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The controversial Nursing perception of Electro convulsive Therapy: A true Experience from Egypt

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The controversial Nursing perception of Electro convulsive Therapy: A true Experience from Egypt

  1. 1. The controversial Nursing perception of Electro convulsive Therapy: A true Experience from Egypt Author:MahmoudAgiza StudentNurse- Facultyof Nursing/The BritishUniversityinEgpt Electroconvulsive therapy (ECT) still one of the most debatable treatments for psychological diseases and still a subject of emotional arguments among different groups in the world. ECT is used for more than fifty years and is considered the oldest psychiatric physical treatment. The Egyptian media introduced ECT in a very negative way though different movies and many Egyptians have a negative impact of treatment using ECT and perceived as a form of violence against patients. As a student nurse; I had several experiences with ECT administration and found that Applying ethical values to a clinical practice needs consideration of variety of aspects and can be challenging. I witnessed one of the painful situations when ECT was administered against patient’s well and I couldn’t help or interfere. This happened in one of the teaching hospitals where my patient was diagnosed with major depression and being treated with electroconvulsive therapy without obtaining his consent. The patient diagnosed with major depression and attempted to suicide before being hospitalized. The patient was worried about the adverse effects after he experienced the situation once before and hated the experience of ECT. The first session was administered against patient’s well and the psychiatrist responsible for his treatment has observed patient’s fear and worries, but he prescribed the ECT again although the patient refused the treatment. Unfortunately, the medical team enforced the patient to undergo ECT aggressively using restrains. This situation occurred many times for other patients later. This experience raised many concerns in my mind related to the nursing role in the process of administration of ECT and regarding the ethical values of justice and non-maleficence, along with other issues (Flanigan2010). I wish I could interfere to protect the patient and decrease his suffer and pain but I was under training and wasn’t aware of hospital policy and possible ways of raising complaints. After this experience, I decided to develop knowledge about ECT in general and the nursing role with patients who will receive ECT.
  2. 2. I discovered that I had an advocacy role towards my patients and that I should be aware of the Egyptian mental Health act and other legislations to be able to help the patient and defend his rights. As a nurse, I realised that mental health nursing is not only about skills and years of experiences but it’s also about knowledge of country legislations, human rights and organizational strategies. Therefore, I started to develop knowledge about the nature of ECT and effect on the brain. The first electroconvulsive therapy treatment used to treat psychiatric disorders including depression and schizophrenia was performed in Rome by Italian psychiatrist “UgoCerletti and LucioBibi” in April 1938. Electroconvulsive therapy is defined as a type of therapy in which through electrodes are positioned on the temples, electric current is applied to the brain to induce a generalized seizure and acquire the preferred result (Townsend 2011). The dose of electricity used in ECT ranges from 70 to 125 volts of electrical current for 0.7 to 1.5 seconds. The patient then experiences two phases of seizures. The tonic phase remains about 10 to 15 seconds and then the colonic phase is observed and lasts for 30 to 60 seconds (Townsend 2011).I lacked this knowledge before ,but, when I read these documents, I understood how and when ECT started and what is the dose and effect on patients and the more I know about the procedure and