When a patient goes through a surgical procedure, they often require some extra care for a time afterward. For some patients, that just means a couple of hours of recovery. For others, healing may be a much more intensive process, requiring round-the-clock care, regular medication, and plenty of bandage changes.
As a result, surgical settings—like the patient’s care—can take many forms. And though you can classify all surgical facilities into a general definition, the specifics of an individual setting will depend heavily on the patients the facility is designed to treat and their particular healthcare needs. Therefore, there is no simple answer to the central question, “What is a surgical unit?”
This guide digs into the specifics of surgical units in the American healthcare system, covering some of the most common types you may come across as a staff or per diem nurse in the surgical field. Let’s get started!
Surgical Unit: A Broad Definition
At the most fundamental level, a surgical unit or facility is a place where surgeries are performed. It may also be a place where patients are cared for and treated before or after the surgery.
In these cases, a patient will be prepared for surgery in the surgical unit, then transferred to the operating room (OR)—which is also part of the surgical unit—for the surgery itself. Then, upon the successful completion of the surgery, the patient will be transferred to the post-anesthesia care unit (PACU) and then discharged or transferred to another hospital unit, such as Med/Surg or the intensive care unit (ICU), for the remainder of their recovery.
And that’s it! Pretty much every specific factor of the surgical unit will be defined by other factors like the types of surgery performed by the surgical facility in question and the internal operations and setup of that hospital or other surgical facility.
Typically, understanding the role of the surgical unit comes down to understanding the type of hospital or facility with which this unit is linked. To better understand the differences, here are a few common facilities that surgical units can be grouped into.
Outpatient Facilities Connected to Hospitals
The surgeries performed at outpatient facilities are usually not medical emergencies and are often less complex than surgeries requiring overnight hospital stays. In fact, these surgeries may take only a few minutes or hours. Typical outpatient surgeries include the following:
- Hernia repairs
- Mole removals
- Knee replacements
- Tonsillectomies
- Gallbladder removals
- Some cosmetic surgeries
- Cataract surgeries
After outpatient surgeries, patients may be monitored in the PACU or an outpatient postoperative care area. Although uncommon, if complications arise, patients are transferred to a hospital unit for additional monitoring and care. However, they usually stay until they can urinate, drink without nausea, or perform other tasks required by the surgeon. Patients then go home, and a nurse calls them the following day for updates or to answer questions.
Ambulatory Surgery Centers
In some cases, surgery is not performed in a hospital at all. Free-standing surgery centers—also called ambulatory surgery centers (ASCs)—can be a great option for patients seeking convenient same-day surgical care, including diagnostic and preventive procedures.
Thanks to advances in surgical techniques, anesthesia, and pain management, nowadays, more than half of all surgeries are performed in outpatient surgical settings. After ambulatory surgeries, patients recover in their own homes.
Inpatient Hospital Surgical Units
Although most surgeries are performed in outpatient settings, not all patients are candidates for outpatient procedures. When surgeons expect patients to require one or more nights in the hospital, patients are admitted to hospital surgical units. Common inpatient surgeries include the following:
- Breast reconstructions
- Bone and skin grafts
- Treatment of craniofacial fractures
- Drainage of bone lesions
- Removal of ribs
- Amputations
- Organ transplants
After surgery and recovery in a PACU, patients are transferred to an intensive care unit or a Med/Surg floor for additional monitoring and care. Nurses in these hospital units help patients follow the diet, activity, and medication regimen prescribed by the surgeon. Finally, before going home, nurses review home-care instructions, including medications, bandages, activity restrictions, and required follow-up appointments.
Emergency vs. Elective Surgery
The other major difference between surgical units or teams is whether a unit or team performs emergency or elective surgeries.
Not all surgical facilities make this differentiation, and the specialized emergency surgery team is a relatively new trend in healthcare. The need for separate teams stems from the frequent cancellation of elective surgeries due to emergency surgeries or delays in emergency patient care, leading to frequent after-hours operating. These problems are solved by having a general surgeon dedicated solely to the care of emergency patients, on-site during business hours and on-call after-hours.
This new surgical model is referred to as an “acute surgical unit” (ASU), “acute general surgical unit,” or “acute care surgery” (ACS). Many studies have demonstrated the advantages of this model, including reduced time from arrival at the surgical facility to the operating room, length of stay, and complications.
Putting It All Together
Unfortunately, there is no single definition for a surgical unit. Even the name “surgical unit” is not universally adopted: Many hospitals refer to theirs as a surgery center, a perioperative unit, or simply the “operating room” or “OR.”
Each of these names carries different meanings and assumptions as well. A perioperative unit includes patient recovery resources, while an operating room is more geared towards surgical aspects, with patients recovering elsewhere in the facility.
At the end of the day, the only universal commonality binding surgical units—or whatever else they may be called—is the fact that they are all places where surgery is performed. The rest of the patient’s journey, from arrival to eventual recovery and departure, can be handled in a variety of ways, depending on the nature of that patient’s surgery and the type of facility they are visiting.
As someone who wants to learn more about operating room nursing, this may not be the most satisfying answer. However, the variety of these units can be a real draw for those hoping to become OR nurses. Whether you prefer bonding with patients over a long recovery or working in a fast-paced outpatient environment, there’s a perfect job out there for you!
To learn more about life as an operating room nurse, check out our ultimate guide! In it, you’ll find everything you need to know about the career and the greater OR field. Thanks for reading!
