Nurses Pushing Propofol for Conscious Sedation -Your Thoughts? - page 6

by *traumaRN*

19,848 Visits | 67 Comments

I would be interested in getting feedback from GI nurses that are involved in propofol sedation in settings with and without anesthesia. Your thoughts and experiences please. Thank you, Randy... Read More


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    Quote from health professinal
    originally posted by wtbcrna
    http://www.nature.com/ajg/journal/v1...g2009429a.html

    decreased pain with colonoscopies with warm water intake especially for patients with ibs.
    thank you.

    actually a very enthusiastic thank you for referring me to that site! i found some other great research articles. i can see that you genuinely like to share information that might be of help to others- although i hope you won't be offended if i say that your "bedside manner" might not work so well in my field
    i have a very professional, very kind, and often humorous bedside manner. the way health professionals are with their patients is rarely how they are on the outside world. i am firm believer you need to have good rapport with your patients, and as a provider you should try to do what you can to make the patient feel as comfortable as possible.
    i have done some strange requests for patients in order to make them feel more comfortable. i knew their requests weren't going to have the outcome they expected, but i always did my best to make it work for them as long as it was safe.

    by the way my writing style is very blunt/sometimes sarcastic, and often comes off confrontational...... personality flaw i guess.... and no i am not offended. it takes a lot to offend me most of the time, especially after being a former prison nurse.
    health professinal likes this.
  2. 0
    Quote from wtbcrna
    I have a very professional, very kind, and often humorous bedside manner. The way health professionals are with their patients is rarely how they are on the outside world. I am firm believer you need to have good rapport with your patients, and as a provider you should try to do what you can to make the patient feel as comfortable as possible.
    I have done some strange requests for patients in order to make them feel more comfortable. I knew their requests weren't going to have the outcome they expected, but I always did my best to make it work for them as long as it was safe.

    By the way my writing style is very blunt/sometimes sarcastic, and often comes off confrontational...... personality flaw I guess.... and no I am not offended. It takes a lot to offend me most of the time, especially after being a former prison nurse.
  3. 0
    I would encourage you to tell the performing MD your experience in writing.
    Then I would get another MD that is willing to listen and work with you.
  4. 0
    Quote from nola1202
    I would encourage you to tell the performing MD your experience in writing.
    Then I would get another MD that is willing to listen and work with you.
    Thanks. Yes I did that. Thankfully I won't have to undergo a colonoscopy for another 10 years.
  5. 0
    [color=#17365d]follow-up: i just received a copy of the report sent to my pcp re the procedure. it states, "the anesthesia plan was to use moderate sedation..." but under physicains orders, it mentions nothing about a sedative. although the dosage line on my copy is not very clear, it appears to state merely "1. start iv with 500 ml of 0.9% ns [normal saline]... 2. oxygen therapy...3. discharge...". as i suspected, i was deceived and not given fentanyl. and even though i had been screaming in pain, it goes on to state, "the colonoscopy was performed without difficulty. the patient tolerated the procedure well..." . note: my signed consent was done on an electronic pad on which i repeated again,"no sedation, analgesic only" before my signature.
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    If you specified no sedation/analgesic only and they gave you sedation, you probably have a cause of action. It's terrible that anyone whould lie to a patient like this. I have had 3 colonoscopies and always spoke with the doctor first and verified that she would not administer sedation; and just for safety we write this on the consent and both sign it. My last one use the electronic consent, we wrote the no sedation/fentanyl only on a progress note, both signed it and I gave it to my wife before the procedure began. One nurse loudly questioned why I insisted that we document this; my GI doc answered: "because more than a few patients have been promised a sedation-free/fentanyl only exam only to be given sedation anyway; many people do not want the creepy benzo amnesia and or loss of control.......many patients will not pay for propofol which is often unecessary for screening colonoscopy,,,most of the GI docs get theirs unsedated anyway....any more questions?"
  7. 0
    Quote from swift125
    most of the GI docs get theirs unsedated anyway....any more questions?"
    Reference?
  8. 0
    with all due respect wannabecrna-it's a common sense issue...any any of the doocs at your facitlit...really, you ask for ref???
  9. 0
    Quote from swift125
    with all due respect wannabecrna-it's a common sense issue...any any of the doocs at your facitlit...really, you ask for ref???
    I have known a lot of gastroenterologists and none have foregone sedation for their personal procedures. Simple fact no one can speak for a large population without having done some sort of study/survey. Commonsense has no place in this. Commonsense to me would indicate that a GI doc would want sedation with propofol only based on the hundreds of thousands of patients research has shown this to be the most beneficial/satisfying for.
  10. 0
    Quote from wtbcrna
    I have known a lot of gastroenterologists and none have foregone sedation for their personal procedures. Simple fact no one can speak for a large population without having done some sort of study/survey. Commonsense has no place in this. Commonsense to me would indicate that a GI doc would want sedation with propofol only based on the hundreds of thousands of patients research has shown this to be the most beneficial/satisfying for.
    sorry wannabecrna...you are wrong.I know a lot of GI docs (not as a nurse) and most skip the dubious benefits of sedation for their own endo procedures. Many patients (myself included) specify fentanyl only (yes, we request this and the doc approves or disapproves the request)............I won't argue with any nurse about this............please lay off the cut and paste "references" your "experience" is lacking..maybe this works as a prison nurse, but in the real world patients have the right to request whatever drugs they want (or refuse) for elective procedures. The physician can agree or not...it's not up to a nurse (CRNA included).............to make this decision.


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