Pre-Surgical Instructions

The following will help you prepare for your visit to Skagit Valley Hospital, providing information on what will take place before and after your surgery or download a printable, pdf version of our Pre-Surgical Patient Instruction booklet.

Pre-Surgical Procedure
Day of Your Surgery/Procedure
Getting Well
Going Home
Additional Resources

Pre-Surgical Procedure

Registration Phone Call
Registration staff from the Day Surgery Department will contact you by phone to complete your registration, or you may call 360-814-2496 at your convenience Monday – Friday from 6 a.m. to 6:30 p.m. They will need your name, address, insurance and emergency contact information. Please have your insurance card available.

Pre-op Clinic Phone Call
You will receive a phone call from a Pre-op Clinic nurse 1 - 3 days prior to the date of your surgery. If you have questions prior to receiving the call from our Pre-op Clinic nurse, please call 360-814-2496 from 9 a.m. to 5 p.m. It is possible we do not have your latest contact information. During this call, the nurse will review your health history, including your medications and any allergies and review specific instructions for what you need to do prior to your surgery.

The Night Before Your Surgery/Procedure

Skagit Valley Hospital has implemented an evidence-based protocol for our Total Joint patients that we call “Nose to Toes”. Our protocol includes additional measures put into practice to decrease the risk of surgical site infections. Your orthopedic surgeon will provide you with a Nose to Toes kit that includes a nasal swab and disposable wipes. These items reduce bacteria found in the nose and on the skin that can cause infection at the surgical site. We ask for your help and participation in the Nose to Toes program the night before your surgery. Complete instructions for preparing for surgery will be provided by your surgeon's office or can be found by clicking here.

Do not eat or drink anything after midnight the night before your surgery, not even water, gum, breath mints, or tobacco products (including cigarettes). Your doctor may give you more detailed instructions.

Swallow the pills you are told to take the morning of your surgery with just a sip of water.

Call your doctor if you have questions or concerns before your surgery/procedure or you feel any signs and symptoms of a cold coming on, or you have any other illnesses or health concerns.

Day of Your Surgery/Procedure

Before leaving home, remember:

  • Leave valuables at home, including: cash, credit cards, checkbooks, jewelry, items of sentimental value, or valuable items (including valuable clothing).
  • All jewelry, including body jewelry, must be removed before surgery. (This includes wedding bands due to post-op swelling.)
  • You may brush your teeth the day of your surgery, but do not swallow any water, toothpaste or mouthwash.
  • Shower and wash and dry your hair before coming for your surgery/procedure. It could be a day or longer before you can do these things again. (If your hair is wet or damp, it is difficult to stay warm.) Do not use hairspray, perfume, cologne or nail polish.
  • Do not wear make-up or mascara.
  • Bring a case to safely store: eyeglasses, contact lenses, hearing aids and dentures (partials or retainers).
  • Bring eye drops, respiratory inhalers or C-pap if you use them.
  • You may bring reading materials and/or a headset stereo.
  • If you are delayed for any reason, call 360-814-2311.
  • Identify a Care Partner who will assist you throughout your surgery day, including driving your home after your procedure.  Patients are not allowed to drive home on their own following surgery.
  • Identify a family member or friend who can help you make your hospital stay and discharge go smoothly. Choosing one person to communicate with other family members and friends can conserve your energy. It also helps the doctor and nurses focus on providing you the care that you need. Give this person’s name to the admitting nurse or family contact volunteer.

Arrive at Skagit Valley Hospital

On the day of surgery please arrive at the hospital two hours before your surgery. It is possible that your procedure time may be moved due to unforeseen cancellations or emergencies. If it is necessary to move your procedure, we will notify you as soon as possible. Entering on the north side of the building, take the North Lobby Elevators to the second floor and check in at the Volunteer Information Desk.

