In honor of Scoliosis Awareness Month, clinical manager Jennifer Bowden, R.N., joined us on Facebook LIVE to discuss the most frequently asked questions about scoliosis. Below is a recap of the conversation.

Watch the live segment. 

What is the difference between an ambulatory care and inpatient nurse?

• An ambulatory care nurse, also known as clinic nurse, is the nurse a patient will see when he or she has a clinic visit.
• An inpatient nurse takes care of the patient once out of surgery.

At an initial appointment for scoliosis, what can a patient expect? 

• The patient is seen by their doctor and clinic nurse. They could also be evaluated by a physician’s assistant or fellow/resident.
• If the patient does not have X-rays on file, it is possible that they may be sent to radiology to have those taken.
• The doctor will complete a clinical exam to check for scoliosis.
• Depending on the outcome of the clinical exam, X-rays are checked if there are concerns regarding a potential curve in the back.
• The doctor will give the patient a time frame of when he or she needs to come back for another visit.

Scoliosis Surgery 
Who do the parents contact if they have questions about surgery?

• Clinic nurse
• Families are encouraged to call with any questions they may have at any time.
• Our staff encourage parents/patients to write down any and all questions.

While a patient is in surgery, where does the parent/guardian wait?

• Patient will be assigned a room on the inpatient unit – parents can wait in that room.
• Surgery waiting area is on the 4th floor – quiet and away from hustle and bustle
• Cafeteria – on the C level by the A elevators
• While the patient is in surgery, the parent/guardian must stay inside the hospital at all times.
• Each parent/guardian is given a pager to be notified/updated regarding the progress of the surgery.

Most common updates during surgery

• It takes about an hour to get the patient prepped before surgery actually begins.
• The parent/guardian is updated when the surgery actually begins.
• Updates come every one to two hours
• Parents are notified when the patient is being closed up.
• When the surgery is complete, the surgeon will call and speak to the parent.

What does the admission process for spine surgery look like?

• Most spine patients check into the hospital the day before surgery.
• Labs and X-rays are taken, if needed
• Clinical photos are taken so that the patient can remember what he or she looked like before the surgery.
• The patient and their family are able to meet their care team:
  • Inpatient nurse
  • If needed, a child life specialist and physical/occupational therapist
  • OR nurse
  • Anesthesiologist

What happens after surgery?

• The patient will be in recovery (PACU) for half an hour to an hour or longer.
• Once the patient is awake and the breathing tube is removed, the parents are called to see their child in recovery.
• Parents are escorted to the patient’s room and the recovery nurse will take the patient to their room.
• Recovery nurse will give the inpatient nurse a report on the child.

Who is the patient seeing after surgery?

• Inpatient nurse
• Patient care techs
• Doctors
• Residents and fellows

Pain management after surgery

• Education on pain takes place before surgery
• Really sore and still after surgery – the nurse teaches the patient how to assess their pain

Will the patient wake up during surgery?

• No, the patient is fully asleep during surgery.
• Anesthesia is given to the patient to keep them asleep
• The patient’s spinal cord wil be monitored throughout the duration of the surgery.

Movement after surgery

• Physical or occupational therapy can be part of the process after surgery, if needed.
• Nurses help patients get out of bed.
• The nurse will teach the patient how to roll over, prop themselves up and turn over.
• The care taker at home will also be taught how to help the patient get out of bed and move around safely.

Going home after surgery

• Pain is under control
• Incision looks good
• Patient is up and moving
• Eating and drinking – no vomiting
• Bowel movement in the hospital – biggest problem after this surgery is constipation and gut issues

The drive home from the hospital: Is there a certain set up needed in the car? 

• Every patient is different
• Take pain medication close to when departing the hospital
• Most patients like to recline in the car seat versus sitting up straight.
• The nurse will help the patient down to the car and will make sure they are safely situated inside the car.
• Every hour to two hours, we recommend the patient to get up and move/change positions.

Specific bed set up at home

• No restrictions on the bed setup at home
• If the bed is upstairs, recommend sleeping somewhere downstairs
• No hospital bed is necessary
• Some patients like being in a recliner, instead of lying flat

Incision care

• Nurses educate parent/guardian on how to change the dressing covering the incision.
• No creams or lotions on the incision until told by your doctor.
• A nurse will provide the parent with supplies to change the dressing.
• No soaking the incision, showers only – do not want the incision under water because it could cause an infection
• After shower, remove the dressing, pat area dry and then apply a new dressing

Will the patient have a scar from surgery?

• Yes, a long and thin scar down the middle of their back.
• If well taken care of, it will flatten out and look like a faint pencil mark down the middle of the patient’s back.
• For at least two years after surgery, it is recommended that the scar be covered with sunscreen or a shirt when out in the sun.