Propofol

I propose that you or a classmate volunteer to be intubated and on a ventilator with no sedation. I suspect your perspective would change dramatically.

LMAO!

One thing I don't see addressed here is the misconception that patient sedation actually makes the nurse's job easier.

First of all, everyone is right about sedation being for the patient's benefit in the case of intubation. ET tube + inadequately sedated patient = panic, and is in my opinion akin to torture. If a patient is on a ventilator, receiving no sedation, and not fighting it, that bodes very poorly for the patient. So let's just assume that sedation with intubation is a given, and the extra work thing is a moot point.

Now, let's imagine an agitated patient. They may require frequent settling, a locked room etc. This may be extra work for the nurse. Now say we take the same patient and sedate him... Now he needs continuous cardiac monitoring, frequent safety checks, extra documentation, close monitoring of sedation level and titration of drips/ dosages, the list goes on.

Unless a patient is at the point of harming himself or someone else it is far less work (if more annoying) for me to have him conscious.

The least amount of sedation that keeps a person compliant with the ventilator is really what the goal is. If you are constantly adjusting the sedation to effect and not just letting it ride at a single level forever, there shouldn't be a problem with extended amounts of time on the ventilator because you'd be using the minimum amount of sedation necessary, and that will clear out of a patient's system pretty quickly when it's turned off.

Of course, all of that goes out the window when you've got a family who insists on shaking/shouting/agitating the patient continually to the point that you have to run a higher level of sedation at all times, but that's a whole different story. Sometimes the families are willing to be educated on how to help take care of their family member and sometimes they will fight you every step of the way.

I propose that you or a classmate volunteer to be intubated and on a ventilator with no sedation. I suspect your perspective would change dramatically.

If I'm intubated, I want all the drugs I can get. If there's a stupid nurse (or nursing student) at my bedside trying to calm me down, I'm going to be even more agitated and need MORE drugs.

As an alternative, OP ... you can do this experiment:

Stick one finger as far back in your oropharynx as you can. Remain in that position as long as you can. Consider what that feels like, physically and psychologically. Or, recall the sensation the last time you choked on a piece of food.

Still think that sedation is for the "convenience" of nurses and not for the patient's benefit?

are you kidding me, I never said I thought it SHOULD be used for the convenience of nurses. I never said sedation SHOULD NOT be used. I am just bringing up the point that sedation is sometimes over used and when it is it can cause patients to have longer hospital stays. Under-sedation can also be a problem for the patient. Both sides need to be looked at and weighed in order to get the appropriate care for patients, thus the purpose of this forum. I work in an ICU and the focus here is using the least amount of sedation possible for the benefit of patients recovery time. I appreciate all the constructive and informative remarks.

How the heck did a reasonable question from a student as to what ICU nurses have seen turn into Hey OP clark... How would you like to be intubated? Try it and see! Yikes.

Patients who require mechanical ventilation commonly require sedation and analgesia. Neuromuscular blockade is also needed for some patients. Although pharmacological support is an important intervention, administration of analgesics, sedatives, and neuromuscular blockade often results in prolonged mechanical ventilation and related consequences such as ventilator-associated pneumonia.

Sole, M.L., Klein, D.G., & Moseley, M.J. (2009). Introduction to critical care cursing

(5^th ed.). St. Louis, MO: Elsevier.