My career as a nurse anesthetist recently began at two plastic surgery centers, where I knew I'd face significant challenges in managing PONV. Rates of the relatively common complication are often much higher after plastics cases (35% to 40%) than after other types of procedures (25% to 30%). Instead of waiting to treat nauseous patients postoperatively, I went on the offensive by using a personal protocol that produced immediate positive results (see "A Proactive Approach to PONV Prevention").
Incidence of PONV among my patients has noticeably declined and PACU nurses report that patients feel better, faster. As a result, patient satisfaction at the surgery centers has significantly improved. I've found out from firsthand experience that it's important to prevent PONV, not treat it. Doing so requires a perioperative strategy that will achieve optimal outcomes for happier patients.