Please bring the following items with you to the hospital:

  • A list of all your medications including herbal products, vitamins and non-prescription medicines. Include the medicine name, strength and how often you take it. For example: Amoxicillin 250 mg take one every 8 hours; multivitamin take one every morning, etc. If you do not have a complete list, bring the original bottles with you.
  • All papers given to you by your doctor and the office staff.
  • Advance Directive if you have one (i.e. living will, power of attorney). If you do not have one and would like one, it is possible to fill one out at the hospital when you arrive or find a WA state Advance Directive form here.
  • Insurance card(s)
  • Clothes that will fit comfortably over your surgical area.
  • Pacemaker card (if you have one)

While You are Here

While you are here, you will be asked questions such as:

What is your name?
What is your birth date?
What surgery are you having done?
Do you have any allergies?

Do not be alarmed by these questions. We know who you are. We ask some or all of these questions over and over again to verify that we are talking to the correct person.

Surgical Site Marking
Everyone will be asked to confirm what surgery or procedure he or she is having. Some surgical procedures require the surgeon or physician’s assistant to mark the site of surgery with his initials. Marking the site is required for procedures involving right/left distinction and multiple structures (such as fingers and toes).

Getting Well

Gentle exercises can help you prevent circulation problems. You may be asked to do ankle pumps. To do ankle pumps, bend your feet toward you (use your ankles to flex) and away from you (point your feet).

Deep Breathing
Deep breathing after surgery helps to expand your lungs and keep them clear. We will remind you to breathe deeply and often.

Pain Management
We want to make your stay as pain-free as possible. Both drugs and non-drug treatment can be helpful in preventing and controlling pain. Everyone’s pain is different, so please let us know about any pain or discomfort you are experiencing.

As a person with pain, you have:

  • The right to have your report of pain taken seriously and to be treated with dignity and respect by doctors, nurses, pharmacists and other healthcare professionals.
  • The right to have your pain assessed and reassessed regularly and your treatment adjusted if your pain has not eased.
  • The right to actively participate in decisions about how to manage your pain.

How to work with your doctors and nurses:

  • Speak up about pain. Tell your doctor and nurse that you are in pain. Do not wait until the pain is severe. Pain is a common problem that requires attention.
  • Help us measure pain. Along with measuring your blood pressure, pulse, breathing and temperature your doctors and nurses will measure your pain in order to treat it.
  • Only you can tell us about your pain and describe it.

Here are some ways to describe pain:

  • Using a scale of zero to 10, call your pain a number. Zero means no pain at all and 10 is the worst pain you can imagine.
  • Describe what your pain feels like. Use specific words like sharp, stabbing, dull, aching or burning.
  • It is what you call it.
  • Tell your doctor and nurse where it hurts.
  • Explain how your pain affects your daily life. Can you sleep? How is your mood? Does your pain affect your work or exercise?
  • Are you able to enjoy your family and friends?
  • Tell us what makes your pain better or worse. Does movement or certain positions change your pain?
  • Tell us about past treatment you have had for pain. Explain what has worked for you. What types of medicines have helped?
  • Does heat or cold on the painful area help? Have complementary therapies such as massage, meditation, imagery, or aromatherapy helped?
  • You may receive a survey a few weeks after your surgery from Skagit Valley Hospital’s Infection Control team. They may ask you if you have experienced any of these symptoms. Please answer and return the survey. It helps us keep you and future patients safe.
  • Don’t be afraid to speak up about your pain!

Signs and symptoms of wound infection

Watch for signs and symptoms of infection. If you notice any of these signs notify your doctor. Signs and symptoms might include:

  • Fever, higher than 100.5 degrees F.
  • Redness, heat, or excessive swelling in the wound area
  • Red streaks in the skin around the wound or progressing away from the wound
  • White, yellowish, or greenish fluid coming from the wound
  • Tender lumps or swelling in your armpit, groin, or neck
  • Foul odor from the wound
  • Generalized chills

Tobacco Free
Skagit Valley Hospital is a tobacco-free hospital. If you use tobacco, we will talk to you about the support we can give you. We have nicotine patches, gum and lozenges for breakthrough cravings. Your doctor can order these items for you. For helpful information about quitting, call toll-free 1-877-270-STOP or go to

Friends and Family

Friends and family members are welcome to wait in our Day Surgery waiting room during your surgery. Space is limited. Skagit Valley Hospital is wireless internet-enabled campus-wide for those of you with WiFi-enabled laptop computers.

