As we’ve mentioned before, studies have found that the vast majority of patients receive a prescription for opioids after the completion of their surgery. ERAS attempts to put a stop to the liberal and uneducated prescribing of opioids to patients.
The first way it does this is by simply prescribing less, if any opioids at all. All the preoperative steps leading up to this point, whether they be diet, exercise or education, have been designed to prepare the patient’s body for surgery and help it recover more quickly. Additionally, the use of minimally invasive surgery, less intraoperative opioids, less anesthesia and close monitoring of the body all help make the recovery process more speedy and less painful for the patient.
Customized Recovery Plan
When the patient first wakes up from their spine surgery, an ERAS-certified nurse practitioner is responsible for assessing their level of pain. Based on how they are feeling, the NP will make any necessary adjustments to the pain management plan that they set out with the patient in the preoperative phase of ERAS.
This is a really important part of the recovery model. Every patient is different and every patient experiences surgery differently. Their bodies may require more time to recover, they may be more sensitive to pain than they originally imagined, they may feel absolutely fine and able to function normally. It’s difficult to say for sure until the surgery has actually been completed.
At this point, nurse practitioners are able to make educated decisions about the patient’s recovery plan and tailor the regimine to each individual person.
This is vastly different than what is currently practiced in the healthcare industry.
On the contrary, opioids are often viewed as the one-pill-fixes-all solution for patients. Doctors and nurses simply don’t have, or won’t take, the time to customize a treatment plan for every patient they see. Rather, they prescribe pain medication and send them on their way with well-wishes and glad tidings. That’s not enough and it’s leaving uninformed people to fend for themselves in one of the most critical parts of their care.
Patients should not be content with a doctor who performs a surgery and considers their job done.
The job is done when you have recovered recovered from your surgery and are satisfied with the results of your procedure.
Think about it this way:
Say you’ve hired a contractor to come into your home and help you get rid of some mold that has started taking over your basement. You are paying them to see the project through to completion, right? You might even lay out a contract with them, spelling out exactly what you expect your money will get you and what completion of the project looks like in your eyes. In this case, it would be removing the mold from the basement and returning the area to a normal, breathable state.
Now, what would you do if that contractor completely gutted your basement, pulled out all the mold and called the job done. Certainly he got out what was causing the problem, but he didn’t finish the job.
The job is done when the contractor has met the expectations that you laid out in the original contract. If he hasn’t done that, the job isn’t done. You might call him back to your house, you might call his boss and demand a refund, you might even take him to court. Not finishing a job you’ve been paid for is a pretty serious offense.
It’s similar in healthcare, the only difference is that since you’re typically not paying the physician directly so there’s a little less skin in the game for them. The healthcare industry knows that they’re going to get paid regardless of your results. You could have a failed back surgery and be in the same amount of pain that you were in before and they would still get paid. This being the case, they’re incentivized to push as many people through the operating room as possible, regardless of their outcomes.
This shouldn’t be the case, and customized recovery plans based on ERAS guidelines are changing the healthcare industry for the better.
Not only will your ERAS-certified nurse practitioner help you customize your recovery plan, but if certain multimodal medications are required for pain management and recovery, they’ll also take the time to walk you through how you should handle the drugs safely and effectively. They also will not prescribe any more than are absolutely necessary, helping avoid the risk of addiction.
Additionally, they will also walk you through how to recover from your anesthesia and prepare you for what you should expect in the following hours and days in terms of pain and post-surgical bodily behavior. Expect to receive practical, understandable instructions on what you should eat, what kind of activities you should do and which ones you should avoid, how to sit, how to sleep, how to stretch and more.
These instructions are designed to put you, not opioids, in the driver’s seat of your recovery and help it go as smoothly and quickly as possible.