Patient Centered Care

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At St. Mary’s Regional Medical Center we deliver patient-centered care. In other words, the healthcare we provide is based on the needs of each individual. This care is guided by our mission.

Mission Statement
Our Mission is to continue the healing ministry of the Catholic Church in the Spirit of St. Marguerite d’Youville by providing preventive, curative, restorative, and supportive services with compassion and respect for everyone.

We commit to these values as guides to our decisions and behavior:

Respect
The intentional affirmation that all human beings are gifted with life and uniqueness and deserve to be treated with dignity.

Excellence
The deliberate effort toward achieving outcomes of the highest quality while striving for innovation and continual improvement.

Compassion
The individualized and personalized caring and comforting offered through our holistic presence as health care providers.

Stewardship
The responsible and accountable use of all our human, material, and financial resources.

Your Care—
All patients receive care and treatment based on the best and most recent advancements in healthcare. As an inpatient, you will have a team working together to assure that you receive the finest care available. You and your family members are the most important part of this team. We encourage you to ask questions and offer your opinions in your treatment and care. If you have any concerns about your care, we encourage you to contact your Patient Representative at 777-8208 or Risk Management at 777-8241. You may be referred to another agency if you desire.

Admission Information

Preparing for Your Pre-admission Testing (PAT) Visit

What should I bring?

• Social Security Number
• Insurance Information
• List of medications
• PAT Order Sheet from your doctor
• Any letter from your insurance company

Bring your insurance card, if you have one. To bill your insurance carrier(s) for services rendered, we will need the name of the carrier (company), their complete mailing address, your policy’s group number, and your personal identification number. If your insurance carrier requires a referral form, please bring it with you to your first appointment. If you are covered by Medicare or Medicaid, please bring the appropriate card as well. You will be asked to pay for services not covered by insurance (your co-pay and/or deductible). Please bring cash, check, or major credit card (Visa, MasterCard, or American Express).

Medical Records
If your visit is for a second opinion or on a physician’s referral, you may need to bring medical records, x-rays, results from lab tests, pathology slides, or other materials. Your physician may have sent these to us already. Be sure to ask your doctor before you visit here.

What should I bring for my hospital stay?

• Personal toiletries, bathrobe, slippers or socks.
• A list of medications you usually take.
• Your glasses, dentures, hearing aid, etc.
• Any instructions your physician may have provided.
• Your phone card for long distance calls. Local calls are free.
• Walkers, canes, crutches.

What should I leave at home?

• Jewelry or other valuables.
• SMRMC is not responsible for personal items.
• A lot of money or extra credit cards (you may, however, want a few dollars to buy a magazine or snacks).
• Hair dryer, electric shaver, radio or other electrical appliances.

Things to Remember During Your Stay

Our Visiting Policy
Your family and friends over 16 years of age are welcome to visit. Only two visitors are recommended in a patient room at a time so that you can rest and recuperate. Visitors should enter through the main lobby (Campus Avenue) entrance. Visiting hours and policies vary; please check the information provided in your hospital room.

Donating/Storing Blood
If your physician recommends, you may choose to donate and store a supply of your own blood before a scheduled surgery. You may also want to donate blood for family members or friends, if you have a compatible blood type. Call 777-8400 for more information.

Advance Directives
You have the right to make informed decisions about your health care, including right to refuse treatment. You also may give directions, in advance, about your wishes for healthcare should the time come when you cannot communicate yourself. If you have an advance directive, such as a living will or durable power of attorney for healthcare, please bring it with you at the time of admission. Our Chaplains or Social Workers can help you fill out these documents or answer any questions you may have.

Ethics Consultation
Some decisions about your healthcare or the care of a loved one who is very ill are difficult to make. In addition to speaking with your physician and healthcare team, you may want to consult with the Institutional Ethics Committee. Please ask your nurse to contact a representative.

Your Safety
At St. Mary’s Regional Medical Center, your safety is our priority. All the members of your healthcare team work hard to provide the safest environment and care. You are the most important member of the healthcare team! Listed below are five steps to safer health care:

1. ASK QUESTIONS!
   •Speak up if you have concerns. It’s OK to ask questions and expect answers you can understand.
   •Choose a doctor you feel comfortable talking to about your health and treatment.

