Last Words before Induction.......

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ok,what and why, if at all, do you say to your patients right before you push the propofol (or your drug of choice). some say don't say a thing!!!!--it stimulates the sympathetic response if you tell them they are about to go to sleep, some say gentle hypnosis, some say "describe to them how they will wake up". what are your famous "last words"????

Specializes in MDS coordinator, hospice, ortho/ neuro.

My husband tried to tell the anesthesiologist that he was "resistant" to drugs and that most stuff didnt touch him........last thing he heard was " OK, resist this......" :chuckle

I am sensitive to a lot of drugs, and I make sure they know this........the first thing I remember hearing after one surgery was " damn, she's finally awake!!"......another time I heard " are you sure she's awake?"

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Y'all should become acquainted with Peggy Huddleston's "Prepare for Surgery, Heal Faster." I used this program (modified) before I had my first (and, so far, only) major surgery. I didn't use the tape she provides, but rather filled it with Orthodox Christian Liturgical music. But I liked the fact that there were things the MDA/CRNA was supposed to say to me just before I was put to sleep and just before waking up--suggestions that I would heal quickly, that the surgery went well, etc. etc.

I don't know if the nurses were telling the truth, but they were impressed with my recovery. My friends who let me stay at their homes after surgery were also impressed with my recovery: they expected to have to do a lot more for me!

NurseFirst

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Great thread.. This topic ties into the moment that a career of anesthesia was first planted into my head. I had an acl repair many years ago with a CRNA managing my anesthetic. I remember how psyched he was to educate me about the profession. I remember his name and exactly what he looks like.. (I've completely forgotten who the surgeon was). There was a point during the surgery when I heard a drill start up. I said, 'you may want to knock me out for this part', and the last thing i remember hearing was him saying, 'Im one step ahead of you'. Just after he said that, it felt like I dropped through the table into a blissful dream. I woke up as I was heading to the PACU and he handed me a pepsi when we got there. That CRNA made my surgery a GREAT experience, and not something to be feared. I want to provide that kind of a surgical experience for others..

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I usually reassure them by saying "we will take good care of you, see you when you wake up".

One of my favorite MDA's always tells the pt to pick out a good dream or go to your happy place.

Sprout :nurse:

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I think that as you take care of more patients, you become more intuitive to who's nervous. Most patients don't show classic signs of being nervous, some sigh deeply, some look around, some ask a lot of questions, some don't say anything. I think you also become better at calming these people because you recognize their discomfort. Plus it's one of our few chances to talk with the patient while they're awake so it's no wonder we use all the compassion skills we have.

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Specializes in LTC, assisted living, med-surg, psych.

From a patient's point of view: I've had nothing but good experiences with CRNAs. I've had a couple of anesthesiologists who were pretty good, too, but the nurse anesthetists where I work are the best......they always tell me exactly what to expect and what they're doing (which is good---the OR is definitely not my home turf, and besides, being a nurse probably makes me more nervous than the average patient because I know all the stuff that can go wrong!). Then when they're ready to put me under, they'll say "Don't worry, you know we've got your back.......now count backwards from 100, and you'll probably be asleep by 95.......see you when you wake up". I'd count "100.....99.....uh, 98, I think....." :sleep:

They also take the time pre-op to go over things with me and make sure to have my albuterol inhaler on hand, because they know I always drop my sats in PACU and have to have a couple of puffs, plus 02 until I'm completely awake. (This is, of course, the advantage to having all of one's surgeries done in the same place. :)) However, I've had several different procedures in several different hospitals, and the CRNAs have always been great. My hat's off to all of you!

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when i had to have an emergency appendectomy 2 years ago, the surgeon (not anesthesiologist) started talking to me about my job (I was a waitress @ the time at a pretty popular place)...he would tell me what his favorite burger was, etc..and before I knew it, I was asleep. Thought talking about a hamburger was a weird way to have me go to sleep, but I didn't know what hit me!

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before I go back to the room I tell the patient what to expect once we get to the room, ie. hooking up monitors, letting them breathe oxygen while I get ready to put them to sleep. Right before I start pushing the drugs I tell them they will start to get sleepy, just take some big breaths of the O2 and when they wake up we will either be on the way to recovery or in recovery. I have had no complaints.

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Specializes in Periop, CNOR.

Our CRNA's will go over the process in its entirety when we pre-op our patient. When they roll in, after getting them on the table, padded, belted, etc.... we all take it down a notch and just hang out with the patient up to induction and intubation. Most of our CRNA's will warn of a "warmth or burning sensation" when they push the propofol (from personal experience warmth is an understatement, it burned like HELL!). Then the standard (for our facility anyway) "think of somewhere nice you would like to be" and they are out. Succ is pushed and they are intubated

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i am not a nurse yet and wont be for a while but i remember, though come to think of it it may have been a dream cuz i drempt it a few days before one person saying "blow up the bubbles, blow up the bubbles" and someone else saying, "let me hold your hand" whether it was real or a dream it was nice. if you are wondering about the blow up the bubble thing i was twelve and had bubble gum flavored gas to put me to sleep just to let you know.

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From a patient's point of view: I've had nothing but good experiences with CRNAs. I've had a couple of anesthesiologists who were pretty good, too, but the nurse anesthetists where I work are the best......they always tell me exactly what to expect and what they're doing (which is good---the OR is definitely not my home turf, and besides, being a nurse probably makes me more nervous than the average patient because I know all the stuff that can go wrong!). Then when they're ready to put me under, they'll say "Don't worry, you know we've got your back.......now count backwards from 100, and you'll probably be asleep by 95.......see you when you wake up". I'd count "100.....99.....uh, 98, I think....." :sleep:

They also take the time pre-op to go over things with me and make sure to have my albuterol inhaler on hand, because they know I always drop my sats in PACU and have to have a couple of puffs, plus 02 until I'm completely awake. (This is, of course, the advantage to having all of one's surgeries done in the same place. :)) However, I've had several different procedures in several different hospitals, and the CRNAs have always been great. My hat's off to all of you![/quote

WOW, off topic, sorry.but how many surgeries have you HAD???

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