Nurses Pushing Propofol for Conscious Sedation -Your Thoughts?

Specialties Gastroenterology

Published

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

PS. I was trained in psychiatry where compassion was emphasized. I did not work for a drug manufacturer.

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Perhaps it's time to review this?:

A Patient’s Bill of Rights

A Patient's Bill of Rights was first adopted by the

American Hospital Association in 1973.

Effective health care requires collaboration between patients and physicians and other health care professionals. Open and honest communication, respect for personal and professional values, and sensitivity to differences are integral to optimal patient care. … must ensure a health care ethic that respects the role of patients in decision making about treatment choices and other aspects of their care. The collaborative nature of health care requires that patients, or their families/surrogates, participate in their care.

All these activities must be conducted with an overriding concern for the values and dignity of patients.

Bill of Rights

1. The patient has the right to considerate and respectful care.

2. The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning diagnosis, treatment, and prognosis.

Except in emergencies when the patient lacks decision-making capacity and the need for treatment is urgent, the patient is entitled to the opportunity to discuss and request information related to the specific procedures and/or treatments, the risks involved, the possible length of recuperation, and the medically reasonable alternatives and their accompanying risks and benefits.

3. The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action. In case of such refusal, the patient is entitled to other appropriate care and services that the hospital provides or transfer to another hospital. The hospital should notify patients of any policy that might affect patient choice within the institution.

4. The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. The hospital must provide evaluation, service, and/or referral as indicated by the urgency of the case. ..

5. The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient's treatment and care…

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Specializes in Anesthesia.

I did my Masters research looking at sedation practices for GI procedures. I am sorry your outcome was less than satisfactory, but I see this all the time where patients come in wanting all these things that are out of the normal for that particular place and expect excellent outcomes. These patients set themselves up for failure before the procedure even starts.

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I did my Masters research looking at sedation practices for GI procedures. I am sorry your outcome was less than satisfactory, but I see this all the time where patients come in wanting all these things that are out of the normal for that particular place and expect excellent outcomes. These patients set themselves up for failure before the procedure even starts.

There are 4 docs at that endoscopy center and they all use different med protocols. Besides, as an endoscopist, they should be familiar with different medications. And if not, since advance notice was given, they should familiarize themselves with a patient's choice of meds. So there is no "normal for that particular place". And this has nothing to do with expecting "excellent outcomes". I find it intteresting that you keep mis-characterizing the concerns expressed in my report.

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Specializes in Anesthesia.
There are 4 docs at that endoscopy center and they all use different med protocols. Besides, as an endoscopist, they should be familiar with different medications. And if not, since advance notice was given, they should familiarize themselves with a patient's choice of meds. So there is no "normal for that particular place". And this has nothing to do with expecting "excellent outcomes". I find it intteresting that you keep mis-characterizing the concerns expressed in my report.

You don't just familiarize yourself with a medication and hope to become proficient in its use for sedation. Do you think the endoscopist became proficient in doing colonoscopies by just doing one or two? There is a reason people in anesthesia spend thousands of hours getting experience doing sedations.

I don't think I am mischaracterizing your concerns at all. I am giving you a provider's perspective and you can do with it what you want.

It is also interesting to note that many countries do not routinely do sedation/analgesia at all for colonoscopies, because it isn't considered that painful. A lot of what we perceive is based on cultural perception.

I have to ask what is/was your profession in psychiatry and level of education? I am a CRNA with a MSN.

I don't see where the endoscopist was deceitful. You asked for a pediatric scope to be used, and you got a pediatric scope. You asked for only fentanyl. You got only fentanyl even though you got 3x the starting dose of fentanyl you quoted in the study it was still painful for you. The endoscopist and the nurse tried to convince to use propofol for your sedation you refused and got exactly the sedation done the way you wanted....

I also don't see how the GI clinic violated any patient rights that you quoted also. They could have provided better customer service and been nicer, but again this maybe just a perception issue or they could just be jerks...

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"I am giving you a provider's perspective and you can do with it what you want". I am giving you a patient's perspective and you can do with it what you want. Amen.

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Specializes in Anesthesia.
"I am giving you a provider's perspective and you can do with it what you want". I am giving you a patient's perspective and you can do with it what you want. Amen.

Care to answer the question about educational level and what you did in psychiatry?

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No. Since I am giving you a patient's perspective, training as a psychiatrist etc. is not relevant.

You have done a terrific job representing a provider's perspective. You couldn't have done a better job if you were a lawyer for a provider org or rep from a drug company.

Now I would like to know if there are any others who would like to offer another perspective besides yours.

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Specializes in Anesthesia.
No. Since I am giving you a patient's perspective, training as a psychiatrist etc. is not relevant.

You have done a terrific job representing a provider's perspective. You couldn't have done a better job if you were a lawyer for a provider org or rep from a drug company.

Now I would like to know if there are any others who would like to offer another perspective besides yours.

This thread is about NAPS (nurse administered propofol sedation) not patients bad experiences with having a colonoscopy. You should find another thread on that topic or start your own thread if that is what you want to discuss.

Yes, your education/profession is relevant to all discussions if you are claiming to be a health professional. Your posts leave me to believe that you are not a health professional, and more like a lay person that gets most of their health information from the internet.

Also, the fact that your not willing to share your educational level/profession in anonymous internet forum gives reasonable doubt that you are health professional.

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Sorry, I didn't read past the title, "Nurses Pushing Propofol for Conscious Sedation -Your Thoughts?" so if there is no one else wishing to provide feedback, I will sign off this thread.

(a psychiatrist as patient who experienced a doctor and Nurse Pushing Propofol for Conscious Sedation)

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Specializes in Anesthesia.
Sorry, I didn't read past the title, "Nurses Pushing Propofol for Conscious Sedation -Your Thoughts?" so if there is no one else wishing to provide feedback, I will sign off this thread.

(a psychiatrist as patient who experienced a doctor and Nurse Pushing Propofol for Conscious Sedation)

A psychiatrist that has trouble communicating with other health professionals and controlling the conversation without becoming emotional.........

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Advertising or personal attacks are NOT allowed.

This CRNA with a MSN has done a terrific job representing a provider's perspective. He (I assume) couldn't have done a better job if he were a lawyer for a provider org or drug company.

Perhaps the difficulty in communicating also has to do with the differences in corpus callosum. I will sign off this thread now since I have not received any other responses.

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