2. MEDICATIONS
   •Keep a list of all medicines you take and bring with you when you come in to the hospital.
   •Tell your doctor and pharmacist about ALL medicines you take including over the counter medicines such as aspirin, ibuprofen, vitamins or herbal preparations..
   •Tell your doctor and pharmacist any DRUG ALLERGIES.
   •Ask about side effects of medications you are taking.
   •If the medicine looks different than expected ASK your nurse, doctor, or pharmacist.

3. TEST RESULTS
   •Ask the doctor or nurse when and how you will get results of tests and procedures.
   •Don’t assume the results are OK if you don’t get them back when expected. ASK your doctor.

4. SURGERY
   •Make sure you understand what will happen if you need surgery. You, your doctor, and your surgeon should all agree on exactly what will be done during the operation.
   •Tell the surgeon, anesthesiologist, and nurse if you have allergies or ever had a bad reaction to anesthesia.
   •Ask your surgeon “Who will take charge of my care while I’m in the hospital?”.
   •Ask your doctor “Exactly what will you be doing?”, “How long will it take?”, “What will happen after surgery?”, How can I expect to feel during my recovery?”.

What to Expect When You Have Surgery
This segment will provide you and your family with information about your hospitalization and our facility. It will give you an idea of what to expect before, during, and after surgery. The better you are informed about and involved in your own care, the better your recovery. Remember, you are the most important member of the healthcare team.

Before Your Surgery
When you are scheduled for surgery, you will be scheduled for Pre-admission Testing (PAT). Routine tests, such as an EKG, chest X-ray, urine test and/or blood test will be performed, and an interview with a Registered Nurse will be conducted. These tests give the doctors a “baseline” before you come to the hospital for surgery. As you are recovering, these tests may be repeated and the results compared to your pre-operative tests. You will be asked questions about your past medical history. Also, please bring us a list of your current medications. The more we know about you, the better we can take care of you.Before your surgery, your doctor will explain the surgical procedure, its risks, and its benefits. You will be asked to sign a legal consent form. It is helpful to write down any questions you have in advance, so you can ask the doctor these questions at this time. Family members are encouraged to be present when the surgeon visits.

You will meet a Pre-Admission Testing nurse at your appointment. The Anesthesiologist will meet and speak with you on the day of your surgery. Remember to discuss your allergies and any past surgeries with him/her. There are many different types of anesthesia, which the anesthesiologist will discuss with you. A certain type of anesthesia may be suggested, based on your general health, medications, preferences, and procedure. Your nurse will discuss other aspects of your surgery with you. Please ask her/him any questions you may have.

Morning of Surgery
You will be asked to call 777-8232 (Admitting Office) the day before your surgery to confirm when to arrive and where to go the morning of your surgery. There is a surgery waiting area (on the 1st floor)) in the hospital where your family may wait for you.

You will be asked to remove make-up, nail polish, jewelry, dentures, glasses, contact lenses, wigs, hairpieces, hearing aids, and hairpins prior to surgery. Please avoid powder, lotion, or perfume on the day of your surgery. You may bathe or shower with your regular soap before surgery. Please send any valuables home with your family (rings, watches, earrings, wallets, etc.), or ask your nurse to call security so they can be locked in a safe. The hospital cannot be responsible for lost or damaged valuables or personal belongings.

You will not be allowed to have anything to eat or drink from midnight on the night before your surgery. You may hear the term NPO, which means nothing by mouth. Follow any other special instructions your doctor or nurse gives you regarding your medications or procedure. About one hour before your surgery is scheduled, you will be transported to the preoperative holding room where an IV will be inserted. Once you are in the operating room, you will be asked to breathe oxygen through a mask, and the anesthesiologist will give you medication through your IV that will quickly put you to sleep. When you are fully asleep, surgery will begin.

When your operation is over, the surgeon will let your family know how you are doing and where you are. You may wake up in the POST ANESTHESIA CARE UNIT (recovery room). The nurses will be monitoring your blood pressure and heart rate frequently as well as checking your bandage/incision. You may have some oxygen over your nose until you awaken fully. The nurses may ask you questions and instruct you to take deep breaths and cough. This is to help remove congestion from your lungs and prevent pneumonia.

