Conscious sedation and consent

[kpagett]

Hello there. I am an endoscopy nurse working in the UK. I am also studying and am looking at the right of the patient under the influence of conscious sedation to withdraw their consent mid procedure.

I would be interested to know if any units have set policy to deal with the situation? I believe some units now recognise this as a problem and are addressing the issue. From experience however there are still those doctors that will listen to the patient and/or nurse and there are those who will attempt to carry on despite the patient saying stop and ignoring the nurse completely.

[suzanne4, RN]

If the patient is alert enough and asking the doctor to stop, it looks more like issues with the conscious sedation that they are receiving. They should have gad enough medication so that they are sleeping thru the procedure or are under a twilight sleep.

Can I ask waht meds and in what doses that you are using routinely? That amy be where the issue lies.

I worked in a GI lab for years, and have never had a patient ask that it be stopped, they need to be comfortable enough. And if complaining of apin, then they need more medication.

[ZZTopRN, BSN, RN]

I have been treated for "watermelon stomach" for over a year with periodic cauterizations of my stomach until the bleeding was under control. Hg went from 6 to 14.1. However, 3 months after the next procedure (endoscopy) I was completely conscious and was having pain and tried telling the doctor. I have always been not conscious during the prior procedures. The usual fentynal and versed. However, I asked the doc why I was having pain and why I was conscious. He said it was because he "went into the esophagus." This time he said I had AV malformation of the esophagus and to come back in 3 months. Gave me the pictures of the side that was cauterized along with the other side where seeping blood could be seen. In that early am I had horrible pain and called the doctor. He told me to go to the emergency room, I asked why couldn't he just order some medication for me? Anyway, he said he was going to meet me in the emergency department, which never happened. The ER doc came and told me the CT scan was normal and not another word was said to me or anyone came back. Finally, tiring of lying on the stretcher in the ER wiped out from the pain and lack of sleep, I asked the nurse to remove my IV, I was going home. The ER doc called my doc, and my doc said I could go home. When he called the next day and asked how I was feeling, you can imagine what my comments were. I told him that we were parting company and he apologized. I have an appointment with him in about 3 weeks to "discuss this misunderstanding." As I said, he did a wonderful job with cauterizing the bleeders in my stomach, but AV malformation all of a sudden, conscious, and the doc saying he gave me all the pain med he could, what the #!"%?

Although I am going to have the appointment with him, I want to give him the benefit of the dbout, but he is part of one of those large corporate hospitals that runs the endoscopy like an assembly line. I just don't know whether to trust him any more. He is Dr. ***** INC.s And of course, if a doctor belongs to a large corporate hospital, you will have much trouble finding another doctor who will take you. This hospital chain has just about gobbled up all the hospitals in this city. I feel kind of scared! AV malformation of the esophagus. Gee, I wonder if I have the same thing in my brain. Sorry if I sound wound up, but I am really uncomfortable with all these "whiz through" procedures. I need some comfort!!!!!!!