Patient with awareness

DutchgirlRN, ASN, RN · Feb 16, 2005

No offense DutchGirl, but cutting and pasting this piece from Carol Wieher's website will not earn you any points here. Do you think we haven't seen it before? It adds nothing to the discussion, just fans the flames.
And do you really think that everyone in this section of the board isn't aware of monitors that claim to prevent awareness under anesthesia? And no offense to Centennial Medical Center - I know nothing about them, but that really sounds like a marketing claim, pure and simple. (Perhaps you work there?)
There are several different manufacturers making these types of monitors, and to date, NONE OF THEM have been shown to reliably predict awareness under anesthesia. Again, you're just fanning the flames.

Well Good Morning to you too and who pissed in your corn flakes this morning??? I was telling the members (not just you) what I had heard on the news and no I don't work at Centennial for whatever difference that makes. So what if I post some info from a website? Who in the hell is Carol Wieher anyway? I was just looking for some helpful information because I wanted to know more about Anesthesia awareness myself. What kind of points am I supposed to be earning? I don't need acceptance on this site, I already have it. What flames am I supposedly fanning? I'm not looking for trouble, never do. And yes I do take offense at your post. Totally uncalled for. Must have hit a nerve on you somewhere. Don't take that out on me. Get a life !

DutchgirlRN, ASN, RN · Feb 16, 2005

I really don't know whether to post here anymore or not. It was so nice to find a safe forum to discuss my experience, but I'm really don't want to piss people off. Also, frankly I'm not up for taking the brunt of the backlash.

Mana Tangata, Please don't stop posting. You did nothing wrong. You have every right to be anonymous and yet you came forward with the truth. You can't please everyone. There are many regulars to this post who side with you. You did nothing wrong. You had a very bad experience and unfortunately for whatever reason... it does happen, you're not the first and won't be the last. I never read that you were bringing out the big guns and hunting for reasons to slam CRNA's or sue a CRNA. You just wanted some answers (and who wouldn't), needed to vent and needed some unprejuidiced compassion. I tried to help by providing some additional info about this condition and if you'll read the post I got slammed by some rude member who obviously feels guilty about something or just has a nasty attitude. Don't let the bastards get you down. We're a great group and always here for you, you just have to pull the weeds as you go along. God Bless

loisane · Feb 16, 2005

I was cut lose without any couseling, completely unprepared for the psychological consequenses. .

Mana, anesthesia professionals are sometimes accountable for awareness and sometimes not. That is because sometimes it is due to negligence and bad practice, but many times it occurs when there is no negligence, and nothing wrong with the practice of anesthesia given. It is frustrating for the victim, because there may be nobody to "blame", and it is only human nature to want there to be an identifiable reason that this happened.

However, we are ALWAYS accountable for our reaction to the patient after such an event has occured. I am sorry you did not get the after care you required. As jwk stated, there are procedures we all know about, that should be followed in every case.

I have two friends who also experienced this, both trauma cases. Do I think that they received substandard care? No. I don't think in either case the anesthesia providor knew about the awareness. This was a good ten years ago, so before all the press.

This is a new issue to the public. It is NOT a new issue to those of us who do this for a living. I only mention this, because I think there is the perception among the public that if they don't spread the word, the anesthesia community will remain unaware.

Awareness has been studied for decades. One of the things that is well known from these studies is that patients in particular situations are at an increased risk for awareness. Trauma is one of those at risk populations. It has to do with the way our drugs work. In trauma there is often so much blood loss, that the addition of our usual anesthesia drugs is not safe for the patient. In order to save a patient's life, we may have to risk awareness. I think most people would understand that trade off, once it is explained to them.

loisane crna

Mana_Tangata · Feb 16, 2005

Mana, anesthesia professionals are sometimes accountable for awareness and sometimes not. That is because sometimes it is due to negligence and bad practice, but many times it occurs when there is no negligence, and nothing wrong with the practice of anesthesia given. It is frustrating for the victim, because there may be nobody to "blame", and it is only human nature to want there to be an identifiable reason that this happened.
However, we are ALWAYS accountable for our reaction to the patient after such an event has occured. I am sorry you did not get the after care you required. As jwk stated, there are procedures we all know about, that should be followed in every case.
This is a new issue to the public. It is NOT a new issue to those of us who do this for a living. I only mention this, because I think there is the perception among the public that if they don't spread the word, the anesthesia community will remain unaware.
Awareness has been studied for decades. One of the things that is well known from these studies is that patients in particular situations are at an increased risk for awareness. Trauma is one of those at risk populations. It has to do with the way our drugs work. In trauma there is often so much blood loss, that the addition of our usual anesthesia drugs is not safe for the patient. In order to save a patient's life, we may have to risk awareness. I think most people would understand that trade off, once it is explained to them.
loisane crna

I don't think that the anesthesia community is unaware - I agree with you that the exact opposite is the case and you have been barraged with the topic. As far as other folks in the medical profession, and getting policies in place, I'm not so sure. I think that the reason I did not get the after care recommended by JCAHO is because the hospital did not have any policies to deal with me. While I am very angry at the anesthesiologist regarding my aftercare, I have to acknowlege that the experience was probably very traumatic for him as well, and he may not have been thinking clearly. (we are all human) If the hospital had some kind of policy it would have helped both him and me.

jwk · Feb 16, 2005

Well Good Morning to you too and who pissed in your corn flakes this morning??? I was telling the members (not just you) what I had heard on the news and no I don't work at Centennial for whatever difference that makes. So what if I post some info from a website? Who in the hell is Carol Wieher anyway? I was just looking for some helpful information because I wanted to know more about Anesthesia awareness myself. What kind of points am I supposed to be earning? I don't need acceptance on this site, I already have it. What flames am I supposedly fanning? I'm not looking for trouble, never do. And yes I do take offense at your post. Totally uncalled for. Must have hit a nerve on you somewhere. Don't take that out on me. Get a life !

