March 4, 2020
If you have been scheduled for lung surgery, you likely have already met a number of health care professionals in various clinic settings and had many of your questions answered about the operation and recovery. However, once you are admitted to the hospital and undergo surgery, you will meet a number of new individuals who will be involved in your daily care and play critical roles in your successful recovery. Getting to know these health care professionals and their specific roles may help you understand better what to expect during your inpatient stay and whom to ask for any questions that might arise. While every hospital may be a little bit different, some general roles are typically occupied by members of the care team.
The cardiothoracic surgeon is the team member who helped you make the decision to proceed with surgery and will perform the operative procedure on your lung. As the leader of your care team, the surgeon will guide the rest of the team in deciding aspects of your recovery. Many surgeons see their patients in the hospital each day during rounds, but many other care team members also will be in communication with your surgeon and help execute the plan of care. In some hospitals, surgeons round on their patients as a group—meaning you might be seen or cared for by one of your surgeon’s partners.
If you are having your surgery at a teaching hospital, general surgery residents or cardiothoracic surgery residents may help take care of you. They are often the first ones to check on you early in the morning and are the first person called by your nurse if issues come up at night or on the weekends. Residents are still in training, but they are medical doctors who are able to write orders for medications and tests. In addition, they are able to help manage any difficulties you may be having. While the residents may need to discuss the more important aspects of your care (such as when to remove your chest drainage tube) with your attending surgeon, they are able to make many independent decisions. The residents taking care of you after surgery likely have assisted your surgeon in your operation, and they will follow you throughout your stay.
Advanced Practice Provider
Advanced Practice Providers, or APPs, may include nurse practitioners or physician assistants. APPs typically have many years of training, including master’s degrees. Depending on the practice of your surgeon, the APP taking care of you in the hospital may have been involved in your preoperative clinic evaluation and/or in your surgical procedure; however, in some circumstances, the APP caring for you in the hospital may be new to you after surgery. Regardless, the APP is someone you will definitely be glad to get to know. He or she will manage many of the minute-to-minute issues that arise during the day and is often nearby to help, even if the surgeon and residents are tied up in the operating room. APPs also are able to write orders for tests and medications and help troubleshoot any problems that you may encounter. They will work hard to prepare you for going home after surgery, and will often provide much of the education that you receive about your discharge.
In most hospitals, the bedside nurses are registered nurses (RNs), meaning that they have 4-year nursing degrees. You will have a bedside nurse 24 hours a day who can help you with getting up, taking your medications, and answering your questions. He or she will provide you with some of the education needed for care when you are at home (such as routine wound care and surgical dressing changes) and help obtain supplies for home use. It’s important to know that your bedside nurse is the link between you and your medical team.
Respiratory therapists, or RTs, are very important members of the care team after lung surgery. Because patients who have lung surgery are at risk for breathing complications and pneumonia, breathing treatments are very important to ensure a healthy recovery. RTs will help administer those breathing treatments, and they may make recommendations to the other members of your team (your surgeon, residents, and APP) about which treatments might be best for you.
Physical Therapist/Occupational Therapist
Depending on the hospital’s practice and your level of activity before surgery, you may have orders for evaluation and treatment by physical and occupational therapists after surgery. These individuals will help you increase your movement, resume normal activity, and prepare you for return to your daily functions in anticipation of returning home. They also can assist in ordering medical equipment such as a walker or shower chair to use at home.
Nursing assistants will aid in your recovery by performing tasks delegated to them by your RN, such as helping you out of bed, bathing you, making your bed, taking your vital signs, checking your blood sugar, if needed, and changing your bandages.
In many hospitals, special transport staff will bring you to various locations in the hospital. They may pick you up in a wheelchair and take you for a chest x-ray or elsewhere in the hospital, if needed.
Pathologist and Radiologist
Some physicians involved in your care are very important but you won’t actually see them. The pathologist is the doctor trained to look at tissue removed by your surgeon under the microscope and provide information about the diagnosis, aggressiveness of a tumor, and whether any lymph nodes are involved. Depending on the hospital, the pathologist usually gets his/her report to your surgeon’s team anywhere from 2 to 7 days after surgery.
The radiologist is a doctor specially trained to evaluate images, such as chest x-rays, obtained during your hospitalization. While your surgeon, the APP, and residents also will likely view the images, the expert interpretation from the radiologist is often helpful in following your progress.
Depending on your pre-existing medical problems and any complications that you develop, other teams or specialists may be involved in your care. If you had an epidural placed or if you are on pain medications before your surgery, a special pain management team may be involved. If your surgeon admits you to the intensive care unit after surgery, a critical care team led by an intensivist may help manage moment-to-moment issues. A number of other specialty teams—such as cardiology, nephrology (kidneys), and many others—potentially could be involved, depending on how you are doing. Importantly, while you may need a medical oncologist or radiation oncologist to help with your cancer care after surgery, these individuals are not typically involved during the inpatient postoperative hospitalization.
Wherever you have your operation, there are several people who will be involved in your care. Your successful recovery truly takes a team. While the team members mentioned above each have their areas of expertise, remember that everyone wants to help. If you have a question or concern, go ahead and ask! If the person you ask doesn’t know the answer, he or she certainly can find someone who does.
Finally, remember that the surgeon leads your team, but everyone else has very important roles. You and your family also are key members of the team, and your efforts and participation contribute greatly to the course of your postoperative recovery.
The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons.
The STS mission is to advance cardiothoracic surgeons’ delivery of the highest quality patient care through collaboration, education, research, and advocacy.