Day of Procedure at the Hospital
Arrival to the Hospital
- Pregnant patients having a planned C-section arrive to Women’s Center entrance of the hospital for registration.
- Patients having a heart or vascular procedure arrive to the NC Heart and Vascular Hospital entrance.
- Patients other than the above patients arrive to the main entrance of the hospital for registration.
- If you have questions about what time to arrive for your procedure, call your doctor’s office. They will notify you of any changes to your procedure or arrival time.
- Bring your picture ID and your insurance card(s). You will need these to complete the registration process.
- Copays will be collected at registration, if indicated by your insurance. If you have questions, please call 984-974-2222.
Waiting Areas
Upon entering the waiting room, visitors should check in with a Guest Services representative at the front desk to confirm arrival. Status tracking boards in each waiting area follow the progress of the patient's procedure in real-time. Visitors accompanying patients the day of their procedure will be updated via text messaging and/or phone calls at various stages of the procedure.
Bringing a jacket or sweater is suggested, as waiting rooms may be cool, and also pack items to pass the time, such as books or devices. Dining options include the Courtyard Café located in the Main Hospital on the first floor, and Kardia Cafe in the North Carolina Heart and Vascular Hospital first floor, both offer options for food and drinks.
The visitation restrictions at UNC Health Rex are subject to change, please be sure to check before planning who will wait with a patient having a procedure. Free Wi-Fi is available under the network name "Guest-UNCHealth." Please check in with reception if leaving the waiting area, to allow for continued timely updates.
Preoperative Area
Once registration is complete, you and your family will wait in the waiting area. Then you will be escorted to the preoperative area where your nurse will prepare you for your procedure. Your family will join you once your preparation is complete and wait with you until you go into your procedure. A parent will accompany all pediatric patients. You will be asked to remove all clothing, undergarments, and jewelry and change into a gown. We will provide a belongings bag, which your family will keep with them during your procedure. If needed, there are lockers available. We will provide you with a warming blanket, but if you are cold, please let your team know.
Our safety protocols include checking your name, date of birth, procedure, and location for your procedure multiple times. Your anesthesia and nursing teams will also repeat the review of your medical history and medications, this too is for your safety. Your blood pressure, heart rate, and oxygen levels will be checked and an IV started. You will meet with your procedure and anesthesia teams and have time for any questions you may have. Once you confirm you understand the information you have been told about your procedure, anesthesia, and risks, and have no more questions you will read and sign one consent for your procedure and one consent for your anesthesia.
UNC Health Rex strives to keep on schedule, each and every patient is given the time and attention necessary to ensure proper preparation and a safe procedure, therefore waiting times are not exact. We will let you know as soon as possible if an unexpected event causes a delay and keep you as comfortable as possible if you and your family must wait longer than initially anticipated.
In the Procedure Area
You will be met in the preoperative area and taken to the on a stretcher by your care team. A Certified Registered Nurse Anesthetist (CRNA) and procedure room nurse will be with you throughout your procedure. Once you are in the room there will be several other team members including the doctor performing your procedure present to ensure your procedure is safe and successful.
The entire team’s focus is your safety and comfort. If at any time you are uncomfortable or have questions, please let your team know. When you enter the room, you will notice the lights are bright and the room may feel cold, but you will be provided a warming blanket and talked through every step. The entire team will ensure your safety by once again verifying your name, date of birth, correct procedure, and correct site for the procedure. You will be attached to several monitors to constantly track your blood pressure, heart rate, and breathing. Safety measures include surgical site infection prevention.
Surgical Site Infections (SSIs)
An SSI is an infection of the part of the body where surgery was performed. Most patients do not develop an SSI, nationally 2-5% of patients having surgery will develop an SSI. At discharge, all patients receive education on common signs and symptoms of SSIs which include:
• Redness or pain around the surgery area
• Tan, brown, or white fluid draining from the surgical wound
• Fever
Most SSIs can be treated with antibiotics. Rarely surgical site infections require another surgery to treat the infection. At UNC Health Rex we are committed to your health and wellbeing. Here are a few things we do to prevent the site of your procedure from becoming infected.
SSI Prevention - What We do:
• We clean our hands with soap and water or an alcohol-based hand gel before and after caring for each patient.
• We will use clippers, not a razor, to remove any hair near your surgery or procedure site.
• Your surgical team will clean/scrub their hands and arms with antimicrobial soap and wear hair covers, gowns, masks, and gloves in the operating or procedure room.
• We will clean your skin at the site of surgery with a special soap that kills germs.
• We will likely give you antibiotics before, during, or after your procedure.
SSI Prevention - What you can do:
• Wash your hands! Before and after you eat and after using the bathroom.
• Shaving with a razor can irritate skin and make infections more likely. You should not shave the surgery area for 24 hours prior to surgery.
