Most people wake up from general anesthesia with blearily opened eyes, the irresistible urge to rub their nose, and that's about it. Many will flail their arms a bit, but without strength, and the moment quickly passes. Occasionally someone will rouse combative, which is why staff stay nearby as they emerge, to keep them safe, and on the bed.
Much more rarely, they wake up fighting and uncontrollable, and strong. So that the nurse and tech, sometimes the resident, are using their body weight to keep them from running all the way to the floor. I've seen a few bad wake-ups, the worst* still has to be the Tongan woman just coming out of heart surgery, swatting away orderlies. I got her to focus on me, sat her up, and slowly she came around to post-anesthesia version of oriented.
This week, the second worst wake-up. Strong guy, went down oddly, taking a lot of drugs to get any effect during induction, more to get him out. This is often a sign of recreational drug use (or chronic pain narcotic tolerance), and long term smoking. It also meant that he metabolized the hell out of the propofol at the end of surgery, and woke up before the dressing and knee immobilizer were on, swinging and kicking. Nothing could calm him down, although the worst passed off after a few minutes. When we turned him up to get the roller under him, he snatched at me. This is dangerous, a grab so strong and he could wind up on the floor. I held my place, but rolling him over scared me. I took the time to get him to grip tight to his own elbows, made him promise to hold, and we rolled FAST. It worked, to my deep relief.
I've found I've lost my taste for the adrenaline high. I've had a headache, intermittently, ever since. This is why I like boring, nothing going wrong.
That this is the weather does not help me, although it's exactly what to expect this time of year, here.
18 Jul 3:53 pm 101(f) 41(dew point) (winds) 13 N 10G20 FEW080 SCT120
D's brother, who lives about 40 minutes away from them, agreed to help C and Moira move tomorrow. C seems to think they may not need him. He's not moved as many times as D and I have, but you never know, sometimes cockeyed optimism is right. I've never seen it happen relative to a move, but one never knows.
*Not counting post anesthetic psychosis, I've seen that twice. Can't find anything online to describe it, it's pretty rare. I'll see if I can get some data from our Director of Anesthesia for next week.
14 comments:
I can remember coming round from abdominal surgery 12 yrs ago and asking (very politely), if I could please have a cup of tea!
Thankyou for posting about your nursing experiences, I find it all so interesting. Please look after yourself though.
ps thankyou for the compliment:)
h,
Not an unusual request, although more commonly it's coffee around here. Bad dry mouth and general dehydration.
Doing my best, working on plans for the future.
I never knew it could be so challenging physically.
Yours is a physically, as well as mentally, challenging career, one I could not do successfully. My hat is off to you, with sincere admiration and gratitude.
It is my CRNP, with 30+ years experience in the ER, who is walking me through my heart-attack recovery. I am so glad I have her helping me - she knows how to listen to the things I don't say to get to what's wrong.
Good work, Zhoen.
:)
den, Crow,
Part of what I've always loved about it. I have to think and I have to move. It's a very physical job. Which has also been the problem, I keep re-injuring my back, can't let it really heal properly.
The one time I came round from general anaesthesia was incredibly disconcerting at first, since the nurse whose face I saw was someone who'd been a worker at play school (pre-school or nursery school), and I'd last seen her when I was aged about 5 (I was now 18).
So it took a good few moments for her to convince me that I hadn't in fact died.
Wow! I didn't know that sometimes people came up swinging. Crikey!
trou,
Oh, wow, that must've been freaky.
Dale,
Yup.
i just came out of anesthesia 11 days ago, and it was my worst experience in the 5 surgeries i have had. i was under 4.25 hours and had an arterial line which came close to causing me to leave the hospital while it was being placed. i am covered in anesthesia inflicted bruises which are still deep purple and burgundy. i awoke freezing cold in a way i have never known "cold." my teeth were chattering enough to make noises. i later found my tongue very sore along one side which i supposed came from my chattering teeth biting it. i begged for blankets over and over, but never felt like they had given me any since i remained cold for what seemed like forever. i was in recovery almost 2 hours and didn't feel warm until close to the time i was sent to my room. my pain was horrible from the moment of consciousness, and i apparently made everyone so aware of it that another nurse in the recovery room came over and asked me to be "quiet with my pain." given that i didn't even realize i was making much noise it was a rather rude request in my anesthetized brain, and i hated her the whole time i was there and referred to her as the "mean, old, white-haired woman" when telling my own nurse about her. my other 4 experiences in recovery were warm, nurturing, and caring experiences, and i left recovery feeling very fond of the nurses who cared for me. i was only under for those surgeries about 70-80 mins each time. this time i left there hoping to never lay eyes on any of them again, happy to find friendly and caring nurses on the floor whose names i will always remember.
sky,
I am so sorry, that was a harsh and miserable experience. That cold should have been handled better (with warmed IV fluids) the shaking was probably the drugs wearing off, and there is a treatment for that too. And I would love to come smack that mean pacu nurse, anytime.
The amount of time you were under certainly contributed to all the damage.
thanks much. i wish you could smack her! i would be your cheerleader!
is the recovery room under the supervision of the anesthesia dept in most hospitals or is it a separate entity entirely?
i was so traumatized i have thought about this experience daily since being discharged. i may call the hospital to discuss it with someone who hopefully could prevent someone else from going through a similar experience. it just made no sense to me that i was freezing cold for so long or that my teeth were chattering so loudly. i worried i was having a seizure.
Sky,
Let them know. Give them feedback. It's important, the only way anything changes.
Each place has a different admin structure, call and ask and rattle their cages, for the sake of other patients after you. They really listen when a patient tells them. If you can do it, you will have a huge impact.
i will. a nurse who was in another area of recovery called me last night to see how i was doing. she always checks on me when i am there (she lives near us). she did not know i was there until just as i was sent into recovery because she went in late that day. when she found me she said i begged her to help me and to go tell my husband how much pain i was in. she said she told that nurse to do something about my pain and then indicated to me she thought he was on the internet! she gave me the name and number of who to call and i plan to do that today!
i never saw his face, have no idea what he looked like, nothing. he was on a stool the whole time. i have NEVER been in recovery without seeing the face of my nurse! i am not sure how he could have done much to help me without ever standing up - perhaps he did and my eyes were always shut, but you would think i would have at least glimpsed him at some point! thanks for the support.
This is full of interest for me too. Painful also to read of Sky's experiences - I had similar after each of my children were born (the first by caesarean), perhaps a reaction to epidural because I did not have general anaesthetic, and the nurses were not kind.
My son had general anaesthetic when having teeth removed and it frightened him a great deal because he experienced leaving the body and looking down at himself. Good nursing can make so much difference.
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