After Surgery
Your activity and diet after surgery will depend on your procedure. Usually, the doctors want you to get up as soon as possible, and the nurses or physical therapist will help you do this. DO NOT try to get up alone. You will increase activity slowly over the first day or two. Your IV will remain in place until you are able to drink liquids without any nausea or other problems. If the IV becomes painful, red, or swollen, please tell your nurse. You will be asked to wear surgical stockings (with or without a compression pump) to decrease the risk of blood clots while you are less active.

Immediately after your procedure, you may have a PCA (patient-controlled analgesia) pump that enables you to get a safe dose of pain medication through your IV with the push of a button. Later, you may take a pill for pain medication. Ask your nurse for this medication, it will not be given to you automatically. Keep your nurses and doctors informed about your pain. Waiting until the pain is very severe makes it more difficult for you to get comfortable.

Your doctor and nurses will give you instructions before you are discharged. You will be told about wound care or dressings, activity restrictions, and follow-up appointments. After discharge, should you experience a fever greater than 101 degrees, redness, drainage, severe pain, swelling, shortness of breath, nausea, or vomiting, please call the hospital immediately at 777- 8100. Ask for your doctor or the doctor on call.

Recovering From Your Surgery

Making the Best Recovery
This segment will provide you and your family with information you need to reduce complications during your hospitalization and to make the best recovery from your surgery. Your recovery will be quicker if you are involved in your own care and work with those health care team members who are trying to help you. Remember, you are the most important member of the health care team.

Post-Operative Activity Guidelines
After surgery, you may be uncomfortable and may have pain. It is important that you perform the following exercises:

Deep-Breathing And Coughing
Because of pain after surgery, patients often do not take deep breaths, causing mucus to collect in the lungs. By taking deep breaths, you will cough mucus out and prevent it from collecting. You should continue deep-breathing exercises throughout your hospital stay.

Deep-Breathing Exercises
The most comfortable position for taking deep breaths is on your back with the head of the bed raised a little. Breathe in through your nose and out through your mouth. Do each exercise 10 times each hour you are awake.

• Put your hand on your abdomen between your stomach and chest. Your hand should feel like it’s on top of an inflating balloon. Now let the air out through your mouth by relaxing.
• Put your hands on the sides of your chest. As you take a deep breath, try to make your hands spread away from each other on either side of your chest. Now let the air out through your mouth by relaxing.
• A plastic breathing device called a Triflo may be given to you after surgery. The Triflo has three blue balls inside a clear plastic box. You are to make the balls rise by sucking air into your chest as you would suck on a straw. The light blue ball will come up first, followed by the medium blue ball, and finally the dark blue ball. Try to hold up as many balls as possible, then relax, and let the balls drop.

Coughing Exercises
The most comfortable position in which to cough is sitting upright. Holding a pillow or rolled-up blanket against your stitches or staples may make coughing easier. When you cough, relax your neck and shoulders and cough from your belly, not from your throat. Bending your knees may also make coughing more comfortable. Cough two or three times then rest. Do not be afraid to cough. Your incision is firmly held together by stitches or staples.

Leg Exercises
Each exercise is to be done while lying on your back with your legs straight in front of you on the mattress.

• Keeping your legs on the mattress, draw circles with your toes, moving your foot at the ankle. Do this five times in each direction.
• Pump your feet up and down like you would press on a gas pedal. You can pump with both feet at the same time.
• Slide one foot up towards your buttocks and back down. Now do the same with your other leg.
• Keeping your knees straight, slide one leg at a time out to the edge of the mattress and back to the center.

You can stop doing these exercises when you start walking outside your room at least four times a day.

Moving In Bed
Any movement may be painful or uncomfortable, but moving in bed is very important. You should be changing your position at least every two hours to prevent your skin from getting too much pressure, which can lead to pressure sores.

