The day I spent at the chosen ECT clinic to observe the process of electroconvulsive therapy provided the opportunity to learn about the initial preparation, patient consent, procedures, potential side effects, benefits, and medications to be avoided. Applying Gibbs’ reflective cycle, the paper will be constructed according to the following structure: description, feelings, evaluation, analysis, conclusion, and an action plan. In particular, I observed equipment checks, ECT documentation, the preparation of patients, anesthesia peculiarities, and the recovery process.
During this observation, I was thinking about several issues that caregivers should take into account to ensure high-quality ECT services. First, I felt that nurses and therapists take responsibility for a patient in the course of this treatment as they are expected to make sure that everything is clear and appropriate. Nurses are assigned to meet outpatient users and accompany inpatient ones during the whole process of the therapy. Second, I was impressed with the detailed documentation required to be completed for every patient as part of ECT. The presentation of complete induction forms as well as rules and procedures was also rather comprehensive, which is likely to contribute to the elimination of any errors. Third, my experience regarding ECT was considerably enriched as I understood this treatment option in an in-depth manner.
The observation of equipment checks, namely, defibrillator, oxygen suction, thymatron, and electroencephalographic (EEG) low dosage allowed me to understand how they work and how to use them in practice. The mental health act (MHA) consent should be signed by patients before the therapy, while they are allowed to change their decisions as well. The patients’ capacity is taken into account, and it determines the necessity for authorization and review of a second opinion appointed doctor (SOAD). For example, if a service user is under the age of 18 and lacks capability, ECT should be authorized by a SOAD, while those of the same age with capacity require only a certification. I learned that ECT documentation consists of general medical notes, ECG, blood tests, ECT pathways programme, section papers, day patient pathways, and a current prescription card. Most importantly, the observation revealed that documentation re-check is essential to prevent any misunderstanding as the following aspects are critical: MHA pathway, medication, physical health, and other associated concerns.
The preparation of service users consisted of the detailed explanations about diet, medication, benefits, and possible side effects. For example, it was stressed to patients that some temporary memory loss may occur within few hours. The recovery procedures were also identified to patients in a comprehensible way. As for ECT, the administration of short-term anesthetic was followed by small electric current to achieve twitching in the limbs, which took approximately ten minutes. The observation of an anesthetist who was present during the therapy showed that he used general anesthesia to help muscles in relaxing.
To conclude, the observation of recovery period was short yet productive since some patients showed slight haziness, and others felt good after the therapy. Operating department practitioners (ODPs) reported about accompanying patients to wards and homes as well as their overall well-being during post-recovery and discharge. In general, I consider that the observation was helpful to understand the essence of ECT. If I were to observe ECT again, I would notice more challenges encountered by care providers and patients before, during, and after the therapy. Based on the above information, it would be possible to improve the current practices and achieve better health outcomes in patients receiving ECT.