Can a patient refuse sedation?

  1. 0
    My G.I. want to use Versed for a long colonoscopy.

    Even tho my last colonoscopy was painful,i don't think i want to be sedated with weird meds.

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  2. 36 Comments...

  3. 5
    A patient can refuse any and all procedures/meds/treatments they want.
  4. 5
    But keep in mind the doctor can also refuse to do the procedure so its best to hash it out and get things out in the open before hand.
  5. 1
    you can refuse anything you want to refuse, thats your right!

    like crohnie said tho, some doctors may not want to do the procedure without you being sedated. you may want to discuss your options with them beforehand.
    herring_RN likes this.
  6. 2
    Am I ever feeling like a woose!! I had propofol for my colonoscopy!!
    darne20 and flightnurse2b like this.
  7. 5
    No need to feel like a woose!!! The important things is to have our colonoscopies as needed and recommended! Whether we are a woose or a masochist or somewhere in between has absolutely no bearing. Just have those scopes as needed!!!

    Now, if you wanna talk about those darn preps before a colonoscopy ......:angryfirebugeyes::bowingpur
    nurse671, VivaLasViejas, darne20, and 2 others like this.
  8. 1
    I had a flexible sigmoidoscopy without anesthesia.
    Last time for a colonoscopy the MD suggested a CRNA. I paid an extra $100.00 because insurance didn't approve it.
    I am glad because I want a competent RN without any other duty for conscious sedation.

    It is YOUR choice. The same as for all patients.
    darne20 likes this.
  9. 1
    Absolutely, but as stated, the doc can decline to do the procedure. I get yearly colonoscopies and after one absolutely horrible experience with Versed (Midazolam), I would never consent to that drug again. The long-term memory loss and the depression has to be experienced to be believed. About 90% of patients have a decent experience with Versed; but 10% do not. Most patients leave the endoscopy suite in a semi-daze and appear to be content; in about 10% the nightmares etc. start later. I used to think that the horror stories about Versed ( or versedbusters) were a little exaggerated, but I have never heard of a drug that was so hated to have it's own website. My degree is in clinical pharmacology; I believe that patients who are properly consented beforehand by a nurse (ie: this drug is being given so you will forget the procedure, not: this drug is to make you comfy) will, for the most part, do o.k. with Versed. I was not properly consented, and even though I know a lot about benzodiazepines and GABA-A receptor theory, the creepy amnesia from Versed haunted me for a long time before I figured out what was wrong. Even now, facing painful elbow and wrist surgery on both arms, I'm sure that I will consent only to a Bier Block without any sedation whatsoever. Sure, discuss your options with the GI doc beforehand; any reasonable doc will let you skip Versed, if you need something for pain consider Fentanyl only. But I hate to say it, most GI docs like an amnesic patient and only see the patient immediately after the procedure and the problems start later. My last 2 colonoscopies were with nothing; each time I was ready for them to try to talk me into conscious sedation..when I mentioned problems with Versed, the doc agreed immediately and she told me that they had a lot of patients complain about it and that she would not consent to receiving it herself. I had my latest colonoscopy at the hospital where I work an I made sure that everyone knew my low opinion of Versed and the doc assured me that I would not get it. I was surprized when they had a problem with me declining the IV (I wanted to make sure that there were no screw-ups); the nurse who wanted to start the IV was a CRNA; my doc had called her in so that I could get Propofol instead of Versed. When I declined Propofol, the CRNA told me that there was no extra charge for her services (as a courtesy since my first exam was a disaster and I was given Versed even though it was a listed allergy. She was somewhat disappointed that I no longer trust sedation of any kind; all of this could have been avoided if a nurse was available to do informed consent for the first procedure-never let economics or scheduling remove your professional nursing skills from the process-you are essential to patient safety. Interestingly enough, the CRNA told me that she would also decline Versed and that she almost never uses it. Unfortunately, I doubt that I will ever consent to any type of sedation, no matter ho painful the procedure. And I know better; a bad experience with Versed can do that to you, even if you have a Ph.D. Just make sure that you get real informed consent before and type of mind-altering drugs are administered.
    neveragain likes this.
  10. 1
    In theory the patient is allowed to have some say over sedation drugs or anything else for that matter. In practice it's not true. My nurse never said a word even though she knew that I had declined the drugs and had not signed an informed consent for same. I think she was intimidated (?) by the CRNA and the Doctor.
    darne20 likes this.
  11. 1
    Yes, you can. However, it is only fair that you advise your doctor well before the procedure that you will not accept sedation. Understand that your refusing sedation whether days prior to the procedure or immediately prior to the procedure, your doctor also has the option of refusing to do the procedure w/o sedation. That is why it is best to discuss the matter well before hand so the two of you come to a meeting of the minds.
    darne20 likes this.

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