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Leaving Hospital
When in hospital, the orthopaedic team will support you with the first stage of your recovery from surgery, and then you will continue with your recovery at home. It can sometimes seem daunting to leave hospital care, but before you leave, the team will make sure you are medically well and will be able to move around safely at home. You will also be given verbal and written information and advice to aid your recovery, as well as a contact number in case you have any queries or concerns.
Each surgery has its own criteria for safe discharge, but in general the following must be achieved before you leave hospital.
If you have had lower limb surgery (hip, knee, ankle, or foot), you must:
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be able to walk safely around the ward with crutches or another type of walking aid
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be able to manage a set of stairs or a step safely (depending on what you have at home)
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be able to manage your daily tasks (even if this is in an alternative way initially)
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be medically stable and your wound not actively bleeding
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be given information and advice for your recovery including medications, wound care and follow up appointments
If you have had upper limb surgery (shoulder, elbow, wrist, or hand), you must:
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be able to manage your daily tasks (even if this is in an alternative way initially)
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be medically stable and your wound not actively bleeding
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be given information and advice for your recovery including medications, wound care and follow up appointments
Please note: if you have day case surgery you will need a responsible adult to stay with you for the first 24 hours following your operation.
If you have any questions about the progress of your recovery and your potential discharge date, please discuss it with a member of the orthopaedic team on your ward. We will try to keep you updated as you recover.
These are some common questions that patients have about their return home after their operation.
Will I be able to go up and down stairs?
Most patients will manage to go up and down stairs after their operation. If you have had surgery to your leg or foot, the physiotherapists will practise the stairs with you while you are in hospital. A description of how to go up and down stairs after your operation is included in your information booklet and a video demonstrating the technique can be found here.
If you are ‘non weight bearing’ (not allowed to put your foot to the floor) after surgery, the therapists will show you how to hop up if you are able. If you are not able to hop we can discuss the possibility of sleeping downstairs initially, or going up and down stairs on your bottom.
Will I be able to live alone?
A lot of patients will be able to manage alone at home after their operation. If you live alone it is important to consider how you will manage your grocery shopping and making and carrying meals. This section will provide more information to help you prepare.
Will I need care?
In most cases patients will not need to organise carers to assist them at home. However if you feel you may need some additional help, you can organise this before you come in for your surgery. The nurses can provide you with a list of companies who provide private care at your pre assessment appointment.
Will transport be provided to take me home?
We ask that you organise for a family member or friend to take you home from hospital, or alternatively use a taxi. If you feel you need hospital transport, please discuss this with a member of nursing staff.
Returning to activites
How soon can I travel after my operation?
Flying is not recommended for at least three months following your operation due to the risk of a blood clot. Some consultants may vary with this advice. Please contact your consultant via their secretary if you need to fly before the timescales advised.
For any other long-distance travel (car, train, coach) please make sure you can walk around regularly.
Will I be able to go swimming after my operation?
Yes. Swimming is a good activity to strengthen your body. However your wound needs to be fully healed before you go into the pool. If you have had lower limb surgery, you need to be confident with your walking so you can walk safely on the wet poolside. We recommend you use a pool with a staircase rather than a ladder to enter and exit the pool. You may need to adapt your stroke if you have been advised to avoid certain movements.
When can I return to driving?
This will depend on the restrictions from your specific operation. You must never drive in the first 48 hours following a general anaesthetic. After this time it is important to follow advice from your surgeon and physiotherapist.
Your inpatient stay
Please refer to the preparation for surgery section which explains what to bring to hospital and how you can prepare your home for when you leave hospital.
Day of surgery
Eating and drinking
Please follow the instructions given to you about when to stop eating and drinking before your operation. If there is food or liquid in your stomach during your anaesthetic, it could come up into the back of your throat and damage your lungs. This is rare however if it does happen it can be very serious.
If you have not followed the correct fasting instructions, your operation will be cancelled.
Medications
If you normally take prescribed medicines in the morning, please continue to take these on the day of surgery, apart from tablets you have been specifically told not to take by the pre-assessment team. Take them with a sip of still water. Please do not drink alcohol for 24 hours before surgery.
