Laryngectomy

Lisa is the daughter of Mr Habib who is going to undergo a laryngectomy. He has given you permission to speak to her about his surgery. Please explain his surgery to her.

Setting

  • WIPER  (wash hands, introduce yourself, permission, expose patient, reposition)
  • Ask if she is happy to see you
  • Ask if she wants any other family/friends present

Perception

  • Recap on past events – her understanding of diagnosis, prior knowledge of laryngectomy surgery
  • “Thank you for bringing me up to date.”

Invitation 

  • “Can I explain the surgery to you now?”

Knowledge

  • Describe laryngectomy 
  • Draw – voice box, top of food pipe and lymph nodes taken out. Left with hole in front of the neck.
    • Big operation – takes all day, HDU post-op, 7-10 post-op stay
    • ?PEG Pre-op/NG tube post-op
    • Voice – Initially writing, experience ward nurses with these patients, electrolarynx, tracheoesophageal speech, speaking vale
    • May need further radiotherapy

Empathy

  • “I can see this is maybe a larger operation than you were expecting”

Strategy and Summary

  • Summarise consultation. Today we have talked about…. 
  • Offer chance to ask final questions
  • Offer leaflet on diagnosis and laryngectomy surgery
  • Once again my name is…
  • Secretary number and head and neck nurse specialist number
  • Offer follow-up conversation if she wants
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