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Guidelines suggest that the nurse should have an active role in the preparation, administration, and recovery stages of ECT
The role of nursing in the administration of electroconvulsive therapy (ECT) is evolving. Historically, the nurse provided support and education to the ECT patient and his or her family, and assured that the patient's physical needs were met. The nurse also had limited involvement in assessment.13 It is becoming increasingly apparent that a multifaceted approach to the role of nursing in the ECT process is needed. This is due to the increasing psychiatric and medical complexities seen in the patients receiving ECT and to the change in nursing science and practice.
In 1982, the American Nurses Assodation, in its Standards of Psychiatric and Mental Health Nursing Practice, defined areas of nursing practice in ECT.4 These include education, emotional support, assessment prior to initiation of treatment, preparation and monitoring of the patient during ECT, and assessment of the patient's response to ECT. In 1987, the Royal College of Nursing of the United Kingdom developed guidelines that expanded the nurse's participation in the administration of ECT.5 These guidelines suggested that the nurse should have an active role in the preparation, administration, and recovery stages of ECT.
The American Psychiatric Association has adopted these general recommendations6 and, in turn, Burns and Stuart' propose that nurses become more active in the treatment, education, and assessment process. They suggest more comprehensive nursing that includes more independence and collaboration. We are finding that additional roles for nursing are developing, which support and expand upon these guidelines. ECT nursing today includes participation in the active clinical process, in the education of not only nurses but physicians in training and other professionals, in administrative duties, and in research ventures involving ECT
CLINICAL ROLE
Prior to the decision to administer ECT, the nurse has actively participated in assessment of the patient, which began at the time of admission. The results of this ongoing assessment should be considered by the treatment team when deciding on an appropriate treatment for the patient. If the decision is made to treat the patient with ECT, the nurse is responsible for educating the patient and family. This begins with a further assessment of the patient's and family's needs, particularly...