Arrival
You will come into hospital on the same day as your operation. You will be asked to attend either the Sandbourne suite or the Derwent ward to be admitted for your surgery. If you are admitted to the Derwent ward you will return to it after your operation. If you are admitted to the Sandbourne suite you may stay on the orthopaedic ward in the main hospital building, or on the Derwent ward following your operation. This will depend on your past medical history and bed availability. Please note you may move between wards during your admission for medical or bed management reasons.
When you arrive, a member of the nursing team will admit you and complete your pre-operative nursing assessment. This will include checking markers of your health (called ‘observations’) such as your blood pressure and you may also need a blood test. You will be visited by the surgeon and anaesthetist before your operation and will have the chance to ask any questions you have.
In preparation for theatre, you will be asked to put on a hospital gown and remove piercings, jewellery, and any other loose items such as glasses, false nails, and dentures.
Immediately post-surgery
Following your operation, you will be taken to the recovery section of theatres. You will always have a nurse with you to monitor you. They will be checking your observations such as your blood pressure, heart rate and oxygen levels regularly. You may need to breathe oxygen through a light plastic mask and may have a drip in your arm. If you feel sick, or are in pain, let your nurse know so they can treat you quickly.
When your nurse is satisfied you have recovered safely from your anaesthetic, you will be taken to the orthopaedic ward.
Medical management
You will have a daily review by the ward doctor and a member of the surgical team while you are in hospital. They will monitor your general health, adjust your pain relief as needed, and arrange and check your blood results and x-ray.
Pain management
The nurses will offer you painkillers at regular intervals throughout the day while you are on the ward. They will begin to offer you these before the anaesthetic has worn off to ensure you have some pain relief in your system before feeling returns. In between these times, if your pain is increasing or has not been managed by the pain relief you have been given, there is additional pain relief you can request when needed. In terms of pain management, it is important to act early. If the pain becomes severe it may require more medication to bring it back under control and may delay your recovery.
Please note, while in hospital you should not self-administer any medications. All your medications should be given to you by the nursing staff so they can be monitored to ensure maximum dosages are not exceeded.
Physiotherapy and occupational therapy
The physiotherapists review patients on the ward to teach exercises and ensure they can walk safely with an appropriate walking aid if needed. They can also make referrals for ongoing outpatient physiotherapy. The occupational therapists will discuss how to manage everyday activities when you return home and provide equipment to help you with this if necessary.
More information regarding physiotherapy and occupational therapy can be found here.
Other information for your inpatient stay
Getting back to your normal routine will help you feel more like your usual self, so we encourage you to get dressed in comfortable day clothes while on the ward.
What are the visiting hours for the ward?
Visiting times are 2-8pm, however please be aware there may be occasions where we need to interrupt your visitors to provide some of your care, such as observations, dressing changes, therapy review, or x-ray.
Is it safe to bring valuables into hospital with me?
There is a lockable drawer in your bedside locker, but we recommend you don’t bring in too many valuables. Valuables are brought into hospital at your own risk. University Hospitals Dorset cannot take any responsibility for your belongings.
Can my relatives bring in flowers?
We regret that we can’t allow flowers or plants onto the ward. This is because they are a source of infection, which could affect your, or other patient’s, wounds.
Discharge
How long will I stay in hospital?
We will aim to get you home as soon as you are medically fit, your symptoms are well controlled, and you can safely manage at home. For most people this is after one to two nights in hospital.
What needs to be achieved before I go home?
To ensure you are ready to go home we need to check the following:
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you are considered ‘medically fit’
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your blood results and x-ray of your joint are satisfactory
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your wound is showing signs of healing
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your pain is controlled
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you can walk around safely with an appropriate walking aid by yourself (most patients go home on two elbow crutches or walking sticks after hip or knee surgery).
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you can get on and off the bed, toilet, and chair by yourself
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you have managed to do a step or set of stairs safely (depending on what you have at home)
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you are aware of how to manage day to day activities while following any specific instructions from your surgeon.
What will I take home with me?
