Electroconvulsive Therapy

elkpark · Mar 23, 2011

I wouldn't call myself an "ECT nurse," but I've been a psychiatric nurse for a long time, and have been involved in ECT and working with clients receiving ECT. What are your specific questions?

Mashira · Mar 28, 2011

I understand the pre-procedure assessments, but I am wondering what I would actually be doing during the procedure other than applying the BP cuff and perhaps administering the sedative?

Domestika · Apr 2, 2011

In my experience the nurse is mostly there to set things up once the patient comes in and disconnect things once the procedure is done. The procedure is so quick, there's really not time to do much else. The anesthetist should be handling most everything else and the physician is doing the actual procedure. I've seen an experienced nurse get people in and out in basically 15 minutes. The majority of that time is the anesthetic doing its thing and then making sure the patient is stable before performing the actual procedure.

Lucky724 · Jun 23, 2011

I too am curious about this treatment..it sounds...barbaric in the sense of convulsions..does the patient actually convulse?

Whispera, MSN, RN · Jun 23, 2011

It's not at all like in the movies, at least most of the time. Sedatives and paralytics are given. Usually all you'll see is a lower leg twitch.

MickeyTong · Jun 23, 2011

I too am curious about this treatment..it sounds...barbaric in the sense of convulsions..does the patient actually convulse?

The patient is unconscious (general anaesthetic) and has had a muscle relaxant. As Whispera wrote, all you'll see is a slight twitch of the lower leg (and a pointing index finger and a bit of a facial grimace). There is no incontinence.

ECT saves lives. Do you think mastectomy is barbaric?

Lucky724 · Jun 23, 2011

My post was not meant to be insulting or to cause anyone to become defensive.. the reason I was asking is because, in the 1970's, my mother went through the treatment and is WAS barbaric at that time...I wanted to know if the measures taken and treatment provided, had progressed since then. And, yes, in the sense a breast is removed, I do think its" barbaric" in the sense of the trauma to the body but also necessary - as ECT is. It was a question based out of personal interest - that is all. It's unfortunately you assumed something more.

MickeyTong · Jun 23, 2011

My post was not meant to be insulting or to cause anyone to become defensive.. the reason I was asking is because, in the 1970's, my mother went through the treatment and is WAS barbaric at that time...I wanted to know if the measures taken and treatment provided, had progressed since then. And, yes, in the sense a breast is removed, I do think its" barbaric" in the sense of the trauma to the body but also necessary - as ECT is. It was a question based out of personal interest - that is all. It's unfortunately you assumed something more.

The word "barbaric" implies "insensitive, unnecessary brutality". Unfortunately, psychiatry has a history of "treatments" that were ...... less than humane and grotesquely inconsiderate. And we still, sometimes, actually inject people with powerful drugs which have unpleasant side effects against their expressed wishes.

Sorry to hear about your mother: I've no doubt her experience was horrific.

Progress has been made since the 1970s. ECT is now a treatment of last resort when a profound depression has failed to respond to antidepressant meds, or if the patient's mood needs to improve faster than than the meds will work.

Starting Over... · Jun 24, 2011

"...Electroconvulsive Therapy....?"

Look up fainting in Webster's Unabridged dictionary and you will surely find my picture

:eek:

...And just went I thought psych nursing was for me...I recant

elkpark · Jun 24, 2011

The word "barbaric" implies "insensitive, unnecessary brutality". Unfortunately, psychiatry has a history of "treatments" that were ...... less than humane and grotesquely inconsiderate. And we still, sometimes, actually inject people with powerful drugs which have unpleasant side effects against their expressed wishes.
Sorry to hear about your mother: I've no doubt her experience was horrific.
Progress has been made since the 1970s. ECT is now a treatment of last resort when a profound depression has failed to respond to antidepressant meds, or if the patient's mood needs to improve faster than than the meds will work.

Not only is there much more specificity in the indications for ECT than there used to be in the "bad old days" (when they basically shocked anyone for anything -- I had an aunt who was in and out of state hospitals in the '60s and '70s, who also had "old style" ECT in those days and talked with me about her experiences years later) but the amount of electricity has been decreased quite a bit over the years, and, as already noted, people are now anesthetized and paralyzed so there is almost no physical seizure activity, just the related electrical activity in the brain (which is the purposes of the treatment) and no awareness/memory of the actual procedure.

Everybody has seen the old movies set in psych hospitals that prominently feature ECT, but v. few people have any awareness of, let alone exposure to, modern ECT practice. I find that, when it comes up in conversation, most people are unaware that it's still being used and assume that it was banned long ago. It's v. different than it used to be (and as portrayed in the movies), and I've personally seen it help (dramatically) lots of people who weren't helped by anything else psychiatry had to offer, and who would have died (or ended up institutionalized in a near vegetative state) from their conditions if they hadn't gotten some relief.

ECT is a safe, effective treatment for some psychiatric conditions/disorders for which we don't have any other effective treatments, and I, personally, would be much more willing to have ECT (based on what I know and what I've seen over the years in psych nursing) than I would be to take a lot of the psych drugs we give people ...

MickeyTong · Jun 24, 2011

"...Electroconvulsive Therapy....?"
Look up fainting in Webster's Unabridged dictionary and you will surely find my picture
...And just went I thought psych nursing was for me...I recant

I haven't met a single patient in the past 9 or 10 years who has been prescribed ECT. It really is a treatment of last resort.