The patient who has opted to allow a general practitioner to perform an operation deserves understanding in regard to the stress that accompanies the procedure. Regardless of how attractive or comfortable the practice space has been designed, harsh lamps, the clattering of instruments, and the filling of a syringe are disquieting signals.
Make the patient as comfortable as possible. A patient that is anxious and stressed while lying on the examination table will make the work more difficult. Before the patient is led into the treatment room, you may discuss exactly what will happen and the order in which events will occur. Consider whether the patient would prefer to undergo the procedure alone or in the presence of the person accompanying them (family member or friend).
The rule for operations is always:
- The patient lies.
- The family sits.
Explain to the patient that even with anaesthesia, the patient may be able to feel actions, but will not feel any pain. It is necessary to perform the operation while they are lying on the examination table, as there is always a chance that they can collapse, and that it is also a more comfortable way to work. Tell the patient that each piece of tissue that is removed must be examined by a pathologist, and state what you anticipate the results to be, if applicable.
When you enter the treatment room together, everything should be ready so that the operation can begin immediately. Ensure that the patient is comfortable so that they may remain in the same position throughout the entire operation. Position the assistant or the patient’s partner near the head of the patient for mental support. Maintain contact with the patient so that you can check regularly how the patient is doing and, if necessary, inject more local anaesthetic. Do not forget to repeat to the patient what will happen, especially when you are about to do something that may cause a painful sensation, such as injection through the skin for infiltration anaesthesia. Patients like to hear encouraging remarks from you, so that they know that everything is going well and that the end of the procedure is soon in sight. Ask the patient whether he is interested in seeing the excised tissue.
After the procedure, ask the patient to take a seat in the consultation room. This allows the patient time to re-acclimate to the vertical position, while you continue to observe for subsequent vasovagal reactions. Now is an appropriate time to discuss the specifics of follow-up treatment.
- When will the next check-up and bandage change take place?
- Should the bandage be kept wet?
- Are soda baths or sitz baths required?
- Is it necessary to keep a body part immobile or elevated?
- When will the stitches be removed?
- When will the pathology results be known, and how does the patient access the results?
- Is there a risk of recurrence?
- When can the patient resume work?
If there are no further questions, the patient can go home.