Surgical services in Western Sydney

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Male voiceover: Welcome to Westmead Hospital we understand you may be very nervous about your upcoming surgery and have a lot of questions. In this video we will show you our hospital and explain what is going to happen at various steps of your surgical journey with us and what you can do to make a quicker recovery.

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[Black text on white background: Enhanced recovery after surgery]
[A graphic of 3 people standing together, black text on white background: Preadmission]
[A couple walk toward and enter a hospital and make their way to the pre-admission clinic]

Male voiceover throughout video: before surgery you will be given an appointment to attend for an assessment at our pre-admission clinic which is located in the university clinics block on level 2 you are very welcome to bring a family member with you if you wish.

If English is not your first language please ask our staff to arrange an interpreter for you in advance. Please don't forget to bring all your current medications, medical results, and paperwork as this will help us make a more thorough assessment.

Our nurses will first measure your heart rate blood pressure, oxygen saturation, and check your blood glucose level if you are diabetic. We will also measure your height and weight, an ECG or a lung function test may be performed depending upon your medical condition.

You will then meet our anaesthetic and surgical teams who will ask you your medical history and your physical examination. They will explain your anaesthetic options and the operation to you and answer any related questions which you may have.

We may ask you to go for more investigations or blood tests after the consultation. During the consultation our team will go through all your medications and give you verbal and written instructions on what to do with them before surgery.

If you are a smoker, we strongly advise you to stop as soon as possible as this will dramatically improve your lung function and reduce post-operative complications. There is plenty of resources available to help you to quit and you can speak to our team at any time.

You may be given some information leaflets relating to your surgery to help you understand more about the operation and the post-operative care. We strongly advise all our patients to exercise at least 30 minutes every day before surgery if they can. These exercises will strengthen your muscles and make for a more speedy recovery. You should also have plenty of rest and sleep during this period.

[Screen shows black text over an image of different foods: Nutrition. Eat plenty of healthy and high protein foods, reduce or eliminate alcohol, protein supplement drinks, see your GP or dietitian for advice.]

You should eat plenty of healthy and protein-rich food before surgery. You should also reduce or eliminate alcohol. In some circumstances we may suggest a protein supplement drink to you. It is often a good idea to see your GP and a dietitian for advice especially if you are overweight or underweight.

[Screen shows black text over an image of a small glass of water: The day before surgery. Ring the day surgery to confirm appointment, keep yourself well hydrated, follow the perioperative instructions.]

The day before surgery you will be given a telephone number to ring to find out what time you need to arrive at the hospital. You should get yourself well hydrated and follow the perioperative instructions.

[Screen shows black text over an image of a surgeon wearing a mask in an operating theatre: Fasting guidelines. Non-fatty solid food is allowed up to 6 hours before arriving at the hospital. Drink clear fluid up to 2 hours before arriving at the hospital. Take all your essential medications as instructed.]

Fasting is essential prior to sedation or a general anaesthetic. Non-fatty solid food may be taken up to 6 hours prior to anaesthesia, patients are encouraged to drink clear fluids for up to 2 hours before arriving at the hospital. Please take all your essential medications as instructed by your anaesthetist or surgeon, speak to our doctors if you have any fluid restrictions.

[Screen shows black text over an image of water in a glass: These clear liquids are acceptable, clear apple juice, black coffee, black tea, water, sports drink. Avoid cloudy or milk-based drink and alcohol.]

These clear fluids are acceptable: clear apple juice, black coffee, black tea, water and sports drink.

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[Screen shows a graphic of a man in bed in an operating theatre with a surgeon standing next to him. Black text next to the graphic: Day of surgery]

[Screen shows black text over an image of an open suitcase with a white t-shirt placed inside: Check that you have: medications in original packages, recent x-rays, tests and scans, toiletries, night clothing, dressing gown and slippers, Medicare, private insurance cards, prescription glasses, walking and hearing aids, CPAP machine, Do not bring valuable items and jewellery, do not wear make up or nail polish]

On the day of surgery please make sure you bring the following items.

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To help reduce wound infection we advise you to have a proper shower the night before your surgery with an antibacterial agent or neutral detergent and repeat this on the morning of your operation. On your day of surgery take one of the lifts opposite to the pre-admission clinic to the admission office on level 3, you are very welcome to bring one close family member or a friend with you.

It is preferable if your family member or friend keeps your belongings and delivers them to your ward after the operation. Our porters will deliver your belongings if this is not possible. You will then be seen by our perioperative nurses, they will check your observations to make sure you are fit enough to have your operation.

