I am considering getting Rhinoplasty. When I went to visit with the facial surgeon I was told that he doesn't have any nurses on staff. Does this mean that there will not be any nurses present during the surgery? Should I be concerned?
Should I Be Concerned if the Doctor Has No Nurses?
Doctor Answers 10
Patient care before, during, and after rhinoplasty
The surgeon with whom you have consulted may not have nurses working in the office but if he/she is performing your surgery at a certified surgical facility, there should be nurses present to care for you before, during and after your rhinoplasty. Be sure to ask your surgeon for the accreditation status of the facility at which you are having your surgery. Your questions are quite appropriate.
There is not necessarily a need for nurses to be present in the office when you come in for your consult or postoperative visits. Every office is different and there is certainly no right or wrong way to staff the office. The surgeon may be handling all clinical questions and care on his/her own, which is perfectly reasonable and common in our field.
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Several things to check when considering plastic surgery
You should always ask these types of questions and I applaud your homework. If the facial surgeon is performing the procedure in his office, you should definitely make sure that the facility is accredited, that your doctor is board certified and that he has appropriate certified staff - this includes a board certified anesthesia and an OR nurse.
Physicians that perform procedures in their offices can sometimes bend the rules a little bit and many times some physicians will have an office based surgery center to avoid the stringent requirements involved in getting priviledges to perform specific surgeries (this doesn't seem to be the case here).
Don't compromise your safety.
I hope this helps.
Office Nurses vs. O.R. Nurses
Many plastic surgeons do not employ a full-time nurse in their private offices where they see their consultations and follow-ups. Other surgeons employ a squadron of nurses who do practically everything, including Botox and injectable fillers, as well as the majority of post-operative care. Either of these scenarios is perfectly normal.
If your surgeon does not have an office nurse, you can expect that he will probably be the one to personally change your bandages and see you through your follow-up after your procedure.
At the surgery center or in-office O.R., there will be registered nurses, surgical technicians, and anesthesia providers assisting your surgeon during your procedure. If the doctor has his own in-office O.R., he will hire a "per-diem" nurse and surgical technician to assist with your surgery.
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There should be a nurse present when you have your procedure
It is unclear from your question whether you are talking about the doctor's office or operating facility. If, when you went for your consult, there were no nurses present, this may just be during his or her office hours. If the doctor operates in an accredited operating room, either in his or her office, a surgi-center or the hospital, there should be a nurse present. If the surgery is being done in a surgi-center or the hospital, then the doctor may very well likely not have any nurses on his staff, since the surgi-center or hospital provide the nurses for the operations. It is important for you to clarify this with your doctors office.
I hope this is helpful.
David Shafer, MD
New York City
Concern if the Doctor Has No Nurses
While nurses are not required for the consultation process, you should ensure that there will be registered nurses present to care for you on the day of surgery. If the surgery is being performed at an accredited facility, then nurses should be present. Your concerns are valid and should be addressed.
Should my rhinoplasty surgeon have a nurse on staff
Not all plastic surgeons have a nurse working with them in the office. Some surgeons prefer to do the postoperative care themselves or by a physician assistant who is on staff.
There should be a nurse present in the operating room during your surgery though. If the surgeon operates at a unaffiliated facility (not at his office) the nurse would be provided by that facility. I would just ask the surgeon for clarification and make sure the surgery is done at an accredited operating room
You should be a little concerned.
The fact that he does not have a nurse on his staff MAY indicate either that he is not busy or that he cuts corners.
But I would not rule him out just because of this. He may have a fine operating room staff including a nurse. You just need to investigate. A nurse for the post operative care is very important.
Concern About Rhinoplasty Surgeon Without a Nurse
Hi again realidad,
Most surgeons do have nurses in their primary office. Some surgeons go to many different offices, particularly here in Los Angeles; many will sublease an office in Beverly Hills or Newport Beach for 1/2 day a week to maintain a "prestigious" address. In that case, they may travel to the "satellite" office without a nurse.
I have dealt with a "cosmetic" physician who only has a cell phone, no nurses, no office. Definitely draw the line at a surgeon without an office or land telephone. Stay away from "hotel" treatments by the "doctor with a suitcase".
Patients do need to choose their rhinoplasty surgeon most carefully, and it is important to feel comfortable and trusting with your physician.
It depends what "on staff" means.
Not having any nurses as a part of office staff is not unusual. Many plastic surgeons have some clinical staff caring for patients in the office, but some do not. Some surgeons choose to do all the clnical care themselves. At least in the office setting.
However, for the procedure, I agree with above comments that the procedure should be done at an accredited facility. I would also investigate to make sure that your surgeon is a board certified, and check WHICH board they are certified by. The American Board of Plastic Surgery has a very rigorous process of certification. You also want a board certified anesthesiologist and registered nurses taking care of you in the recovery area.