Patient with awareness - page 3

What do you think of a patient who had a resting HR of 43, initial BP of 114/58 (athlete, no cardio probs) who was kept at about 120/60 and a HR of 65-83 for about 2 hours, and had intraoperative... Read More

  1. by   loisane
    Quote from Mana_Tangata
    I was cut lose without any couseling, completely unprepared for the psychological consequenses. .
    Mana, anesthesia professionals are sometimes accountable for awareness and sometimes not. That is because sometimes it is due to negligence and bad practice, but many times it occurs when there is no negligence, and nothing wrong with the practice of anesthesia given. It is frustrating for the victim, because there may be nobody to "blame", and it is only human nature to want there to be an identifiable reason that this happened.

    However, we are ALWAYS accountable for our reaction to the patient after such an event has occured. I am sorry you did not get the after care you required. As jwk stated, there are procedures we all know about, that should be followed in every case.

    Quote from Mana_Tangata
    I have two friends who also experienced this, both trauma cases. Do I think that they received substandard care? No. I don't think in either case the anesthesia providor knew about the awareness. This was a good ten years ago, so before all the press.
    This is a new issue to the public. It is NOT a new issue to those of us who do this for a living. I only mention this, because I think there is the perception among the public that if they don't spread the word, the anesthesia community will remain unaware.

    Awareness has been studied for decades. One of the things that is well known from these studies is that patients in particular situations are at an increased risk for awareness. Trauma is one of those at risk populations. It has to do with the way our drugs work. In trauma there is often so much blood loss, that the addition of our usual anesthesia drugs is not safe for the patient. In order to save a patient's life, we may have to risk awareness. I think most people would understand that trade off, once it is explained to them.

    loisane crna
  2. by   Mana_Tangata
    Quote from loisane
    Mana, anesthesia professionals are sometimes accountable for awareness and sometimes not. That is because sometimes it is due to negligence and bad practice, but many times it occurs when there is no negligence, and nothing wrong with the practice of anesthesia given. It is frustrating for the victim, because there may be nobody to "blame", and it is only human nature to want there to be an identifiable reason that this happened.

    However, we are ALWAYS accountable for our reaction to the patient after such an event has occured. I am sorry you did not get the after care you required. As jwk stated, there are procedures we all know about, that should be followed in every case.



    This is a new issue to the public. It is NOT a new issue to those of us who do this for a living. I only mention this, because I think there is the perception among the public that if they don't spread the word, the anesthesia community will remain unaware.

    Awareness has been studied for decades. One of the things that is well known from these studies is that patients in particular situations are at an increased risk for awareness. Trauma is one of those at risk populations. It has to do with the way our drugs work. In trauma there is often so much blood loss, that the addition of our usual anesthesia drugs is not safe for the patient. In order to save a patient's life, we may have to risk awareness. I think most people would understand that trade off, once it is explained to them.

    loisane crna
    I don't think that the anesthesia community is unaware - I agree with you that the exact opposite is the case and you have been barraged with the topic. As far as other folks in the medical profession, and getting policies in place, I'm not so sure. I think that the reason I did not get the after care recommended by JCAHO is because the hospital did not have any policies to deal with me. While I am very angry at the anesthesiologist regarding my aftercare, I have to acknowlege that the experience was probably very traumatic for him as well, and he may not have been thinking clearly. (we are all human) If the hospital had some kind of policy it would have helped both him and me.
  3. by   jwk
    Quote from DutchgirlRN
    Well Good Morning to you too and who pissed in your corn flakes this morning??? I was telling the members (not just you) what I had heard on the news and no I don't work at Centennial for whatever difference that makes. So what if I post some info from a website? Who in the hell is Carol Wieher anyway? I was just looking for some helpful information because I wanted to know more about Anesthesia awareness myself. What kind of points am I supposed to be earning? I don't need acceptance on this site, I already have it. What flames am I supposedly fanning? I'm not looking for trouble, never do. And yes I do take offense at your post. Totally uncalled for. Must have hit a nerve on you somewhere. Don't take that out on me. Get a life !
    Carol Weihrer (spelled correctly now) makes a living off her story about anesthesia awareness. The piece you cut and pasted into your post was verbatim from her website, whether you know it or not. Anesthesia professionals everywhere have heard her story - we're just not interested in hearing it again. And because she profits from all this, her credibility is shot.

    No offense was intended, certainly not to cause the response that you made. You're posting in an anesthesia section. We're aware of the problem. Whether you want to admit it or not, your posts do, in fact, fan the flames of an extremely controversial topic, particularly between professionals who actually have knowledge of the problem, and monitor manufacturers and the media, who seem to enjoy a sensational story from which both will profit.

    You say you want to know more. Do a search on this forum for anesthesia awareness or BIS. You'll see it discussed ad nauseum, and you'll see the strong opinions that most of us hold regarding this topic.
    Last edit by jwk on Feb 16, '05
  4. by   jwk
    Quote from Mana_Tangata
    I think that the reason I did not get the after care recommended by JCAHO is because the hospital did not have any policies to deal with me. While I am very angry at the anesthesiologist regarding my aftercare, I have to acknowlege that the experience was probably very traumatic for him as well, and he may not have been thinking clearly. (we are all human) If the hospital had some kind of policy it would have helped both him and me.
    If this happened to you in the last few months, you should have been dealt with in a much better way than you have been. Whether we agree with JCAHO on this issue or not (many of us don't for a variety of reasons), their advice to hospitals and anesthesia professionals to deal with the issue up front and with true concern for the patients who believe they have experienced this are sound.

