients ever asked you to go home with them following cosmetic surgery?
Yes! All the time which is the reason why we started oveRNight RN. Over the course of my career I have literally had hundreds of patients beg me to go home with them as they felt so secure with my level of care during surgery. I would tell them that they were ready to go home, and that they were in good hands, but I knew they wished I could go with them. Now, however, as there are a growing number of patients undergoing more invasive surgical procedures, it is obvious that their aftercare needs go beyond that of a responsible adult and into the realm of expert qualified medical supervision. It all started when one day a patient asked me to go home with them and I thought to myself, “Well you know what why can’t I be the nurse that goes home with them? Why can’t they have a nurse? Why is it our practice to perform outpatient surgery and send people home with an inexperienced companion and just hope we’ve given them all the information and instructions necessary for safe healing without being able to guarantee it?” That’s where I got the idea for oveRNight RN. Placing a nurse in the home to answer all of the questions and to intercept when medically necessary gives everyone, doctor and patient, peace of mind and a safer path to healing and recovery.
Michael, are there any statistics of how many patients go home alone after surgery, or go to an empty house?
There’s no absolute figure on that, but I can tell you what it should be, that is zero. Actually it’s a national medical requirement that if someone has outpatient surgery or any kind of surgery at all, they must be accompanied by a responsible adult when they are released. For example, the American Association for Accreditation of Ambulatory Surgery Facilities states that a minimum of 12 to 24 hours of support by a responsible adult is required depending on the type of procedure the patient has, or the type of anesthesia used.
How long should an RN stay with a patient following a cosmetic surgery procedure?
There is no requirement that says a patient must recover with an RN but we have found that many patients and doctors prefer a nurse be with the patient. We offer several levels of service time beginning with a four-hour stay for a minor cosmetic procedure, to a round-the-clock 24 hour stay for more invasive procedures such as when the surgeon may have placed drains, or given the patient immediate post-operative instructions that they need help following. We have patients who have multiple procedures such as a blepharoplasty, facelift and a brow lift that requires specialized care such as keeping their eyes moist, applying eye drops or specialized creams. Occasionally we find the need to stay with a patient for up to 36 hours. There has been the occasional incident where a patient has had a bad (psychotic) reaction to medication and while that is rare, it is really only something a qualified RN can manage.
Do doctor’s ever experience last minute surgery cancellations because a family member or friend has dropped out and cannot help the patient with post-operative recovery?
Yes. This happens quite frequently. One of the main reasons plastic and cosmetic surgeons prefer the services of oveRNight RN is because they have experienced cancellations and last minute problems in the surgery center because the person recovering the patient has a last minute emergency of their own. With oveRNight RN, the doctors know that their patient will not need to cancel surgery, will have a safe ride home and that they are recovering with expert care and guidance, which ultimately contributes to a better result.
Is it the doctor’s responsibility to make sure the patient has someone to care for them following surgery?
All of the doctor’s we know and work with ensure that every patient has a responsible adult take them home. However, surgery is elective and once the patient leaves the facility they are in the hands of the person they have designated to take care of them and the responsibility is theirs alone. Of course, most doctors remain on call following surgery, and many will telephone the patient later that same day to check their progress, but ultimately the responsibility lies with the patient.
Why do people think having cosmetic surgery is easy?
Having a plastic or cosmetic surgery procedure is a choice generally made by a healthy individual. It is not necessarily a required or needed surgery and is often viewed as less important than other surgical procedures that are medically necessary. Therefore, it is perceived that it must be much easier to recover from. Patient education is very important in all facets of surgery but, in my opinion, even more so in the cosmetic medical arena. Most aesthetic practices provide pre-and post-operative instructions but each patient is individual, as is their recovery. There have been a handful of highly publicized serious issues that went wrong following cosmetic surgery and in most cases the patient was recovering alone, or their care giver had left for a short while. It is not always the cosmetic surgery procedure that is the problem either. It could be a heart issue, blood pressure, infection, hematoma or other health issues that go beyond the capabilities of a friend or family member.
Michael, how qualified are the team nurses at oveRNight RN?
The team nurses at oveRNight RN are all qualified Registered Nurses specializing in pre-and post-surgical care. They work recovering patients anywhere from 4 hours, 6 hours, 8 hours, 12 hours, 24 hours plus, depending upon the patients’ needs. They are career nurses who work directly under the physician’s orders, and work with the surgeon to prepare the aftercare plan, as well as to make sure it is followed. Most doctors give patients lengthy discharge instructions and it is important that they get followed. Our nurses are trained in doing that.
How does an oveRNight RN team nurse work with a doctor’s office?
When a surgeon recommends us to one of their patients, we offer a free consultation to learn what level of care is required for their specific needs. We meet with the surgeon to discuss the procedure, obtain details on anesthesia, go through the patient’s medical history and map out their care plan. Learning about the patient’s medical history is important as not everyone is perfectly healthy. Some people may have hypertension or a history of diabetes for example. We work with them to manage everyone’s expectation so we can plan for a safe and fast recovery.
Amanda, does oveRNight RN benefit the surgeon too?
Yes. oveRNight RN benefits the surgeon in many ways. The most obvious is that they can rest easy knowing that their patient who just had a very complex surgery is recovering safely under the guidance of an expert. Like most people, surgeons are tired at the end of a long work day and want to go home and rest up. When their patient is recovering with one of our nurses they know that the patient will return the next day and will have experienced an optimal first 24 hours of healing. Should the doctor receive a call from one of our nurses, it will only be if important updates need to be addressed. Of course, our leading standard of care brings about better healing so that the cosmetic result for the patient will also be better, which is an added bonus. We are also finding that up to 50% of plastic surgery patients go back to the same surgeon for another procedure after recovering with oveRNight RN because they have had such a positive post-operative experience.
To learn more about oveRNight RN, visit www.overnightrn.com. Or call 415.365.0018.