Alana Baird

As a rural nurse accustomed to wearing many hats—nurse, health care aide, discharge planner, and social worker—my patients have often jokingly referred to me as a “Sergeant” or “Warden.” In September 2024, the tables turned as I transitioned from caregiver to patient after being diagnosed with stage 3, grade 4 clear cell renal cell carcinoma. I faced a high-risk open radical nephrectomy and the challenges of a grueling recovery (Figure 1). Suddenly, I found myself held to the same high standards I had set for my own patients. If I was ever to return to work, I needed to embody the discipline I had expected of others.

Figure 1. The author with her family before entering the hospital for surgery.

As fear set in before surgery, I realized the importance of creating a comprehensive perioperative plan to address both mental and physical recovery. I assessed my surgical risks and recognized how crucial patient empowerment and education were for recovery. Yet, I was struck by the absence of preoperative guidance. No one had explained how I could actively participate in my own healing journey. Instead, I was given instructions on where and when to show up, leaving me, a health care professional, terrified. If I felt unprepared, how must patients without medical knowledge feel?

Patients need more than life-saving interventions—they need tools to understand and direct their recovery. Empowering patients to create a detailed postoperative care plan tailored to their abilities promotes both accountability and healing. Key strategies, such as pain and nausea management, early mobilization, deep breathing exercises, digestive motility, and skin integrity maintenance, are interconnected in preventing complications like pulmonary embolisms, deep vein thrombosis, pneumonia, constipation, and pressure injuries. Nutrition, hydration, and a clear understanding of their roles in healing are equally vital. Providing patients with a clear rationale and guiding them in goal-setting fosters motivation and reduces anxiety.

My own recovery was a testament to the power of preparation. Before surgery, I developed a schedule for mobilization, pain management, bowel routines, deep breathing, and nutrition. By taking charge, I avoided prolonged hospitalization and postdischarge complications, leaving the hospital after 8 days (Figure 2). Without a proactive plan, I might have faced a longer recovery and increased physical and emotional challenges.

Figure 2. The author outside the hospital after being discharged.

Empowered patients are active participants, not passive observers, in their care. Preoperative education and collaboration reduce anxiety, improve outcomes, and enhance satisfaction. Patients who understand the rationale behind their recovery plans require less reassurance and gain confidence in managing their own health. Investing time to educate and involve patients transforms their healing journey.

I owe my survival to the expertise of my surgical team, but my recovery reflects the effort I invested daily. Returning to nursing with a newfound perspective, I recognize the physical and emotional toll of recovery, especially for the elderly or frail. My expectations must be tempered with compassion, and my role as “Warden” has evolved to that of a guide, empowering patients to take charge of their health. Together, we can create a recovery process that is both collaborative and transformative.