its details the more I gain confidence that I can help and support my patients. The nurse has a significant role before, during and after the ECT, yet, nursing role can’t be achieved without the cooperation with the whole team of psychiatrist, anesthesia doctor, head nurse and social worker. Nursing is about caring for others but it’s also about giving voice to patients, support them and stand up for them whenever required. References:  CLEARY, M., AND HORSFALL, J., 2014. Electroconvulsive Therapy: Issues for Mental Health Nurses to Consider. National University of Singapore, Yong Loo Lin School of Medicine, Singapore[online], January [viewed 20 April 2014]. Available from: http://eds.a.ebscohost.com/eds/detail?sid=6c2845e2-025d-42e0-ac09- 7d9d14390ae0%40sessionmgr4001&vid=1&hid=4103&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=asx&AN=93256153  FLANIGAN, C., 2010. Ethics and the Use of Electroconvulsive Therapy. Whitireia Nursing Journal, October, vol. 17, no. 4, pp. 1-6.  FLANIGAN, C., 2010. Ethics and the use of electroconvulsive therapy. Whitireia Nursing Journal[online], [viewed 21 April 2014]. Available from:
  3. 3. http://eds.a.ebscohost.com/eds/detail?sid=acd43309-c1b6-45fe-9355- 122832cbf193%40sessionmgr4001&vid=1&hid=4103&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=c8h&AN=2011006674  GASS, J., WEST, B., MARTINDALE,S., AND BURKE, S., 2011. An exploration of the process of informed consent for electroconvulsive therapy (ECT): the nurses' and doctors' role. The Robert Gordon University School of Nursing and Midwifery[online], [viewed 20 April 2014]. Available from: http://eds.a.ebscohost.com/eds/detail?sid=6b93a1f4-49d9-4d46- bbd2- b98a0b7ea603%40sessionmgr4001&vid=1&hid=4103&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=edsoai&AN=edsoai.748235558  KAVANAGH, A., AND MCLOUGHLIN, D., 2009. Electroconvulsive therapy and nursing care. British Journal of Nursing [online], [viewed 21 April 2014]. Available from: http://eds.a.ebscohost.com/eds/detail?sid=1b032309-394c-4514-a3f3- 663f581f44b1%40sessionmgr4005&vid=1&hid=4103&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=asx&AN=45687533  KELLY, S., AND KELLY, L., 2014. Improving patient safety and quality of care for patients receiving electroconvulsive therapy. Mental Health Practice[online], [viewed 22 April 2014]. Available from: http://195.246.60.17:2447/eds/detail?sid=a5ce460d-807e-419c- ac11- 144672cdffc7%40sessionmgr4002&vid=1&hid=4202&bdata=JnNpdGU9ZWRzLWxpdmU% 3d#db=a9h&AN=94412949  PILEGGI, S., AND RYAN, A., 1993. The role of nursing in electroconvulsive therapy. Psychiatric Annals[online], [viewed 21 April 2014]. Available from: http://eds.a.ebscohost.com/eds/detail?sid=258fa33c-c022-4467-b508- b609b334b9cc%40sessionmgr4004&vid=1&hid=4103&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=psyh&AN=1993-26810-001  RAJAGOPAL, R., CHAKRABARTI, S., GROVER, S., AND KHEHRA, N., 2012. Knowledge, experience & attitudes concerning electroconvulsive therapy among patients & their relatives.The Indian Journal Of Medical Research. [online], [viewed 19 April 2014]. Available from: http://195.246.60.17:2447/eds/detail?sid=f062ab3a-d563-4a38-9cb0- eace6d650de8%40sessionmgr4003&vid=1&hid=4202&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=mdc&AN=22446862  THOMAS, C., 2013. Student voices. Observing electroconvulsive therapy. [online], [viewed 21 April 2014]. Available from: http://eds.a.ebscohost.com/eds/detail?sid=135cd5d9- f3ba-49c3-a05b-
  4. 4. f2ea2a9e9052%40sessionmgr4005&vid=1&hid=4103&bdata=JnNpdGU9ZWRzLWxpdmU %3d#db=asx&AN=87920297  TOWNSEND,M., 1996. Psychiatric Mental Health Nursing Concepts of Care. 2nd ed. Philadelphia: F.A Davis Company.  TOWNSEND, M., 2011. Essentials of Psychiatric Mental Health Nursing CONCEPTS OF CARE IN EVIDENCE-BASED PRACTICE. 5th ed. Philadelphia: F.A Davis Company.  TOWNSEND,M., 2011. Nursing Diagnosesin Psychiatric Nursing: Care Plans and Psychotropic Medications. 8th ed. Philadelphia: F.A Davis Company.

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