Your personal details will be carefully checked and you will be given a hospital identification wristband to wear. The nurse will instruct you to change into the hospital gown and put on the surgical hat, you may be given stockings to wear to improve the circulation in your legs.

You will be met by our surgeons to answer any questions, which you may have about your surgery. They will explain the operation to you and get you to sign the consent form if this has not already been done. If needed they will mark the site of your operation. Our anaesthetic doctors will meet you before surgery, they will examine you and ask you a few questions to make sure you are ready for your operation. They will go through your anaesthetic and pain management options and the recovery period.

They will also answer any questions or concerns which you may have. When you are ready you will be taken to our theatre for your operation, your family member or friends may accompany you to the door of the theatre suite. Our perioperative nurse will meet you in the anaesthetic room and ask you questions about your identity and operation again.

We know this may seem repetitive to you but in order to reduce mistakes we must check these details at every stage of your journey. The anaesthetic doctor will then put a drip into your vein and give you anaesthetic medications, the anaesthetic doctor may inject some medication into your back as part of the anaesthetic and post-operative pain management plan.

Local anaesthetic and sedatives may be given to make you feel more comfortable before the procedure. Sometimes the anaesthetic doctor may insert a peripheral nerve block with the aid of an ultrasound machine to numb the area where the operation will take place.

Before you go to sleep our staff will attach various monitoring devices to you to measure your vital signs throughout the operation. Before the start of the operation the whole theatre team will pause for a safety checklist to ensure everyone is prepared, who knows all essential information about you. During the whole time of your operation your anaesthetist will closely monitor your vital signs, they are experts at keeping you safe and minimizing your pain.

Your dignity is important to us and we will keep you covered as much as possible. We will also keep you warm during the operation to reduce the risk of wound infection. After the operation is finished the team will stop for another safety checklist to make sure everyone is aware of your needs in recovery.

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[Screen shows a graphic of a man in bed in a hospital recovery ward with a nurse standing next to him. Black text next to the graphic: Recovery]

After surgery most patients will be taken to the recovery room unless they have cardiac surgery or require immediate post-op ICU monitoring. Oxygen therapy will be given to you while you are waking up from the anaesthetic.

Our recovery staff and anaesthetist will closely monitor you for a period of time and keep you comfortable before you are transferred to the ward or the high dependency unit. Medications will be given to you if you have pain or feel nauseated. At this point your significant other and family relatives are welcome to inquire which admitting wards you will be going to. We understand they are concerned about you but we appreciate their patience when our staff are focused on looking after you during this critical period.

On the ward you will be reviewed by your surgical team every day to make sure you are making good recovery progress. Some discomfort after surgery is expected and our pain team may be asked to see you if needed. The length of time it takes to recover from surgery varies with different types of operation and your body's responses.

There are things you could do to help yourself recover quickly. When you lie in bed after surgery your lung bases may not expand fully and put you at risk of developing a pneumonia. To help your lungs expand regular breathing exercises are strongly recommended such as using the incentive spirometry device several times every hour.

We strongly encourage you to sit out of bed and mobilise when possible to regain your muscle strength, this will help reduce the risk of surgical complications and also the risk of a blood clot in your legs or lungs. If you are unsteady getting up yourself, our nurses and video will help you.

For a quick recovery, it is vital for you to continue eating a good balanced diet, all our dietary plans are designed to provide the necessary nutritional requirements. If the hospital food doesn't suit you, we encourage your family members to bring you the home-cooked food that you prefer. We may refer you to our dietician colleagues if we think this will benefit your recovery.

When you are ready to be discharged you will be given a discharge letter and details of your follow-up appointment from our nursing staff. You will be given the discharge medications you require and advice on equipment you may need. If necessary our allied medical health teams will visit you to help you transition from hospital to home.

Thank you very much for taking the time to watch this film, we wish you all the best with your upcoming surgical journey. Please feel free to ask our staff about your surgery at any time.

[Screen shows white text over a black background: Dr Pete Smith as Mr Smith, Dr Farheen Ali as Mrs Smith, Voice by Dr Anthony Padley]

We look forward to hearing feedback about your experience as this will help us continually improve our services.

[Screen shows white text over a black background: Directed and written by Dr Clement Lee; Special thanks to: Corporate Communications WSLHD, Department of Anaesthesia, Westmead Hospital, Preadmission clinic, Westmead Hospital, Department of Physiotherapy, Westmead Hospital; All animation images are reproduced with permission from the Royal College of Anaesthetists' Perioperative Medicine Programme originally published in "Perioperative Medicine Pathway to Surgical Care, January 2015. Further information available from www.perioperativemedicine.co.uk]

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There is no audio, subtitles provided for this video. A video description is provided in this section. 