Before leaving the ward you will be given:
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an advice sheet about your operation with details of who to contact with any concerns
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any equipment which has been loaned to you such as walking aids or toilet frames
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a discharge letter for your records with information about your admission. On this letter there is also advice regarding signs and symptoms of blood clots and who to contact regarding any concerns
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a letter for your practice nurse who will check your wound and remove clips or stitches as appropriate (patients having foot or hand surgery will often return to the orthopaedic outpatient department for wound review)
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a one week supply of the pain medication you have been using during admission
Your orthopaedic journey
Your outpatient appointment
Once we receive the referral from your GP, we will make you an appointment to see either a consultant or a member of their team.
During your first appointment, we will find out more about your current problem and will usually examine the affected joint or area. If necessary, an x-ray or alternative investigations will be arranged to build up a clearer picture of your condition.
The treatment options available will be discussed with you. Please bear in mind that not all treatments you may have heard about will be appropriate for your specific condition and circumstances. Your consultant’s team will provide you with detailed information including the risks and benefits of any proposed treatment and what would be involved in surgery and recovery if this is an option. You will then have time to consider whether you wish to go ahead with the proposed treatment options.
If you need to contact someone about your outpatient appointment, please contact your consultant’s secretary, or call the telephone number provided on your appointment letter.
Pre-operative assessment appointment
If you and your consultant’s team decide on surgical treatment, you will then be given an appointment to attend the pre-operative assessment clinic. These assessments are to ensure you are fit and well enough for surgery and anaesthetic.
You will be reviewed by a nurse practitioner in our orthopaedic outpatient or main outpatient department. There are specially trained nurses who carry out several tests, including (but not limited to):
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blood tests
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blood pressure checks
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ECGs
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additional cardiology tests, for example an echo cardiogram
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chest x-rays
Please bring the following to your pre-operative assessment appointment:
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a list of all your current medications
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a list of allergies, including the type of reaction (particularly if a latex or nickel allergy)
The pre-assessment team will also assess your past medical history and discuss the arrangements you may need in place to return home after surgery.
If you have a complicated medical history or multiple other conditions, you may be seen by a consultant anaesthetist. They will carry out an extra review to make sure you are fit for surgery. This may happen on the same day as your pre-assessment appointment, or you may have the tests and/or review at another time.
What happens if the assessment shows that I am not fit for surgery?
If you have a medical condition that needs to be treated before you can be safely operated on, this will be highlighted at the pre-assessment. You will need to be referred back to your GP, who can organise any treatments and you will be removed from our waiting list until you are fit for surgery. When your GP lets us know you are well enough to proceed, they will notify our admissions department, who will put you back on the waiting list.
If you have any questions, the telephone number for orthopaedic pre-assessment is 0300 019 4102
Admissions
After your pre assessment appointment, your details will be passed onto the admissions team who will contact you to arrange a date for your procedure. You will be given information regarding your admission, such as what time to arrive and where to go.
You will be called by the orthopaedic outpatient nursing team a few days before your admission date. This is to confirm your date of admission, check that you are fit to proceed with surgery, and answer any questions you have. If you are having a hip or knee replacement, then you will also be contacted by the orthopaedic therapy team to discuss your rehabilitation and managing at home after your surgery.
It is not always possible to give a duration for your stay because each person’s recovery is dependent on several factors. After your procedure you will be seen by a range of professionals who will assist you and assess your recovery. When you are medically well and have achieved all the goals needed for discharge, you can leave hospital and continue your recovery at home.
If you are having a day case procedure, you should be able to go home on the same day as your procedure providing you feel well and there are no complications. If you are having a day case procedure you will be notified of this before your admission as you will need a responsible adult to stay with you for the first 24 hours following your surgery.
Cancellations
If you are unable to attend your appointment, please contact us immediately so we can reschedule your appointment and offer your original appointment to another patient.