    Interesting that you think it may have been traumatic for him. Your compassion towards him speaks volumes about your character and personality - you're much nicer about this than I think I would have been.
  5. by   jewelcutt
    Dutchgirl,

    I think what was flaming about your post is the very article you chose to post, whether you intentionally meant to do it or not. With all the thousands of articles on recall (including the professional ones) you chose to post a personal account that has a great deal of innacurate information in it and is often used to make money by drawing the public to look at the "horrors" of anesthesia. The article assumes we are uncaring professionals towards recall, when infact everything we do is to prevent it. Being a nurse yourself you should know better than to display information like that to uninformed people. Now I didn't mean to insult you in saying that but we all know how innacurate information can get out of control. Mana, you really haven't insulted anyone on this board, you must be incredibly frustrated about the situation and if I where in your shoes I would definitely want the answers, you should keep looking into it.
  6. by   DutchgirlRN
    Quote from jewelcutt
    Dutchgirl,

    I think what was flaming about your post is the very article you chose to post, whether you intentionally meant to do it or not. With all the thousands of articles on recall (including the professional ones) you chose to post a personal account that has a great deal of innacurate information in it and is often used to make money by drawing the public to look at the "horrors" of anesthesia. The article assumes we are uncaring professionals towards recall, when infact everything we do is to prevent it
    I don't know anything about this woman whose article I borrowed from, I was googling and that's where it came from. I apoligize for unknowingly upsetting anyone. On the other hand, some members need not be so sensitive, or so rude!
  7. by   athomas91
    loisane and kevin - very well said...
  8. by   loisane
    Quote from DutchgirlRN
    I don't know anything about this woman whose article I borrowed from, I was googling and that's where it came from. I apoligize for unknowingly upsetting anyone. On the other hand, some members need not be so sensitive, or so rude!
    I have been trying to come up with a way to help Dutchgirl see the big picture here. In the meantime, others have done well, so perhaps enough has been said. I hope I do not risk being overbearing by offering my analogy, anyway.

    As others have emphasized, you are posting on an ANESTHESIA forum. (This seems to be easy to do, judging from the number of posts on various threads here that just don't quite hit the mark of the discussion at hand). When you try to educate us about awareness, it is a little like barging into Picasso's art studio and asking if he had ever considered using paint by numbers! When you stumble in such a public way, someone is bound to point it out to you. And if someone is a little blunt in their manner of pointing it out, that isn't very surprising either.

    Your defense that you didn't know the history of your quote is a little weak. Why shouldn't you know something about the source? You are the one who quoted her. Consider this-if I am preparing education materials for patients, what source do I use-the National Enquirer? or the American Journal of Nursing? Isn't it part of my job as a professional to know the difference? There are lots of professional information on awareness and the formation of memory during anesthesia. I have read dozens of peer reviewed research articles, going back several decades on this subject.

    Not to pick on Dutchgirl, because occassionally we could all benefit from a reminder that our responses here are reflective of health care professionals and the respected field of professional nursing.

    If you have read my other posts, then you know that (unlike some of my colleagues) I do not find fault with the original poster for coming here in her search for answers about what happened to her. But I do think it is important for us to keep the discussion professional, thoughtful and educated.

    Dutchgirl, thank you for the opportunity to use your comments as an illustration of how we can all improve our professional discourse. I am sure you are more than ready to drop this by now, and I appreciate your indulgence!

    loisane crna
  9. by   London88
    Loisane:

    Once again, very well said. It is one thing to make an uninformed statement like Dutchgirl did, but to try and argue to defend that statement is another. There is nothing like a non anesthesia provider trying to educate an anesthesia provider on anesthesia, and then cannot understand why they would illicit such a response like jkw's response.
  10. by   jwk
    Loisane - you rock!
  11. by   DutchgirlRN
    Quote from London88
    Loisane:

    Once again, very well said. It is one thing to make an uninformed statement like Dutchgirl did, but to try and argue to defend that statement is another. There is nothing like a non anesthesia provider trying to educate an anesthesia provider on anesthesia, and then cannot understand why they would illicit such a response like jkw's response.
    I was not trying to defend anything only to explain how I came up with that info, that I didn't know anything and I was sorry. I've had enough of this. I didn't realize that I was on a anesthesia thread. I get your point. I'm gone.
  12. by   loisane
    Quote from DutchgirlRN
    I get your point. I'm gone.
    I was afraid it would sound like I was trying to beat you over the head. I am sorry that my post did not convey the sincere kindness with which it was offered.

    I am not in favor of limiting these discussions to only anesthesia professionals. Nurses spend way to much time in our very limited subspecialties. I am happy to engage with those outside of the profession. I encourage you to stay, and learn more about what we do.

    loisane crna
  13. by   kmchugh
    First, to Loisane: Excellent responses to Dutchgirl. I don't think anyone here would suggest that only anesthesia providers should post here. However, it is always a good idea to know a little about your target audience. You expressed that better than I could have.

    Next, to Mana Tangata: Please don't think I am angry with you, I'm not. Though I didn't care for how you initially presented your case to this board, I can understand why you chose to do it that way. None of what I wrote was in any way a suggestion that you should just be quiet about what happened. In fact, we (anesthesia providers) need to know that it happened. We need to know the circumstances of why it happened, if for no other reason than to try to figure ways to prevent it from happening in the future. And I strongly suggest that you consider counseling. Even though you may feel fine right now, this can lead to PTSD, and long term problems with depression and fear. You shouldn't have to live like that. You should be concerned with yourself, as well as the concern you expressed that this not happen to others. And yes, the hospital where this occurred, as well as your anesthesia provider, have some responsibility to assist you in getting this help. This isn't something you should deal with alone.

    Kevin McHugh

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