Conscious sedation

1. I just wondered if anyone thinks conscious sedation should be something that special training is given to a nurse or just another part of medication administration? The unit I have started in uses conscious sedation and I will be getting "while I'm working" training on conscious sedation but its very informal and nothing specific given on the medications used, just give this or that..of course they know what they are doing but I just feel very uneasy at this point which is early in the game, about doing conscious sedation and all that it entails. To me its very serious with all the potential complications but doesn't seem like a big deal to the ones who have been there a while. What do you think?

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   About MrsK1223

   Joined: Jan '03; Posts: 226; Likes: 11
   RN

   18 Comments

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3. 
   Mar 13, '03

   All nurses where I work, that deal with IV concious sedation have to do training updates every year. I thought it had something to do with JCAHO, but maybe not........
4. 
   Mar 13, '03

   Yep, we require a competency be completed in order to administer CS.
5. 
   Mar 13, '03

   We have a competency as well. It is done annually by all RN's administering the CS....
6. 
   Mar 13, '03

   We do special training and require the nurse to have ACLS.
   
   It rather scares me that your hospital thinks so little of you and the patients to not require in depth understanding of the drugs, their actions, side effects, emergency procedures, and the duties of the RN and the MD. Scary, just scary.
7. 
   Mar 13, '03

   I had a class, Taught be a CRNA< and a checkoff, that had to be completed.
8. 
   Mar 13, '03

   We had to take a compentency....even though it didn't have one neonatal thing on it! I had no idea what the adult things were
9. 
   Mar 13, '03

   Do you guys have to have a Malenpati [I know I totally sc*wed up the spelling] exam before you can administer conscious sedation? We have to have a PA or physician do an airway check before we can administer meds.
10. 
    Mar 14, '03

    We perform conscious sedation quite frequently in our ER. I personally feel we overdo this procedure. We use them for lumbar punctures on adults as well as children. I have wondered for awhile why we do them for lps on adults when I don't recall using conscious sedation to place an epidural on OB .
    Anyway, back to your question...we did not have a competency or special training when we first started doing them on a regular basis. Only after a year into it did they start a competency and are actually training the new people. This was only after we kept on them because we didn't feel comfortable with at least being inserviced on the continuing new meds being used.
11. 
    Mar 14, '03

    You gotta have a competency. I work level 1 ER too and we do adults and kids all the time. Gotta have resuscitation equipment too right there all set up, not to mention reversal agents.
12. 
    Mar 15, '03

    The link posted below will take you to the American Society of Anesthesiology's current guidelines for sedation analgesia. These are widely accepted as standard of care, and JCAHO expects compliance with them, although JCAHO standards don't address them as specifically. You might share a copy with your nurse manager, and if really in doubt about what you're doing, check with your hospital's quality management department, since they're responsible for compliance.
    
    Good Luck!
    
    http://www.asahq.org/publicationsAnd...dation1017.pdf
13. 
    Mar 15, '03

    Every area of nursing should require competency. We require CS competency yearly and would love to have a few more nurses take over conscious sedation or procedural sedation. It is a quick way to make money on weekends with callback pay Standby pay is $3.50hr if over 70 hours a payperiod is done the it goes up $2.00 hr . Most procedures take 45 minutes to 2 hours and our callback pay guarentees us 4 hours of over time pay
14. 
    Mar 15, '03

    What type of unit to do work in? ICU?
    
    I think outside of ICU and the ER, it's not a good idea to ask the nurses to do the conscious sedation. It takes too much time and monitoring out of one's shift. It's too risky.

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