Once your surgery is over, your doctor will meet with a designated family member or friend to update them on your condition.

Your family members can visit you if you are staying overnight in the hospital. All our patient rooms are private rooms to ensure privacy of your medical information. For your comfort and the comfort of other patients, we request you limit visitors to one or two at a time.

Please bring quiet activities for children.

Planning Ahead for Going Home

Talk to your care partner about:

  • Giving you a ride home after you are discharged.
  • Picking up prescriptions before leaving the hospital.
  • Helping you get settled at home and possibly staying with you.
  • Scheduling follow-up appointments with your doctor. After your surgery/procedure, your doctor or nurse will give you and your care partner instructions about when to see your doctor next. When you call for an appointment, say it is for hospital follow-up. If the receptionist knows this, they will make sure you get an appointment when you need it.
  • Discuss with your doctor any limitations you may have after your surgery. 

Going Home
After your surgery you will be closely monitored. When you are ready to go home, a nurse will give you instructions about your home care and medications. You must have a responsible adult drive you home when you are discharged.

If you go home the same day as your surgery, expect a phone call from a nurse the day after your surgery (on Monday, if your surgery is on Friday). The nurse will ask you how you are doing. Please feel free to ask questions.

If you stay in the hospital overnight or longer:

During your hospital stay, our Case Management staff works closely with you, your family members and your nurse to develop a plan for when you go home. The Case Management staff person may be a Case Manager or a Social Worker. If you stay more than one or two days, you may meet more than one member of our staff. Our role is to make an assessment of how well you were functioning before you came to the hospital, and set up services and/or equipment you may need when you go home. For example, you may need a walker or a home health evaluation. If transportation home or to another facility is needed, we will discuss available options with you.

We strive to make your discharge as smooth as possible. If your family or friend is picking you up, please notify them that the discharge time is prior to or around 11 a.m.

Billing Questions
Do you have questions about the cost of your hospital care?

The total amount of charges for your hospital care depends upon the following factors:

  • The type of services your doctor orders. This includes X-rays, CT scans, MRI scans, nuclear medicine tests, EKG, physical therapy, etc.
  • The number of laboratory tests your doctor orders.
  • Medications your doctor orders.
  • How long you stay in the hospital.
  • The amount that you are responsible to pay depends on the insurance coverage you have. The hospital will bill your insurance company (primary and supplemental). You will be responsible for any deductibles, insurance co-pays, or balance on your account that your insurance does not pay.

Depending on the services you received, you may receive several different bills. Skagit Valley Hospital will send you a bill for hospital services. You may receive a separate bill for professional interpretation by a radiologist, pathologist, cardiologist or another physician. If you required anesthesia, you will receive a separate bill for that service. If you have questions concerning your hospital charges, you may call 360-814-2287 during normal business hours, Monday through Friday.

If you have specific questions regarding what your insurance will pay, please contact your insurance company’s customer service department. Their telephone number is usually printed on the back of your insurance card. Assistance with Medicare billing and insurance claims is provided through the Statewide Health Insurance Benefits Advisor (SHIBA) at Skagit Valley Hospital by calling 360-814-2345 to make an appointment at Skagit Valley Hospital.

Additional Resources

Sunrise Inn
The Sunrise Inn, located at the Skagit Valley Hospital campus, is a hospitality house that offers convenient, affordable lodging to family members of hospital patients. For more information and reservations call 360-424-4111.

Staying Healthy
Handwashing is important at all times When you are ill, undergoing treatment, or recovering from surgery, you can be at greater risk for infection. When you are a hospital patient, you may find it difficult to wash your hands as often as you would like. Caregivers at the hospital are available to help with handwashing or can provide handwipes. If water is unavailable use waterless alcohol rinses or gels for handwashing. Products with alcohol are just as effective as washing your hands with traditional soap and water.