• Encourage your visitors to clean their hands on arrival.
• Stop smoking, smokers are more likely to develop an infection.
• Call your doctor if you develop any of the signs of infection listed above.
Anesthesia During Your Procedure
What is Anesthesia?
Anesthesia is used to manage pain during surgery or procedures. There are a few different types. You will meet with the anesthesiologist prior to surgery to discuss which type will be used for you during your procedure.
What determines the type of anesthesia that is best for you?
- Past and current health
- Type of procedure
- Results of blood test, EKG, and other health studies
Types of Anesthesia
General Anesthesia
- Administered through an IV or a mask.
- You are unconscious and have no awareness or other sensations.
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Possible Side Effects: Nausea and vomiting, Metallic taste, Sleepiness, Sore throat, Shivering, Dry mouth
Monitored Anesthesia Care (MAC)
- Sedative medicines administered through your IV, which may make you drowsy or fall asleep.
- You are not unconscious but may not remember your procedure.
- Possible Side Effects: Nausea and vomiting, Sore throat, Sleepiness
Regional Anesthesia
- Blocks sensation of pain to a portion of the body.
- First, you may be given medicine through your IV to help you relax.
- Then, anesthesia is injected around specific nerves to block pain.
- This medicine may keep you pain-free or lessen the pain for up to 72 hours.
- Possible Side Effects: Headache, Back pain, Difficulty urinating
In the Recovery Room
After surgery you will be taken to the recovery room (PACU) by your procedure room nurse and your CRNA. The type of anesthesia you receive, and your procedure will determine if you recover in phase one or two PACU, or occasionally the intensive care unit (ICU). The doctor who performs your procedure will speak to your family or representative while you recover. The amount of time you are in recovery depends the type of anesthesia and your procedure, but also how you react to anesthesia, because everyone reacts differently.
As you wake up you will likely have oxygen on your face to support our breathing and be attached to several monitors to measure your breathing, heart, and blood pressure. Your nurse and anesthesiologist will work together as a team to manage your pain in the recovery room, please see the link below to learn more about pain management after procedure.
If your representative/family member shares their cell phone number, they will be notified throughout your procedure and recovery of your progress by text. If they prefer phone calls, they can let your preoperative nurse know. Your PACU nurse will update your representative/family within one hour of arrival to recovery. Visitation in recovery may be allowed but depends on activity and safety in the overall recovery room. Phase one recovery is for patients who need to be monitored more closely due to the type of anesthesia and surgery; visitation in this phase is more limited. Patients in phase two recovery are more awake and visitation in this phase is encouraged. If you are going home the day of your procedure, in phase two your nurse will get you ready to go home and give you and your representative/family instructions for your care at home. If you are staying overnight, your representative/family will be notified of your room assignment by the waiting room team. Once you are in your room, your family can visit. Depending on the time your procedure is complete, occasionally patients are cared for overnight in the PACU.
If you have any unusual situation or special visiting request, please have your family ask waiting room team to connect them with the PACU charge nurse or relay the details of your situation to the charge nurse. We will accommodate your special needs if at all possible.
We are committed to providing you excellent, safe, and compassionate care and to making the day of surgery as smooth as possible for you and your loved ones. Your recovery team will communicate to you and your family about your progress throughout your time with us, the lines of communication are always open.
Pain and Nausea Management
Nausea may be a side effect of anesthesia. Please tell your anesthesiologist if you have had nausea in the past after receiving anesthesia (or just nausea in general). Medicine can be given before and/or after your procedure for your comfort. If you are experiencing side effects from any medicine given to you (nausea, itching, etc.) please tell your nurse.
All the doctors and nurses on your care team are committed to keeping you as comfortable as possible after your procedure; your comfort is very important to your recovery. Some pain is normal after most procedures and we want you to talk about your discomfort with your nurse so we can take steps to manage it. Your nurses will talk to you about pain using the 1-10 pain scale seen below. Before your procedure, the nurses will talk with you about setting a realistic pain goal on this 1-10 scale Afterward, based on where you are hurting and how much pain you are having, your nurse will discuss with you, different options available for pain relief based on your doctor’s orders.
Pain can be managed in many different ways. Opioid (also called narcotic) pain medications are one option and are often used for more severe pain. These opioid medicines can have several negative side effects, such as nausea and vomiting, constipation, over sedation, and potential for addiction. However, they are sometimes necessary to reduce pain, especially immediately after surgery. Throughout your recovery, your nurses will work with you to make your pain tolerable. Your nurses will also work toward decreasing the amount of opioids given by using other medications and approaches that have been proven to relieve pain without as many side effects. Make sure to alert your doctors and nurses of any problems you have had with pain or pain medications in the past. If interested, you can learn more about the different types of pain management.