The telephone number for orthopaedic admissions is 0300 019 4919
Locations for your procedure and inpatient stay
There are several areas within Royal Bournemouth Hospital where orthopaedic surgery and recovery takes place:
Sandbourne Suite
The Sandbourne suite has an admission area where you will prepare for surgery on the day of your procedure. It has two operating theatres and opposite is the main theatre suite. There are also two recovery bays, one male and one female. You may be asked to arrive at the Sandbourne suite on the day of your surgery if you are having day case surgery, or if you are going to ward 7 or ward 12 after your surgery.
Telephone number: 0300 019 6105
Ward 12
This is a mixed speciality overnight stay ward. You may go to ward 12 after your surgery to recover and be monitored and either go home that day or the following day. You will be reviewed by orthopaedic therapists and doctors as needed while you are on the ward.
Telephone number: 0300 019 4770
Ward 7 (currently located in the eye ward)
Ward 7 is an orthopaedic ward in the main hospital, usually used for patients undergoing more complex hip and knee surgery, or revision surgery. Some patients may require a short stay on this ward following shoulder, or foot and ankle, surgery.
Telephone number: 0300 019 4716
The Derwent
The Derwent has three orthopaedic theatres, primarily used for hip and knee replacement surgery. There are 29 individual patient rooms with ensuites, and all aspects of your inpatient care can happen here, including x-ray, physiotherapy and occupational therapy.
Telephone number for the ward: 0300 019 6223
Telephone number for Derwent physiotherapy/occupational therapy 0300 019 6221
Bournemouth Private Clinic
Patients having private orthopaedic surgery will have their outpatient appointments and inpatient stay in the Bournemouth Private Clinic. This is situated in the main hospital building
Telephone number: 0300 019 5189
Your inpatient stay
Information on your inpatient stay can be found here. This will outline how to prepare for your surgery, what will happen during your stay, and give information about your discharge from hospital.
Follow up appointments
Once you have been discharged home after your surgery, you may need one or more of the following appointments:
Wound check/redressing
This may be with the nurse at your GP practice or in the orthopaedic outpatient department at the Royal Bournemouth hospital. Before you leave hospital, you will be told when to expect a wound review and how to arrange your appointment if needed. You will also be given advice on how to look after your wound.
Follow up with surgeon’s team
In most cases, you will be offered an appointment between two to six weeks after your surgery. This is to review your progress and symptoms and give additional advice for your recovery. Full recovery takes several months, so you should not expect to be fully recovery and symptom free by this appointment.
Plaster room
You may have a plaster cast after surgery to immobilise your joint and allow healing to take place. The technicians in the plaster room will amend or remove a plaster cast when advised by the surgeon and may provide further support such as a walking boot or splint if needed.
More information about plaster care can be found here.
Telephone number: 0300 019 4442
Outpatient physiotherapy
You may need ongoing support from a physiotherapist to guide your recovery after surgery. The appointments will take place at a physiotherapy department closest to where you live. For example, Poole, Christchurch, Wimborne, St Leonards and Swanage hospitals all have outpatient physiotherapy departments. If you live further away, we can discuss a location suitable for you. Please note that hand therapy is a specialist service and not all physiotherapy departments have the specialist equipment to make custom splints etc. If you need any follow up physiotherapy appointments, the orthopaedic physiotherapist will complete a referral and will discuss the location with you.
A small number of patients may need physiotherapy in their own homes. This is provided by your local community therapy team, and they will generally become involved if you have significant mobility issues. Please note there is often a long waiting list for this and physiotherapy as an outpatient at your local hospital is more suitable for most people.
Orthopaedic Services at Bournemouth
Welcome
Welcome to the orthopaedic department at the Royal Bournemouth Hospital. We provide all aspects of planned (elective) orthopaedic treatment to residents of Dorset and the New Forest area. This includes pre-operative appointments, inpatient care, and surgery, as well as physiotherapy, occupational therapy and post-operative outpatient care including review of your recovery and wounds.
As we provide planned services, we consider treatment and surgery following a referral from your GP. Any trauma (unplanned) orthopaedic surgery and care happens at Poole Hospital.
We have designed this webpage to explain what will happen at each stage of your care and to provide detailed information to help you with your treatment and recovery. Contact details are provided throughout in case you need to get in touch with us.