Getting Out Of Bed
Getting out of bed may be difficult after surgery, but it is very important to avoid problems from inactivity. The first time you get out of bed you should have someone there to help you in case you feel dizzy or weak. Follow the steps here to make it easier:

• Roll onto your side, slide your legs over the edge of the bed, and push up with your arms. This puts less stress on your stomach muscles and uses the weight of your legs to help you sit up.
• To stand from the edge of the bed, push down with your arms and stand up. Stand still for a minute to make sure you are balanced and not dizzy. The first time you walk have someone with you for safety.
• If you continue to have difficulty getting out of bed or walking, the doctor may have a physical therapist work with you and/or your family on exercising or using an assistive device to help you walk.

Individualized Care
Your surgeon will give you more specific instructions regarding your post-operative activity/restrictions. Make notes and call with questions. At St. Mary’s Regional Medical Center, we see each patient as an individual with his/her own concerns. We also know that each situation and procedure is different. Please feel free to ask your doctor or nurse for more detailed information. We understand that you are concerned.

Pain Control After Surgery
This segment will provide you and your family with information about pain control during your hospitalization. Your recovery will be the best it can be if you are involved in your own pain management and you are as comfortable as possible after surgery. It is our goal to minimize your pain.

What Is Pain?
Pain is the sensation you experience after injury or damage, such as surgery or a trauma to your body tissue. The degree of your pain is whatever you tell us it is. We accept your report and try to make you as comfortable as possible. To help others understand the degree or severity of your pain, you can express pain by using the numeric pain intensity scale, rating it from 0-10.

Why Is Pain Control Important?
Pain control after surgery is important to your recovery. When your pain is controlled, you are able to speed your recovery by participating in your care, focusing on getting well, and avoiding problems that can occur after surgery. There are two types of pain control: medication and non-medication. After surgery, both types can be used to manage your pain.

Medications Used For Pain Control
Although there are methods of pain control that do not involve medication, many times medications are needed to make patients feel more comfortable. There are different types of medications that may be used for your pain control. There are also many different ways you can receive pain medication. The kind of surgery you are having will be a factor in the pain control choices you will have available to you. You and your doctor will discuss the ways your pain can be controlled.

Receiving Your Medication
PCA or patient controlled analgesia is pain medication administered through your IV. You press a button to obtain medication as needed. A special pump assures safe doses are delivered. If you receive medicine in this way, you will be taught how to use the pump to best control your pain.

An epidural involves a small tube inserted into your back by an anesthesiologist. Pain medicine is given through this tube continuously. A special pump delivers the medication in very small amounts.

Injections (shots) may be given to you at regular intervals around the clock to help control your pain. Please be sure to ask BEFORE your pain is 2 or greater on the 0-5 pain scale.

Medication can be taken by mouth as a capsule, tablet, or liquid when you begin to take liquids again. The nurse will give you your medication, which should be taken at regular intervals around the clock to control your pain. Be sure to ask for the medication when you feel it is time.

Non-Medication Pain Control
Non-medication pain control techniques can be used, with or without medication. They can provide you with some pain relief and increase the effectiveness of your medication.

Breathing Exercises
Breathing exercises can help you control your pain:

1. Breathe in slowly and deeply
2. Begin to breathe out slowly. You should be able to feel yourself beginning to relax and the tension leaving your body.
3. Now, breathe in and out slowly at a rate that is comfortable for you.
4. Imagine yourself in a calming and relaxing place.
5. Continue this exercise for up to 20 minutes.

Physical Agents

• Massage may be helpful after your particular surgery.
• Cold packs may help by reducing swelling and therefore reducing pain.
• Relaxation.

Your Part In Pain Control
Most pain medication is prescribed on an as-needed basis. It will not be given to you automatically. Therefore, be sure to ask for your pain medication as you need it. DON’T be afraid of becoming dependent on your pain medication. Dependency in such a short amount of time is rare. We want you to have as little pain as possible without any side effects. If you have any questions about how you are to receive your medication, feel free to contact any one of your health care providers to assist you and answer your questions. Let your doctor or nurse know if you are having any side effects from your medication such as itching, nausea, constipation, vomiting, or drowsiness. Information on your medication is available to you on request.

Planning For Discharge
It is important to plan ahead. You will need transportation home, and somebody to assist you with meals and household duties for the first few days. You may need the assistance of home health nurses or a short stay at a recovery facility.

Updated: 3/21/03