This video is from a hand-held mobile camera showing the person's view of the hospital as they walk toward their surgery. The video runs for 1 minute and 17 seconds. It shows a person walking through the hospital while holding a paper cup in their right hand to symbolise sipping liquids. As the person walks through the hospital different graphics and text is shown over the video.

The first frame of the video shows a graphic of a cartoon platypus sipping from a glass with a straw. Around the platypus to the left are the words Simple, Safe, Kind and to the right Sip Til Send.

The person is holding a paper cup with water, the words 200ml is written inside the cup. Animated text above reads Sip Til Send Blacktown. At the bottom right is text acknowledging Ninewells Hospital UK, Prince of Wales Hospital NSW, and Royal Adelaide Hospital SA.

The person is holding the same paper cup and walking toward the entrance of the Blacktown Hospital. As they walk, animated text above reads: I have operation today at Blacktown!

The person walks inside the hospital holding the paper cup. Text and graphics appear over the moving video. The upper part of the screen shows the recommended fluid intake before surgery for adults is to sip 200ml or 1 cup every hour until they are called to the theatre complex. The graphic also shows icons, from left to right, a glass of water, an apple juice box, a steaming cup of black coffee, a glass of yellow coloured cordial, and cubes of ice.

The lower part of the screen shows the recommended fluid intake before surgery for children weighing less than and more than 65 kilograms. Children weighing less than 65 kilos can sip up to 3ml per kilogram per hour and children weighing more than 65 kilos can sip no more than 200ml or 1 cup per hour until called to the theatre complex. The graphic also shows icons, from left to right, a glass of water, an apple juice box, a glass of yellow coloured cordial, and cubes of ice.

The person approaches the doors to the surgical ward; a male surgical nurse is standing in front of the doors. A quote from a patient appears on screen, which reads: I felt less anxious with the wait times as I was waiting for my operation.

A male nurse greets the person and waving, the video shifts to the person holding a laminated Sip Til Send information card. Animated text above reads: They told me about this @ Blacktown. The person then places it back on a table and pans upward to show a poster of the Sip Til Send graphic of a cartoon platypus sipping from a glass with a straw. Around the platypus to the left are the words Simple, Safe, Kind and to the right Sip Til Send. The words 'Putting patients first' is included underneath the graphic.

The male nurse leading the person to the A31 Day Procedure Unit Surgical Admissions and Booking section in Blacktown Hospital. Over the video another graphic appears showing the exceptions to the Sip Til Send initiative. It read: Exceptions - do not force if the patient is not feeling well, any patient who is Nil By Mouth for medical or surgical reasons. If in doubt please ask Anaesthetic/Surgical teams, and finally a glass of water with a cross over it and text that reads: Patients on thickened fluids.

The male nurse leads the person into the surgical unit. Another quote from a patient appears, which reads: I honestly felt amazing when I woke up in recovery after my surgery. 
The person follows the make nurse into a waiting area, the person presses on a wall-mounted switch with green and red lights. A graphic over the video repeats the recommended fluid intake before surgery for adults is to sip 200ml or 1 cup every hour until they are called to the theatre complex. The graphic also shows icons, from left to right, a glass of water, an apple juice box, a steaming cup of black coffee, a glass of yellow coloured cordial, and cubes of ice.

The lower part of the screen shows the recommended fluid intake before surgery for children weighing less than and more than 65 kilograms. Children weighing less than 65 kilos can sip up to 3ml per kilogram per hour and children weighing more than 65 kilos can sip no more than 200ml or 1 cup per hour until called to the theatre complex. The graphic also shows icons, from left to right, a glass of water, an apple juice box, a glass of yellow coloured cordial, and cubes of ice.

The person finishes his cup of water; the male nurse is standing nearby. He follows the male nurse toward a hospital bed. A quote from a patient appears on screen, which reads: This Sip Til Send Initiative is something that other hospital need to do!

The male nurse gestures toward a hospital bed, the person climbs on and settles in. Text appears above the video, it reads: No more drinks! Operation time! A quote from a patient appears below the text, which reads: They allowed me to sip my apple juice up until they called me into theatre! It's amazing how times have changed.

The person is now sitting up in bed, wearing multicoloured compression tights with blue shoe covers. Text appears above the video: Surgeon called for me! Thank you, Sip Til Send. A graphic over the video repeats the recommended fluid intake before surgery for adults and children.

End of video.