Mersa59

Mindy, ask for propofol, I did not feel a thing or remember anything with mine, it was the colonoscopy that I was not sedated enough for. mar

nurse baby girl 08, one of my other memories I have was while moaning in pain and calling out, I remember trying to sit up and one of the nurses, placing her hands on my shoulders, trying to get me to lie back down and saying shhhh shhhh.... mersa

we have given the pill cam to several patients on my unit no one had difficulty passing them. From what I read in the literature there is a very small percentage of patients who do not pass them, it was a miniscule amount. Like o.5 % or less. you did not answer me about the push endoscopy? mersa

No, they had 0-2 there and a face mask and gave me some 0-2 while they were sedating me,I went out pretty quickly, did not wake up until the start of the colonoscopy. I was in and out during the colonoscopy. I would wake up and feeling pain, moan or call out and then would fall back to sleep, only to wake up moaning again, the time frame between wake up times I can not tell you. I do not remember all of it, I did not feel all of it. Or "remember" feeling all of it. there were several times that I was aware of pain, and more awake. in comparrison to other times. mersa

CrohnieToo have you assisted in Push endoscopy? where they go as far into the small bowel as they can? What are you giving for sedation with that? I know they are doing more Pill Cam endoscopies now, as they say the Push endoscopy has more pain and discomfort with it, and there are higher risks involved secondary to the nature of the small bowel. more twist and turns, and it moves more easily when the scope is trying to be advanced. thanks for your input. Mersa

No thanks, I did not want to feel anything with either scope. If i would have had bad gagging, I would of done all I could to stop the proceedure.It is my understanding, now, that women have more discomfort with colonoscopy, and there is a higher chance of pain, when you have had abdominal surgery.. I had 3 C-sections in the past. so this may have contributed. However on many other sites, with patient accounts, many women, complain about the painful experience of colonoscopy. I would think this needs to be addressed better, and there needs to be better pain management.....that colonscope is huge,long, and the adult scope looks like a dern water hose. just my opinion and experience. Mersa

cHRONIETOO the egd was done first. I felt nothing , I was totaly out...had propofol for that..........however ....when it was time for the colonoscopy, which was "after" the egd.....I woke up, and woke up several times thru out the proceedure as I mentioned. so if I was sedated enough for the egd, I should have been sedated enough for the colonoscopy. They lightened up on the dose of propofol for the colonoscopy was my guess.my VS were ok thru out. Mersa

I had Prpofol, while it was great for my EGD, I felt absolutely nothing, I was totaly out. For my Colonoscopy , immediately after the EGD it was not what I expected. I was told I would feel nothing and be out. I felt the insertion of the colonscope, and every push for ward of that scope around the bends. I had pain, was moaning and remember moaning and yelling out Owe !!Owe!! Owe!! I also felt the removal of the scope. and had alot of discomfort and pain for a week -10 days after ward. I felt like a horse had kicked me. I have had C-sections and little pain meds after ward. a dislocated shoulder and so on. I am not a wimp to pain....but the propofol did not sedate me well enough for the colonoscopy, and I was angry as my thinking was that I had been lied too. the nursing staff were very accomidating, but again , I felt like I had been lied to about this, as I asked many questions and stated my knowledge of the proceedure and what others had told me they experienced. so while Propofol is better it is not something that sedates enough to keep you totaly unaware of pain, discomfort and what is going on. mersa

I know this article is old. However I need to comment. Droperidol is Inapsine, and Antipsychotic medication. we used it in the past for out of control patients. It is now black boxed, I thought, and no longer used in psychiatry. there have been deaths related to its use. It is a chemical restraint, not a drug that I would think should be used for an EGD or colonoscopy. I was appalled to read this.. I am an R.N. also. Mersa

One of the things that you can do: Document!! Document how many staff you have on any given shift. Then document safety issues with your patients. Document outcomes, secondary to not enough staff, and how the outcome would have been could of been different if more staff were available. keep a runing log going of this to turn into management and administrators. If they want patients coming into their hospitals and want their hospitals to be known as patient friendly, safe, effective, a good place to be when your ill....welll they will listen to /facts that have been documented ......Then just maybe your staffing quota will be raised to meet the needs of your specific unit/ mersa

