I'm Kelsy. I'm a nurse. I work the night shift on a crazy surgical unit and you would not believe the stuff that happens when sick people sleep. To hear more about that and other stories read on....

Monday, March 4, 2013

Anesthesia Flip

It happens quite frequently that after a patient returns from surgery they come out a personality from a different life.  You could have a patient that is rude, demanding, and short before surgery.  After recovering and taking an hour or so in post-anesthesia, they could come back the nicest patient of your life.  It could be the fentynl talking, but still it's nice.
Or sometimes you have the opposite effect.  This patient was a nice guy.  Having some issues, so he needed to go to surgery.  Not immanently, but soon, basically to make him feel better.  Prior to surgery, he was making jokes, introducing me to his wife, very supportive family, telling me about his work.  Really easy to deal with.  So he goes to surgery.  Everything goes fine.  Post-anesthesia calls to give report on surgery, and how he is recovering.  Different story.
The nurse says this, "Well, he's not doing the greatest.  We have him in restraints.  He was spitting at us earlier, crawling off the gurney, and pulling out his IV.  He's quite confused.  Not oriented to time and place at all.  I gave him versed, ativan, and dilaudid.  Nothings working."
Great.  Sounds just peachy.  I tell the nurse, "Well, send him.  It can't get much worse."  I call my supervisor, let her know I may need to 1:1 patient sitter to keep this guy in bed.
He returns to the floor.  And from there my night got interesting.  He frequently was kicking me out of his room that night, saying things like, "Get out of my room.  I'll call the police."  Of course my priority was to keep him safe.  He ended up doing fine through the night.  The dilaudid finally caught up with him and he settled down.
The next night I had said patient again.  He was doing much better.  At this point he had cleared all the crazy medications anesthesia threw at him and was much more himself.  He was even clear enough to apologize to me for how he had treated me the night before.   He was really embarrassed. He apologized profusely.  To which my only response could be, "Really, don't worry about it.  This happens all the time.  You were not yourself and I understand that is not you.  Anesthesia can do that to you."
So a word of advice:  When given the opportunity to have a spinal anesthesia, take it.  A general anesthesia will mess you up.

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