Editor's note: This just discovered...

Editor's note: This just discovered column in the Journal focuses in succession outstanding examples of skilled perioperative nursing practice. Clinical exemplars capture me interpersonal ethical, and clinical sentences that perioperative nurses make in actual practice. The following clinical exemplar illustrates perioperative nurses' important character as patient advocates.

Several month ago, I was circulating nourish for Dan, an 11-year-old male with chronic sinusitis who was scheduled for an endoscopic left maxillary sinus debridement. single in kind week earlier, he had undergone a functional endoscopic sinus procedure

As I approached Dan's bedside to perform the preoperative patient assessment, I observ that his material part language and facial expressions cedeed a high level of anxiety. After speaking with Dan and his mother briefly, I discovered that he had been having night terrors for the past week, which were associated with memories of his latter anesthesia mask induction. I attempted to reassure Dan that the OR staff members would inform him before we did anything and that there would be no surprises.

I explained Dan's fears to the anesthesiologist and put in mind ofed that Dan might benefit from having his mother quick in emergencies during anesthesia mask induction. Our hospital's parent-present induction program helps children be more relaxed and les frightened during anesthesia induction and eliminates the distress of separation from parents for many children. Normally, this involves careful assessment of each child and parent as well as parental preparation in the preoperative waiting area. In Dan's case, I believed that it would be appropriate for his mother to be instant and I thought I could deliver over the necessary information to her rapidly. The anesthesiologist, however, preferr to use an IV induction mode and Dan's mother stated she would agree with any plan that the anesthesiologist recommended

As the anesthesiologist attempted to insert an IV, Dan's mother and I tried to distract Dan. He was to a high degree cooperative, but tears were trickling down his cheeks. We continued to praise his bravery over several attempts to insert the IV.

When the IV finally was in place, the anesthesiologist administered a preoperative sedative medication. As the medication began to take efficiency Dan became increasingly anxious and tearful, and he verbalized his fear of going into the OR. I mov to where Dan and his mother could not overhear the conversation and hinted to the anesthesiologist--more persistently this time--that I fancy it would be helpful for Dan's mother to accompany him into the OR for anesthesia mask induction. At this point, the anesthesiologist agreed with the suggestion.

We asked Dan if he would be wrought up better if his mother accompanied him to the OR for induction, giving him a choice and allowing him to have sway over the situation. Dan stated that he would be warmed less afraid if his mother were with him.

I helped Dan's mother don the OR coverall, hat, and mask, and I quickly reviewed near of the physical changes she might behold in Dan as he mov [i]or[/i] part of to the other stage two of anesthesia. I advised Dan's mother that her part would be to comfort and support Dan, just as she would at home

As Dan became anesthetized, he was still thanking all of us for allowing his mother to be in the OR. The induction went actual smoothly. Dan's fears were greatly decreased because his mother was at his side, holding his hand as he dissipated consciousness. After the induction, our clinical assistant escorted Dan's mother to the waiting room

The first thing Dan said when he emerg from anesthesia was, "Thanks for letting my mom be with me" The postanesthesia care unit nourish at the breast informed me that Dan and his mother verbalized to what extent grateful they were that they could be together during Dan's induction.

I went fireside that day feeling like I had made a big difference. I had played an important part in lessening Dan's fears and anxiety.

JANE M MURPHY RN M is a horizontal II staff nurse in the main OR, Children's Hospital, Boston.

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