Sista soul Good luck on your inclex. The problem with fast tracking, isn't that potential Nurses have not been able to do everything. Preceptoring new nurses is vitaly important. what I have seen is the lack of critical thinking skills in several new nurses coming out of these programs. It realy does a diservice to all new Nurses,and future patients when a school is not making the extra effort to get clinical time into their curriculum for their students. All that wonderful care plan writeing, will be condensed into check off sheets, or coputerized nursing documentation. While it is important to learn theory, it is also very important to learn critical thinking as it applies to patient care issues. In addition to being involved in situations were you use those skills. We always try to find learning opportunities for our new Nurses. We also tell them to ask for help, It however, in the real world, is also important for the New Nurse to speak up and say. I never had the opportunity to do x,y,z, will you let me know when a situation arises with those things, so I can shadow you,and learn. Ask questions, Ask Questions, Ask Questions. If your in a good facility, you will be given good direction, but remember, there are some things that You do need to know how to do, and those are the things that us Old Nurses get frustrated at, when a new nurse comes to the floor to work, and no one bothered to teach them while they were in school. starting IV's is not one of those things, in general you learn that on your job, and go thru a work related skill with protochol, to do so. I work in a teaching Hospital. So we TEACH. However, there is an expectation of base line learning that one needs to have before they come to us. mersa

They are sending potential Nurses thru the fast tract now. little bed side experience, all books, study and theory. well all the theory in the world does not replace common sense and experience of hands on learning. I work in a complcated field, we rarely get text book cases. Our patients are complicated and have multi system problems . What has happened to beside care, and experience as a learning tool? this is the failure that your spotting in the system. fast tract thru the books with out enough hands on, just does not cut it. mersa

I know where your coming from. 1: start keeping a running document of everything you do with dates. 2:have coleagues initial things that they witnessed you do.when you write them up.keep them for your next eval, and for future reference. been there, accused of not caring since I huffed and puffed at times, was sob. ended up in hospital myself , severe anemia. so document document document. everything. management does not like hearing from attendings that nurses are complaining about safety issues. I agree they are useing you as " an example" a scapegoat. hope all works out for you. mersa

Pss to Megan: I do not know how old you are, but my thought is this. We all live thru enough stuff. Not feeling, remembering , and making sure we have enough sedation for otherwise, uncomfortable or painful proceedures Is OK by me. In addition to the fact, that unlike some.I do not need to see certain medical proceedures done on my own body. some things are better left not seen, and just be given the results later on. sorry about those earlier spelling errors, I have been trying to keep busy with this,and running secondary to this prep. have to keep myself occupied in some fashion. I have polyethylene Glycol for this prep, I bought a couple bottles of mg,citrate, over the counter. started out with 1/2 a bottle of that this am. made sure I took colace 4 times yesterday, and once this am. I am saving the remainder of the mg cit, in case this PG does not have me running clear by the end of the bottle. having had to give preps to geri patients for this, I know, what they give does not always clear you enough. so I have extra just in case. as I have no interest in doing this a second time because I end up not being clear. read were someone had that problem and was made to feel terrible by the doc. I hope if that happens to any of you, you give the doc Hell. we all know as Nurses how to take these dern preps and how to give them. sometimes, more is required than was ordered. especially if they want us squeeky clean. keep the faith for an easier way to do this in the future. Mersa59

On the use of Versed: I had Versed in a concious sedation coctail. Had a dislocated shoulder,reduced 3 x's before it stayed put. have to say, I remember saying OWE, OWE, and remember the attending telling the resident to get on the other side of the sheet, and Pull. but that is all I remember. I also remeber the second reduction, they used an injection of merpecaine into the shoulder joint. To me that gave the greater pain relief over all. However I had no problem with the versed, and it is ok that I do not remember much from the first reduction. mersa ( R.N.)