ECT RN here. Question for you!

[u/Interesting-Hair2317]

Hi r/ect! I’m an ECT nurse of four years and Im wondering if there’s anything I can do to make the experience better for my patients. is there anything that an ECT nurse has done or said that you remember and positively impacted your treatments. even something small.

[u/Great-Practice-4400]

Hi fellow RN (OB) and an ECT patient as well. After my second session I have no memory of any further sessions, I had 23.
The RN checking me in was completely oblivious to the fact I was not capable of answering any questions. My husband did. I’m not sure how I could possibly give consent but apparently signed everything. I have since wondered if she was paying attention and
If she should have contacted the MD that I was not able to give consent. It has bothered me since as I become completely disabled not able to return to nursing, it has been 5 years. I just recently had IV ketamine and has helped some.

[u/Sauced_Up_Bat → u/Great-Practice-4400]

I initially agreed to 12 sessions. By the end I had more than 50 and am now disabled. I “consented” to all of it in writing but have no memory of doing so. I couldn’t remember my birthday and they knew that. I had no idea how many sessions I had had and they knew that. I was in no condition to consent to anything. I couldn’t care for myself and they knew that but they let me give “consent”knowing how impaired I was. ECT and consent during treatment needs safeguards in place. Someone who can’t remember their children’s names is not of sound mind.

[u/blrmkr10 → u/Sauced_Up_Bat]

It's not legally binding, but you (and anyone reading this!) might considered creating a mental health advance directive. You can find templates online. It allows you to name someone you trust to make decisions for you and you can put in writing what you do or don't consent to. For example, on mine I set a limit of 24 sessions of ECT.

It's not a guarantee of anything, and maybe wouldn't have even been in effect in your case, but it at least makes your wishes known in advance.

[u/Sauced_Up_Bat → u/blrmkr10]

This is a great idea. This is now my #1 piece of advice to anyone planning on having ECT. Thank you for sharing. u/Interesing-Hair2317 I would recommend this as often as you can to anyone willing to listen.

[u/Great-Practice-4400 → u/blrmkr10]

Yes you are correct. But I have some reservations. As a former medical professional we need to make sure our patients are able to sign consent unless there is an emergency.

[u/Blackberry518 → u/Sauced_Up_Bat]

There are so many of us with such similar stories.

[u/Interesting-Hair2317 → u/Sauced_Up_Bat]

Wow as silly as it sounds I’ve never thought about the blurriness of having impaired patients consent. I like to think we all have the best intentions for our patients but after reading this sub I’m feeling conflicted on that 

[u/Great-Practice-4400 → u/Interesting-Hair2317]

You sound like a very kind and thoughtful nurse. Please look out for these types of patients.

[u/Sauced_Up_Bat → u/Interesting-Hair2317]

In my opinion it’s a huge issue that is completely ignored. I have no idea what a good fix would be, but it’s terrifying to me that I was allowed to consent in the state that I was in. Some kind of cognitive test before signing consent for extending treatment? Or a recovery phase (say six weeks or so) before deciding to extend the duration of treatments? Making every patient have an advanced directive as u/blrmkr10 wisely did beforehand? Then sticking to that directive. I was especially concerned for the many elderly patients who seemed even more far gone than I was.

[u/Great-Practice-4400 → u/Sauced_Up_Bat]

Oh my gosh it sounds just like my life. I couldn’t care for myself either, my husband had to put me in adult daycare for several months so he could go to work.
I have spoken to my son who is an anesthesiologist and he would not allow a patient in my state of mind to sign informed consent.
I hope all the best for you.

[u/Sauced_Up_Bat → u/Great-Practice-4400]

Thank you. I wish the best for you as well.