Carol Weihrer (spelled correctly now) makes a living off her story about anesthesia awareness. The piece you cut and pasted into your post was verbatim from her website, whether you know it or not. Anesthesia professionals everywhere have heard her story - we're just not interested in hearing it again. And because she profits from all this, her credibility is shot.

No offense was intended, certainly not to cause the response that you made. You're posting in an anesthesia section. We're aware of the problem. Whether you want to admit it or not, your posts do, in fact, fan the flames of an extremely controversial topic, particularly between professionals who actually have knowledge of the problem, and monitor manufacturers and the media, who seem to enjoy a sensational story from which both will profit.

You say you want to know more. Do a search on this forum for anesthesia awareness or BIS. You'll see it discussed ad nauseum, and you'll see the strong opinions that most of us hold regarding this topic.

jwk · Feb 16, 2005

I think that the reason I did not get the after care recommended by JCAHO is because the hospital did not have any policies to deal with me. While I am very angry at the anesthesiologist regarding my aftercare, I have to acknowlege that the experience was probably very traumatic for him as well, and he may not have been thinking clearly. (we are all human) If the hospital had some kind of policy it would have helped both him and me.

If this happened to you in the last few months, you should have been dealt with in a much better way than you have been. Whether we agree with JCAHO on this issue or not (many of us don't for a variety of reasons), their advice to hospitals and anesthesia professionals to deal with the issue up front and with true concern for the patients who believe they have experienced this are sound.

Interesting that you think it may have been traumatic for him. Your compassion towards him speaks volumes about your character and personality - you're much nicer about this than I think I would have been.

jewelcutt · Feb 16, 2005

Dutchgirl,

I think what was flaming about your post is the very article you chose to post, whether you intentionally meant to do it or not. With all the thousands of articles on recall (including the professional ones) you chose to post a personal account that has a great deal of innacurate information in it and is often used to make money by drawing the public to look at the "horrors" of anesthesia. The article assumes we are uncaring professionals towards recall, when infact everything we do is to prevent it. Being a nurse yourself you should know better than to display information like that to uninformed people. Now I didn't mean to insult you in saying that but we all know how innacurate information can get out of control. Mana, you really haven't insulted anyone on this board, you must be incredibly frustrated about the situation and if I where in your shoes I would definitely want the answers, you should keep looking into it.

DutchgirlRN, ASN, RN · Feb 16, 2005

Dutchgirl,
I think what was flaming about your post is the very article you chose to post, whether you intentionally meant to do it or not. With all the thousands of articles on recall (including the professional ones) you chose to post a personal account that has a great deal of innacurate information in it and is often used to make money by drawing the public to look at the "horrors" of anesthesia. The article assumes we are uncaring professionals towards recall, when infact everything we do is to prevent it

I don't know anything about this woman whose article I borrowed from, I was googling and that's where it came from. I apoligize for unknowingly upsetting anyone. On the other hand, some members need not be so sensitive, or so rude!

athomas91 · Feb 17, 2005

loisane and kevin - very well said...

loisane · Feb 17, 2005

I don't know anything about this woman whose article I borrowed from, I was googling and that's where it came from. I apoligize for unknowingly upsetting anyone. On the other hand, some members need not be so sensitive, or so rude!

I have been trying to come up with a way to help Dutchgirl see the big picture here. In the meantime, others have done well, so perhaps enough has been said. I hope I do not risk being overbearing by offering my analogy, anyway.

As others have emphasized, you are posting on an ANESTHESIA forum. (This seems to be easy to do, judging from the number of posts on various threads here that just don't quite hit the mark of the discussion at hand). When you try to educate us about awareness, it is a little like barging into Picasso's art studio and asking if he had ever considered using paint by numbers! When you stumble in such a public way, someone is bound to point it out to you. And if someone is a little blunt in their manner of pointing it out, that isn't very surprising either.

Your defense that you didn't know the history of your quote is a little weak. Why shouldn't you know something about the source? You are the one who quoted her. Consider this-if I am preparing education materials for patients, what source do I use-the National Enquirer? or the American Journal of Nursing? Isn't it part of my job as a professional to know the difference? There are lots of professional information on awareness and the formation of memory during anesthesia. I have read dozens of peer reviewed research articles, going back several decades on this subject.

Not to pick on Dutchgirl, because occassionally we could all benefit from a reminder that our responses here are reflective of health care professionals and the respected field of professional nursing.

If you have read my other posts, then you know that (unlike some of my colleagues) I do not find fault with the original poster for coming here in her search for answers about what happened to her. But I do think it is important for us to keep the discussion professional, thoughtful and educated.

Dutchgirl, thank you for the opportunity to use your comments as an illustration of how we can all improve our professional discourse. I am sure you are more than ready to drop this by now, and I appreciate your indulgence!

loisane crna

London88 · Feb 17, 2005

Loisane:

Once again, very well said. It is one thing to make an uninformed statement like Dutchgirl did, but to try and argue to defend that statement is another. There is nothing like a non anesthesia provider trying to educate an anesthesia provider on anesthesia, and then cannot understand why they would illicit such a response like jkw's response.

jwk · Feb 17, 2005

Loisane - you rock!