What Do I Do If There Is No Surgical Protocol?

If you treat post-surgical patients regularly, you’ve likely encountered a situation where no surgical protocol is provided. This can be overwhelming, especially for new graduates or younger clinicians with limited experience in certain procedures. The key is to stay calm, be prepared, and approach the situation methodically.

Step 1: Do Your Research

Before the patient arrives, do your best to gather information. Ideally, the patient will have completed their intake forms in advance, allowing you to know what procedure they underwent. If no protocol is attached to their chart, search online for a reputable protocol that closely matches the surgery.

Showing that you’ve taken time to prepare goes a long way in establishing trust and managing the patient’s expectations.

Step 2: Stay Calm and Focus on Impairments

If you don’t have time to prepare or lack the necessary information during the first session, don’t panic. It’s crucial to remain composed while discussing the patient’s history. Any sign of uncertainty can cause the patient to lose confidence in your care.

In the absence of a specific protocol, start by addressing what you do know: their impairments. Focus on the fundamentals:

• Range of motion deficits

• Strength impairments

• Functional limitations

• Pain levels

These are reliable starting points for treatment, regardless of the procedure. After the session, take the time to research the specific surgery and relevant protocols so you can provide more tailored guidance in the next visit.

Step 3: Embrace a Growth Mindset

Recognize that not every surgery will come with a detailed protocol—and that’s okay. This is a learning opportunity. Surgical techniques are constantly evolving, and new procedures emerge regularly. Even experienced clinicians encounter unfamiliar surgeries from time to time.

For example, I recently worked with a patient who had a proximal tibiofibular joint replacement due to chronic joint subluxations. It was a procedure I had never encountered before. Without a protocol, I relied on my foundational knowledge: treating impairments, monitoring progress, and ensuring the patient felt supported throughout their recovery.

Key Takeaways

1. Expect the unexpected: Accept that you won’t always have a protocol for every surgery. This is a normal part of clinical practice.

2. Be proactive: When possible, research the surgery and find reputable protocols to guide your treatment.

3. Stay focused on impairments: In the absence of a protocol, use your clinical judgment to address range of motion, strength, function, and pain.

4. Keep learning: Adopt a growth mindset and stay curious about new surgical techniques and procedures.

By following these steps, you’ll be better equipped to handle situations where no protocol is available, ensuring your patients receive high-quality care and feel confident in your expertise. With experience and preparation, you can turn these moments of uncertainty into opportunities for growth and professional development.