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Anesthetist Questions ECT Article
JANUARY 1990, VOL. 51, NO 1
AORN JOURNAL
threatening situation. The authors state that “most deaths occur from cardiovascular complications in patients whose cardiac status is already compromised.” Anesthesia personnel are trained in the treatment of these complications. Medications commonly used to treat or pretreat ECT patients include nitroglycerin, nifedipine, and trimethaphan camsylate. Anesthesia personnel are experts in handling complications of general anesthesia, profound changes in blood pressure and heart rate, arrhythmias, aspiration, and airway support. The article described the nurse as noting pulse and oxygen saturation level readings from the oximeter. Additional monitors that are needed include electrocardiogram, blood pressure, and a precordial stethescope to assess ventilation. The adequacy of ventilation is difficult to assess at times, and the use of this monitor is accepted as standard care in most departments of anesthesia. The practice of anesthesia requires a great deal of training and, in my opinion, should not be administered by psychiatrists. As registered nurses, it is our responsibility to provide safe care for our patients. In this case, that means having general anesthesia induced and conducted by someone trained in anesthesia. STEPHEN B. GILBERT, RN, CRNA FREE-LANCEIPER DIEMANESTHETIST UNIVERSITY OF CALIFORNIA AT LOS ANGELES MEDICALCENTER AND NEUROPSYCHIATRIC INSTITUTE
Author’s response. We acknowledge that there are various personal opinions and schools of thought regarding the safe administration of anesthesia. Depending on the health practitioner, one can hear different points of view regarding the administration of anesthesia by psychiatrists, surgeons, gastroenterologists, pulmonologists, and even CRNAs. These debates have existed for years and most likely will continue. We could have explained the education of personnel and the monitoring and evaluation of anesthesia provided during ECT. In light of the prevailing lack of awareness among perioperative nurses regarding ECT, we decided to focus our article on providing a general overview of the 22
process for the perioperative nurse. WILLIAM J. DUFFEY,JR,RN, BSN, CNOR / NURSEMANAGER,OUTPATIENT SURGERY POSTANESTHESIA RECOVERY UNIT HEIDICONRADT, RN, BSN NURSEMANAGER, DEPARIMENT OF PSYCHIATRY ST JOSEPH HOSPITAL & HEALTH CARE CENTER CHICAGO
Reader Suggests Association Name Change
I
applaud the editorial “OR Nurse Day-a day for education, not candy and roses,” which appeared in the November issue of the Journal. I am concerned about our future, and I realize that it is our responsibility to share our pride and knowledge with others. I also am anxious for the change in the title of “OR Nurse Day” to “Perioperative Nurse Day.” This brings a question to mind, though. When will our Association change from the Association of Operating Room Nurses, Inc, to the Association of Perioperative Nurses? That change would help educate others to our proper role. MARYGOODMAN-CARR, RN, BSN ASSISTANT COORDINATOR, SURGICAL SERVICES HUMANA HOSPITAL BRANDON BRANDON, FLA.
Editor’s response. Thank you for your comments. My suggestion regarding national OR Nurse Day was not meant to be generalized to the name of our Association. The idea of a name change, however, has been proposed. The rationale for not changing the name was that AORN has excellent name recognition within the nursing and medical professions, with the lay public, and with national and state legislators and regulatory officials, and to change its name now would be more detrimental than beneficial to perioperative nursing.
AORN JOURNAL
threatening situation. The authors state that “most deaths occur from cardiovascular complications in patients whose cardiac status is already compromised.” Anesthesia personnel are trained in the treatment of these complications. Medications commonly used to treat or pretreat ECT patients include nitroglycerin, nifedipine, and trimethaphan camsylate. Anesthesia personnel are experts in handling complications of general anesthesia, profound changes in blood pressure and heart rate, arrhythmias, aspiration, and airway support. The article described the nurse as noting pulse and oxygen saturation level readings from the oximeter. Additional monitors that are needed include electrocardiogram, blood pressure, and a precordial stethescope to assess ventilation. The adequacy of ventilation is difficult to assess at times, and the use of this monitor is accepted as standard care in most departments of anesthesia. The practice of anesthesia requires a great deal of training and, in my opinion, should not be administered by psychiatrists. As registered nurses, it is our responsibility to provide safe care for our patients. In this case, that means having general anesthesia induced and conducted by someone trained in anesthesia. STEPHEN B. GILBERT, RN, CRNA FREE-LANCEIPER DIEMANESTHETIST UNIVERSITY OF CALIFORNIA AT LOS ANGELES MEDICALCENTER AND NEUROPSYCHIATRIC INSTITUTE
Author’s response. We acknowledge that there are various personal opinions and schools of thought regarding the safe administration of anesthesia. Depending on the health practitioner, one can hear different points of view regarding the administration of anesthesia by psychiatrists, surgeons, gastroenterologists, pulmonologists, and even CRNAs. These debates have existed for years and most likely will continue. We could have explained the education of personnel and the monitoring and evaluation of anesthesia provided during ECT. In light of the prevailing lack of awareness among perioperative nurses regarding ECT, we decided to focus our article on providing a general overview of the 22
process for the perioperative nurse. WILLIAM J. DUFFEY,JR,RN, BSN, CNOR / NURSEMANAGER,OUTPATIENT SURGERY POSTANESTHESIA RECOVERY UNIT HEIDICONRADT, RN, BSN NURSEMANAGER, DEPARIMENT OF PSYCHIATRY ST JOSEPH HOSPITAL & HEALTH CARE CENTER CHICAGO
Reader Suggests Association Name Change
I
applaud the editorial “OR Nurse Day-a day for education, not candy and roses,” which appeared in the November issue of the Journal. I am concerned about our future, and I realize that it is our responsibility to share our pride and knowledge with others. I also am anxious for the change in the title of “OR Nurse Day” to “Perioperative Nurse Day.” This brings a question to mind, though. When will our Association change from the Association of Operating Room Nurses, Inc, to the Association of Perioperative Nurses? That change would help educate others to our proper role. MARYGOODMAN-CARR, RN, BSN ASSISTANT COORDINATOR, SURGICAL SERVICES HUMANA HOSPITAL BRANDON BRANDON, FLA.
Editor’s response. Thank you for your comments. My suggestion regarding national OR Nurse Day was not meant to be generalized to the name of our Association. The idea of a name change, however, has been proposed. The rationale for not changing the name was that AORN has excellent name recognition within the nursing and medical professions, with the lay public, and with national and state legislators and regulatory officials, and to change its name now would be more detrimental than beneficial to perioperative nursing.