Moderate Sedation Tips

  1. Hello all!

    I'm a new endo nurse (<3 years) that came from a community hospital with CRNA's administering propofol. I've charted, assisted doctors with all the procedures, and reprocessed scopes. I'm pretty proficient hands on with the technical aspect of endo procedures. However I just moved out of state and am currently working at a much bigger teaching hospital where nurses do moderate sedation and have techs assisting the doctors. My background is med-surg prior to endoscopy and now I'm rotating from pre-op, intra op, and post op. I've never done moderate sedation before and will be rotating into intra-op soon. I've bought some books to assist me with this new learning curve. Does anybody have any words of advice/wisdom to decrease my anxiety with this? Anything I should brush up on?

    Much much appreciated!
  2. Visit 5h3ryL profile page

    About 5h3ryL, BSN, RN

    Joined: Dec '10; Posts: 24; Likes: 1
    RN; from US
    Specialty: Medsurg/Telemetry


  3. by   brownbook
    Every (all two of them, ha ha) facility I have done moderate sedation in required me to take a moderate sedation study course to be "certified".

    I hate looking up state guidelines and policies, but I believe it might be a legal requirement per BRN or Endoscopy Nursing, or AORN. You might ask your boss or look for yourself. Or ask the education department....someone in this large teaching hospital should know.

    I could give you some advice, but I think you had better clarify if you need to be "certified" before you give moderate sedation?????!!!!! It isn't at all hard, can be done in one day.

    I hope at least you have ACLS? I think that is really mandated!
    Last edit by brownbook on Dec 28, '17
  4. by   5h3ryL
    Thank you for your reply! I do have ACLS and moderate sedation cert isn't required. However, I do have a competency test to take before I can sedate on my own. I guess since I haven't done it, I'm anxious - and being new in a not so awesome team adds stress. Anyway, I will look more into it before I start my intra-op rotation. I just don't feel confident.
  5. by   brownbook
    OK, the competency test is all I was referring to. I made it sound fancier that it is.

    As long as you study up for the test and know the material you should be fine.

    I've been doing moderate sedation for 17 years, never had a problem.....but still do your duty of care for every case. Know where the crash cart is, know where the ambu bag is (does it have all it's parts). Is there a code blue button in the room. Or what number do you call for codes. Know where your narcan is. Know how to open an airway,use an oral airway. I've never had to do any of that stuff, but maybe because I was always prepared in the back of my mind. I think you should never lose a little bit of anxiety in any area of nursing. A little anxiety, what if's, keeps you on your toes.

    From the start you might have to remind yourself over and over....that you are NOT to be distracted, NOT assist the tech or MD, your focus is ONLY the patient. I am over exaggerating, sure once you get comfortable with sedating patients, get familiar with the tech, and MD , get your routine down, you can and will, (should), help out turning the patient, putting pressure on the abdomen, etc. You will, or may be, responsible for keeping track of and labeling specimens.
    Last edit by brownbook on Dec 28, '17
  6. by   AJJKRN
    I find it very odd that you're not required to show a competency prior to performing moderate sedation along with reviewing every year.

    Of course know your drugs and a tip that I got was that if ever needed, use the reversal med for the last sedation med you are giving (if there's a reversal med for it, I believe there's no reversal for Brevital and you just have to wait it out and bag the patient if needed, luckily it wears off pretty quickly).