Friday, October 26, 2007

Shock


This has been a tiring week. I have a test coming up in my nursing theory class which is called something like "Patients w/ Complex Needs" but really is another stew of random lectures by several different instructors some of whom are confused and/or really dull. I'm thrilled about the test, though, because it means that I won't have to sit through a lecture for one class. But the thrill doesn't mean that I've studied. Studying for one of these stew-y class tests takes too much work: you have to download various outlines and notes and some confusing randomness called objectives and then suss out the reading that needs to be done. I bribed my pal to send me a list of the reading and it's scattered in 10 different books seven pages here and two pages there and the tedium is too much for me.

And then there's the psych rotation. My patient is bright and cheery and just a young teenager and says "I'm fine. Nothing's wrong. I won't do it again. Can I go home now?" and still has bruises around the neck from the rope that hung from tree a couple of weeks ago. And I won't even talk about the graphic stories I heard from the psychotic kid who has an angel on one shoulder and a devil on the other who flatly talked about the graphic ways he killed some people. On the sunny side, though, he was the only one in a group discussion of about eight kids who hadn't tried to kill himself recently.


So, did you know they still do shock therapy? It's ECT or electroconvulsive therapy and people are jolted with electricity through electrodes attached to the head until they have a grand mal seizure. The nervous-making thing for me is that they aren't exactly sure how it works, but it seems to be helpful for people suffering from major depression who haven't responded to medication. I got to see someone get a treatment. The person is put out under general anaesthesia and a wrist is tied off. They are given succinylcholine to paralyze their muscles (except for the ones in the tied-off hand). They are jolted and seize for around 45 seconds which is judged by the un-succinylchined hand. The hard thing to watch, for me, was seeing this person I'd just been chatting with get put under and then seem to deflate with the succinylcholine. I've never seen someone anaesthatized before and the succinylcholinealso means that the person is not breathing on their own. It seemed like the anaesthesiologist was rarely putting the bag on the patient and squeezing air into the lungs. I was feeling woozy about the whole thing even knowing that her blood oxygen was being monitored and was fine and knowing that the patient's body needed to have the breathing instinct ("Hello? HELLO!! Too much CO2 here in the brain: breathe, BREATHE!!!") kick in. And then , yes, there's the feeling I can't kick about shocking people. I know it works for lots of people, but it seems so dramatic and primitive.

5 comments:

Kitt said...

Wow, that would totally freak/creep me out. I watched my dog being defibbed (with little doggy-sized paddles, and a murmured "clear" from the vet, just like TV! kind of) and that was freaky enough.

But I guess if it works ... ?

Does it ever go wrong?

Anonymous said...

Yes. People can die. They're under general anaesthesia and the current can whack out the conduction in the heart. Plus, it sends the blood pressure skyrocketing. The patient I saw had a BP of 200 over something right after the procedure.

They say the deaths are lower than deaths from meds, though.

Oh, and some people get memory problems that are supposed to clear up, but don't always.

Molly

License Pending said...

It really does work wonders for those who need it.

I have been reading written by someone who, ironically, is a psych nurse but suffers from bipolar disorder. She just had ECT last week.

You can read about it here.

Molly said...

Thanks for the interesting link, License Pending. That's the thing about ECT: lots of patients report that it has improved their lives dramatically.

I'll be back with a post on Wednesday. I have a series of tests tomorrow keeping me busy!

Anonymous said...

yea, it can work wonders at the price of some short term mem loss,but in those who need it, it's worth it.