📝 Ready for the quiz? RN GA Paperwork Quiz (20 questions)

What This Module Covers

Three days before every scheduled GA, you make a health check call to the family. This call screens for illness that would require cancelling or postponing surgery. This reading also covers six parent communication scripts for the most common conversations during GA paperwork appointments.

The Three-Day Health Check Call

This call is mandatory for every GA case. It is the final safety checkpoint before surgery day.

Call the family three business days before the scheduled surgery. Ask about each of the following, one at a time:

Fever. Has your child had any fever in the past week, even a low-grade fever?

Cold symptoms. Does your child have a runny nose, congestion, or sore throat?

Cough. Has your child been coughing, even mildly?

Antibiotics. Is your child currently on antibiotics or has your child recently finished a course of antibiotics?

Recent illness. Has your child been ill for any reason since our last appointment?

For asthma patients specifically. Has there been any change in your child’s breathing, any increase in inhaler use, or any wheezing?

If all screening questions are clear, document: “Three-day health check completed. Cleared for GA.”

If any answer raises concern, do not make the cancellation decision yourself. Notify Dr. Tsang immediately with the specific findings. Dr. Tsang will decide whether to proceed, delay, or cancel.

When Findings Require Escalation

Some findings require immediate escalation regardless of how minor they seem:

A child who has completed antibiotics within the past week needs physician clearance. Recent antibiotic use suggests an active or recently resolved infection that could complicate anesthesia.

A child with any respiratory symptoms, even a mild cough, needs Dr. Tsang’s assessment. Upper respiratory infections are one of the most common reasons for GA cancellations because they increase airway reactivity during intubation.

A child whose parent reports “just a little runny nose” still needs escalation. Parents often minimize symptoms because they do not want surgery cancelled, especially if they have arranged time off work or travel.

Six Parent Communication Scripts

These scripts cover the most common conversations during GA paperwork appointments. They are not rigid word-for-word scripts. They are frameworks for how to communicate difficult information with clarity and empathy.

Script One: Opening the Appointment

Use this framework when beginning a GA paperwork appointment:

“Thank you for coming in today. I know this can feel overwhelming, especially when it involves anesthesia for your child. Today we are going to walk through everything together, what will happen, what you need to prepare, and what to expect. The goal is that on surgery day, there are no surprises. You will feel prepared and your child will be safe.”

The key principles are: acknowledge the anxiety, establish the purpose, and promise clarity.

Script Two: Fasting Instructions

Use this framework when explaining the fasting requirement:

“This is the most important thing I will tell you today. Your child cannot eat or drink anything for at least five hours before the procedure. That means no food, no water, no milk, no juice, not even a small sip. If your child has anything at all, we will have to cancel the surgery because it is not safe to proceed. I need you to tell me back what you understand about the fasting rule.”

The key principles are: signal the importance, use absolute language, explain the consequence, and verify understanding through teach-back.

Script Three: GA Day Walkthrough

Use this framework when explaining what happens on surgery day:

“On the day of surgery, you will arrive at the facility and check in. Your child will meet the anesthesia team. Depending on your child’s age, they will either breathe through a mask or have a small IV placed to go to sleep. One parent may be able to stay until your child is asleep. Once asleep, Dr. Tsang will take new x-rays, review the treatment plan, and complete all the dental work. Your child will then wake up in the recovery room. The whole day from arrival to going home is usually five to six hours.”

If the parent asks about induction: “Most young children go to sleep breathing through a flavoured mask. Older children may have an IV placed. The anesthesiologist decides what is safest for your child.”

Script Four: Financial Expectations

Use this framework when discussing costs:

“I want to make sure you understand the financial side before surgery day. The treatment estimate is based on what we can see right now. Once your child is asleep and we take full x-rays, Dr. Tsang may find additional work that was not visible before. This means the final cost could be different from the estimate. I want you to know this now so there are no surprises. The deposit and Health and Physical form are due three weeks before surgery.”

The key principles are: set realistic expectations about treatment plan changes, avoid overpromising, and state deadlines clearly.

Script Five: Travel Logistics (For Out-of-Town Families)

Use this framework when the family is traveling for the appointment:

“Because you are traveling for this surgery, there are a few extra things to consider. I recommend arriving the day before surgery rather than the morning of. If your child gets a cold or fever before the trip, we may need to reschedule, so I would recommend flexible travel arrangements when possible. After surgery, please plan to stay overnight rather than traveling home the same day. Your child will be groggy and may need monitoring.”

If applicable: “Please bring all of your child’s medications to the facility, especially inhalers.”

Script Six: BMI and Facility Change Conversation

Use this framework when BMI assessment requires a facility change:

“I have reviewed your child’s medical information and I want to explain what this means for our surgical planning. Based on your child’s current size, the private facility is not the safest option. This is not about appearance or diet. It is about how your child’s body responds to anesthesia. Children with higher body weight have different airway characteristics, and the public hospital has the equipment and team to manage this safely. I want to choose the facility where your child will be safest.”

The key principles are: lead with safety, avoid shaming language, explain the clinical reasoning simply, and frame the hospital as the better option, not a downgrade.

Quick Reference

Script When to Use Key Principle
Opening Every appointment start Acknowledge anxiety, promise clarity
Fasting Every appointment Absolute language, teach-back
GA Day Every appointment Walk through chronologically, set time expectations
Financial Every appointment Set realistic expectations, state deadlines
Travel Out-of-town families only Recommend early arrival, flexible bookings
BMI / Facility When BMI requires hospital referral Lead with safety, no shaming language

Knowledge Check

Before continuing, consider these questions:

  1. What specific questions do you ask during the three-day health check call?
  2. Why should you escalate even a “mild runny nose” before surgery?
  3. How does the teach-back method work for fasting instructions?
  4. What is the key principle when discussing a BMI-related facility change with a parent?

Next Reading

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