JBER medical personnel see patients as family

by Airman 1st Class Kyle Johnson
JBER Public Affairs

8/10/2015 - JOINT BASE ELMENDORF-RICHARDSON, Alaska -- So there you are, sitting in your doctor's office and he says the words you've been expecting, but hoping would never come.

"I think surgery's your best option."

There's a brief moment of processing, then your heart decides to take up residence in your stomach.

Surgery can be daunting; many people are uncomfortable with the idea of trusting themselves to a stranger's care while at their most vulnerable, but to highly-qualified surgeons and technicians at the Perianesthesia Unit in the 673d Medical Group, each patient isn't a stranger - he is somebody's family.
"We keep families safer," said Senior Airman Kristie Stenhouse, a medical technician at the Anesthesia Procedure Unit. "We can fix things that happen close to home, so family overseas don't have to worry."

The APU sees approximately 12 to 20 active duty, dependent, or veteran patients a day for everything from obstetrics to cataracts.

Like any other part of the hospital, a visit to the APU begins with a doctor's appointment.

"At your appointment, you will discuss your concerns and have your questions answered regarding your planned surgery," said Tech. Sgt. Danielle Gagne-Thibodeau, noncommissioned officer in charge of the APU.

The surgeon will then explain the procedure, the risks, the benefits, and alternatives to surgery.

"After all your concerns are answered," Gagne-Thibodeau said, "The surgeon will sign the consent form with you."

"Once that happens, the doctor puts the referral in for the pre-op clinic," Stenhouse said. "The nurses meet with you and go over your medical history to make sure you are fit for surgery."

Typically, the date of surgery will be decided at this point, but in some cases, surgery is performed the same day as the pre-op appointment, to ensure nothing changes between appointments, Stenhouse said.

"This is your opportunity to ask any questions you may have regarding your surgery," Gagne-Thibodeau said. "Our nurse will tell you when you need to stop having food and drinks, when you should call for your show time, and what you need to bring on the day of surgery."

The APU is split into four main sections: check-in, preoperative, operating room, and recovery. Each of these serves a different, but essential purpose to ensure surgery is as smooth and comfortable for the patients as possible.

"You will be required to present your photo ID at check-in," Gagne-Thibodeau said. "Here you will be asked to change into a gown, remove all undergarments, jewelry, glasses, dentures, and hearing aids."

During this process, patients will be asked more questions regarding their medical history. There will be questions which need to be posed repeatedly to ensure nothing slips through the cracks prior to surgery.

The technicians start an intravenous drip and make sure the patient is comfortable.

"I don't want to cause my patients pain, so when I do IVs I like to do them fast and quick," Stenhouse said.

As space becomes available and once the nurses on the preoperative side are ready, patients waiting in the clinic's main lobby will be rolled to that side of the clinic where the patient meets with their doctor and the nurse who will be in the operating room.

Here, information will be verified again to ensure there have not been any misunderstandings.

"We will verify your information frequently to ensure we meet the optimal safety and care you deserve," Gagne-Thibodeau said.

They'll explain the type of anesthesia to be used, the risks associated, and some possible side effects of the procedure.

In the operating room, the doctors use electronic nerve stimulators to ensure the patient is completely unconscious before beginning surgery.

"After [the procedure] is done you come out to the recovery area," Stenhouse said.

"When they come out of surgery I want to make their pain tolerable," she said. "Make them warm make them comfortable."

Nurses in the recovery area ask patients to rate their pain on a scale of 0 to 10.

"Thats our way for adults to tell us their pain range," Stenhouse said. "For kiddos we have little faces they can point to and say which one they are. It's kind of cool. It lets the kids have more of a say with what's going on with them."

When patients are breathing well on their own and their pain is tolerable enough to move, they are escorted into the check-in area as they get ready to head home.

Be it a knee arthroscopy or a gallbladder removal, surgery can take a physical and emotional toll on the patients.

There is also an emotional impact on the staff because the patients aren't just seen as patients. They are people. This is particularly true when a miscarriage happens, she said.

"When you lose a child, it's very emotional," Stenhouse said. "It really brings you back to what we're doing here."

Each patient is in the APU for a different reason, with a different history and background, but the men and women who work at the APU want them all to have the same story - success.

"I wouldn't want someone to take care of my family in Oklahoma and not provide them the best care," Stenhouse said. "It's just treating others like you want your family to be treated. Like you'd want to be treated."