Nursing: the power of enhanced recovery techniques

Surgical nurses play a vital role in overseeing the recovery of patients who have had operations. At King Edward VII’s Hospital, we have been pioneering enhanced recovery after surgery (ERAS) programmes tailored to colorectal patients – those needing operations for colorectal cancers, benign colorectal conditions and hernias. These programmes are often credited with speeding up recovery times: never more pressing than during the COVID pandemic, when getting patients well quickly has been of paramount importance.

Enhanced recovery, which can also be referred to as rapid or accelerated recovery, aims to ensure that patients are in the best possible health before, during and after their operation.

Undergoing surgery can be physically and emotionally draining, and enhanced recovery programmes within hospitals are there to help ensure that the patient can get back to full health as quickly as possible.

ERAS programmes use years of evidence-based practice to improve the care given to our patients and reduce the risk of post-operative complications. In practice, enhanced recovery begins before the patient has even had the operation. I call them at home to give them advice about their diet and staying active, and to manage expectations, all of which can contribute towards a quicker recovery.

Then once they are out of surgery, we get them on the road to recovery as soon as possible. For patients who have had an operation on their bowels, there are some unique things we do to help them. One thing we do is using chewing gum to get the digestive system working again. It sounds like a small thing but chewing helps the body get ready to receive food.

There’s also emerging evidence that taking probiotics may help with recovery too, so that’s something we’ve been trialling with The Precision Surgery Group, a world-renowned team that specialises in robotic colorectal surgery at the hospital.

We also get patients out of bed and into a chair after they’ve had surgery, and try to get them moving about. This helps with their breathing and reduces the risk of blood clots in their legs.

As enhanced recovery begins and ends at home, nurses are central to building and maintaining relationships with patients, ensuring the continuity of care that gives them the best experience possible. Coming to hospital can be a really scary time for people. They often feel vulnerable. Over the past year, without visitors and family members here to support them, it has been especially hard. It’s more important than ever that we get to know them and build that trust.

From the moment a patient is assessed by the colorectal team I will be there for them, from arranging appointments and further tests, to easing fears about a procedure and assisting with the recovery and discharge. I will also be on call to assist with anything they need while they recover at home.