Surgeries begin at 8 AM so the first patients are wheeled out of the operating suite around 9:30 or 10:00 AM. The Anesthesiologist brings them to the recovery room where a hand-off occurs with the Pediatricians and PACU nurses. The patient is generally still unconscious at this point though some very small children awaken quite soon. Vital signs are monitored and the nurses pay very close attention to the patient.

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The Recovery Room team, L-R: Katie Wetterstrand, assistant; Danielle Lallement, nurse; Joanne Gillespie, lead nurse; and Jean Roberts, assistant.

One of our two PACU nurses will sit with the patient until they are stable and awake. As soon as possible the mother is brought in to be with her child. This is not only reassuring to the patient who is surrounded by strange people speaking a strange language, but is essential to relieve the anxiety of the parents who have been restlessly waiting in the hallway. 

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PACU Nurse Danielle Lallement has brought in Hosein's mother as he emerges from anasthesia.

The reaction of parents is difficult to read for an outsider. They remain anxious about what has happened and whether there might be complications. In fact, many of these surgeries may be only the first of several that will be needed as the child grows. In the case of severe burn victims, the team may only be able to address one aspect of the damage at this time, for example, separating fingers that have been fused together by scar tissue and not dealing with facial scarring.

We have two Pediatricians on our team; Lead Pediatrician, Dr. Abha Goel of San Francisco and Dr. Greg Melnick of Miami Beach. The two PACU nurses are Lead Nurse Joanne Gillespie of Pennsylvania and Danielle Lallement of San Francisco.

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Lead PACU Nurse Joanne Gillespie with mother and child – note the quilt given to each patient by Rotary

On these first days of surgery the last patients emerge from the operating theater at 7 PM or later and the PACU team may not be done until well after 8.

Submitted 12 August 2012: R. McAulay