11 - Nursing guidelines for ECT

Summary

The responsibilities of the ECT nurse specialist have continued to expand and develop over recent years. It is now widely recognised that this is an expert role which is pivotal within the ECT core team. This chapter outlines the guidelines for best practice and describes the main responsibilities of the nurses involved in the ECT process (see also Appendices III and IV).

The role and responsibilities of the ward nurse

The ward nurse should be able to provide care and support for both the patient and their relatives before and after treatment on the ward. They should be familiar with the requirements for the treatment in order for them to accurately and sensitively inform both the patient and their relatives of what to expect during the course of treatment. The ward nurse requires the following knowledge and skills:

1. • A good knowledge of current national guidelines and standards, including ECTAS (Cresswell et al, 2012), SEAN (2010), Royal College of Nursing (Finch, 2005), Royal College of Psychiatrists (Waite & Easton, 2013), Association of Anaesthetists of Great Britain and Ireland (2010), NICE (2003) and Nursing and Midwifery Council (2008).

2. • A good working knowledge of local ECT guidelines, protocols and policies.

3. • A good working knowledge of the requirements of legal status and consent to treatment, including prescription.

4. • A good basic knowledge of the following:

5. • referral process

6. • indications for ECT

7. • risks and benefits of ECT

8. • contraindications to ECT

9. • pre-ECT investigations and significance of results

10. • potential drug interactions with ECT

11. • preparation of the patient for ECT

12. • requirements for day-case/out-patient ECT

13. • possible side-effects of ECT

14. • the anaesthetic procedure for ECT including risks and potential side-effects

15. • the ECT procedure

16. • unilateral and bilateral ECT differences, risks and benefits

17. • continuation or maintenance ECT

18. • drugs used in ECT and their potential side-effects

19. • post-ECT observations on return to the ward

20. • the review process between treatments

21. • protocol for patients going out on pass following ECT.