Nurses' Attitudes About Sedation: An Update.

Abstract

More than half of all critical care nurses still believe that sedation is necessary to keep patients comfortable during episodes of mechanical ventilation, according to the new study, “Nurses’ Attitudes and Practices Related to Sedation: A National Survey,” by Guttormson and colleagues. The original research done in 20051 revealed the significant influence of nurses’ attitudes about sedation on sedation practices. In the current study, Guttormson et al reexamine the state of nurses’ attitudes regarding sedation of patients receiving mechanical ventilation to see if those attitudes have changed since the 2005 study in light of the implementation of the pain, agitation, and delirium guidelines. They found that, yes, attitudes have changed: more nurses indicate a belief that sedation is no longer required for all patients receiving mechanical ventilation. This is a significant step forward in addressing concerns about oversedation.We must remember that our current sedation practices are not harmless. Multiple studies show the negative effects of sedation: increased duration of mechanical ventilation, development of delirium, prolonged duration of delirium, decreased overall brain function/cognition, and longer hospital stays.2 Recent studies also indicate a link between our current sedation practices and posttraumatic stress disorder and post–intensive care syndrome.3 Another key point: the results of this new study highlight the need to keep nurses as full partners in developing future sedation guidelines.