Patient Experience Day of Surgery

You will be admitted to Columbia University Medical Center as either an inpatient or a same day surgery patient.

• Same day patients are admitted the same day as their surgery.
• Inpatients are admitted a day or more before surgery.

Same Day Patients

As a same day patient, you will arrive at the Milstein Hospital Building Lobby 2 hours before your scheduled operation time. (For example, if your surgery is scheduled for 8 AM, arrive at Admitting at 6 AM.) Please be patient of possible changes in the schedule due to unanticipated emergencies.

We request that you be accompanied by either a family member or a friend. Security will direct you to the Admitting Office. From there, an escort will take you to the Operating Rooms on the 4th Floor.

Inpatients

If you are admitted to the hospital before your day of surgery, you will be assigned a room where you will spend the night. You will meet with a clinician that will discuss your surgery and also be visited by your surgical team, anesthesiologist and Cardiac Outreach Coordinator. The aim is to obtain the clearest possible picture of your medical needs while offering you a chance to get information about your treatment from a wide range of sources.

You will be asked a series of questions about any previous health problems or operations you may have had how you are feeling currently, and any allergies you may have to foods or medicines. Be sure to provide the exact names and dosages of all medications you are taking, including aspirin, cold medicines and vitamins.

The 4th Floor has everything you and your family need for the first day or so: Operating Room, Waiting Room and the Cardiothoracic Intensive Care Unit (CTICU).

Your family may wait with you in the Holding Area of the Operating Room until you go into surgery. You will be given a hospital gown to wear and asked to remove all clothing, makeup, all nail polish, jewelry, hair pieces and hair pins, dentures, hearing aids, eyeglasses and contact lenses. Any items not taken by your family will be inventoried and kept by security and returned to you after surgery.

Here are some of the questions most frequently asked by patients at this stage of their hospitalization:

Q: How long will the operation take?
A: The operation itself usually takes 3 to 5 hours, but preparation for surgery, administration of anesthesia, and preparation for the transfer to the CTICU extends the time in the operating room to 4 to 6 hours. In the operating room, time is required to insert intravenous lines and set up other equipment to monitor body functions and keep them functioning smoothly during surgery.

Q: How will my family know when the surgery is completed?
A: While the operation is in progress, your family can wait in the hospital waiting room (4th floor of the Milstein Hospital Building) or leave a telephone number where they can be reached. When the surgery is completed your surgeon will contact your family and inform them of your condition.

Q: Where will I be when I wake up?
A: Following surgery you will be brought to the CTICU, where you will remain for approximately 12 to 48 hours. Subsequently, you will be moved to either the stepdown unit or a regular bed on the surgical floor (5 Hudson North or 7 Hudson North).

Q: When will I be able to see my family?
A: Once you have been moved to the CTICU for recovery after surgery and comfortably settled, your family will be allowed in for a brief visit. The CTICU is located in the Milstein Hospital Building. It is recommended that your family not skip meals before visiting in order to maintain their well-being during the time you are in the CTICU.

Q: What are the visiting hours?
A: CTICU: 11:00 am to 6:30 pm and 8:00 pm-10:00 pm. General Surgical Floor and Stepdown (5 Hudson North or 7 Hudson North): 12 noon-8:00 pm

Q: How should my family communicate with the health care team?
A: It is beneficial to designate one family member or friend to maintain communication with your surgeon and the healthcare team. This will enhance the flow of information and decrease the chance for miscommunication.

All visitors must call the CTICU from the waiting room before visiting. Visitors may come two at a time and are limited to immediate family and significant others only while you are in the CTICU. A family spokesperson should be appointed in advance to make phone calls to the CTICU to check on your condition. This is the only person who may call the unit. This will help prevent disruptions in your care.

Operating Room

Here are some general things to expect once you enter the operating room:

• The operating room will be cold and have many bright lights, machines and instruments.
• The operating room team consists of 2 nurses, 2 anesthesiologists, a physician assistant (PA), staff running various machines, the surgical resident and your surgeon.
• Intravenous Lines (IV's) are inserted for medications, fluid replacement and blood pressure monitoring. After the first IV is inserted, the anesthesiologist may administer some medication to make you to feel relaxed and drowsy. The anesthesiologist will ask you to breathe into a lightweight mask and give you medication through your IV so that you sleep during surgery.
• A Foley catheter drains the urine from the bladder, via the penis or vagina, and is usually discontinued the second day after surgery.
• A Swan Ganz catheter is inserted through a vein in your neck, into your heart, and is used to measure volume status and pressure in your heart's chambers.
• A member of the operating room team will shave surgical sites to remove any hair.
• An endotrachael tube (ETT) is inserted into the windpipe through your mouth while you are asleep. This tube is attached to the ventilator that breathes for you during and after surgery.