Methodist and Transplant 22Apr2016
This week I was able to witness electro convulsive therapy. The first thing that we learned was how to set up the patient. The electrodes were placed on the head above the eye and placed on the hips. The patient’s vital signs were taken and recorded and the procedure consent was verified. When the DR and anesthesia provider arrived the procedure began. First a medication was used to decrease their saliva secretions. (Robinol) After that the patients received a medication that put the patient under general anesthesia. Succinylcholine was then used to paralyze the patient. The shock was then delivered which induced the seizure. I thought it was interesting as to how the brain was able to stop the seizures.
During the seizure phase of the ECT treatment I was anxious as to when the patient would stop seizing. There was always a part of me that was thinking “what happens if they don’t stop seizing?” I was also worried that possibly the procedures were going too fast. The DR would start before the last patient could breathe on their own. The nursing staff was professional with patients and had good skills such as being able to provide ventilation via the bag valve mask. I feel as though the treatments are effective and are beneficial to the patients.
One thing that the experience of ECT gave me was a clearer understanding of the process. This has taught me how modern day ECT treatment is performed and I will be able to explain it to patients. I also learned a lot about medications such as Robinol used to decrease saliva excretions. One of the biggest impacts was realizing that I may be suffering from alarm fatigue. One of the patient’s spo2 % began to drop and I was unaware of the situation even though I was only one spot away from the patient.
One thing that I can take away from the ECT experience is being able to describe the procedure to patients. ECT can be a scary procedure and being able to provide basic education to patients who have never experienced it I believe will be beneficial in my career.
One other instance that I had during my clinical day occurred on the level 1 male side. During group therapy the discussion of negative thoughts came up. One thing that was taught as a coping mechanism Is to replace the negative thoughts instead of fighting them. One patient felt as if he was stuck in a pattern of negative thinking. For instance if a person is thinking of harming themselves they should think of another topic such as thinking of how have people shown me love today? Patient privacy is also of paramount importance. One patient worked in a construction company that was renovating the hospital. We had to reassure him that no one from his company would know he is here. Explaining the steps we take to ensure his privacy seemed to put him at ease.
Overall I thought that the care patients receive there was excellent. Personally I don’t want to work in the psych area of nursing but am appreciative of the experiences I have had.