The Role of Nurses in Colorectal Surgeries

Theoretical basis: The problems in rectal and anal diseases have had rising tendency, especially haemorrhoidal diseases, on which we put emphasis in our bachelor thesis. 37% of adult population suffers from this disease so we may line it up to civilization illnesses. Their treatment involves wide range of medical methods, from the conservative therapy to semi invasive ways of treatment. The semi invasive treatment is well withstood by patients and it can help up to 90% of clients. This bachelor thesis is concerned with specifics of nursing duties in a colorectal surgery. It links with topics like taking faecal specimen, basic methods of endoscopy, communication with patients and giving them information about lifestyle. The theoretical basis describes haemorrhoidal disease and gives brief introduction into causes of its developing, most common symptoms and possible treatments. The aim of the thesis: From the practical point of view we set two tasks. The first one is aimed at specifics of nursing job in a colorectal surgery and the second one tries to monitor how nurses in colorectal surgeries inform patients about healthy lifestyle. We asked two research questions regarding these aims. The first research question is: What are the specifics of the nursing job in the colorectal surgery? The second question concerns how nurses in colorectal surgeries provide information to their patients about healthy lifestyle. Methodology: Regarding the bachelor thesis we decided to choose a form of a qualitative research with using semi structural interviews with practical nurses working in colorectal surgeries. The interviews took place from February 28 2014 to March 15 2014 in five colorectal surgeries in following towns: České Budějovice, Písek, Strakonice, Jindřichův Hradec a Třemošná u Plzně. The focus group was created of 6 nurses working in colorectal surgeries. The interviews were performed and recorded with the consent of all practical nurses involved in the research. All extracted data was arranged and categorised into groups that were consequently analysed. The interviewer´s questions were prepared in advance and some extra questions were asked during the interview. The interview was divided into five areas: Identification questions, role of a nurse, examination methods, recommendation and giving information about lifestyle. Results: The results show the specifics of nursing in colorectal surgeries. We found out that nurses working in colorectal surgeries deal mainly with preparing special medical instruments and devices needed for endoscopic examination. Then they assist doctors during a medical examination and with treatment methods of RBL (Barron´s rubber band ligation) and Hemoron, they manipulate with devices in a surgery, check hygiene measures, do administrative work and keep surgery office running. In other conversation areas practical nurses mostly mentioned sampling of biological materials, mainly blood and faecal specimen taking to be given up to histological examination, preparing patients for an endoscopic exam, communication with patients and attending to the intimacy of patients. Consequently we found out that more than half of the practical nurses pay attention to psychological conditioning of the patient before rectoscopy. The research also revealed some weak spots. More than half of the nurses in the focus group do not inform patients about preparations before anoscope exam. Barely one third of the group said that they inform patients about the natural emptying before the exam. Regarding the issue of giving information about lifestyle, we came to the conclusion that practical nurses, even though they do not have enough time, try to inform patients about physical activities, hygiene care and quality of eating and they do it in sufficient rate. But because of the time constrain they put emphasis only on the essential information