combative or disruptive. The goal has been to sedate or anesthetize
these patients by whatever means possible. We need to turn that para-
digm upside down. Luckily, nonpharmacological interventions are
providing better outcomes.
Our program has focused on changing our process to suit the indi-
vidual needs of the patient rather than asking the patient to adapt to
our environment. We do everything in our power to minimize stress to
the patient, to engender cooperation and to make the patient a more
willing participant in the process.
There are 2 advantages to rethinking the approach. The most impor-
tant is that contentious encounters traumatize patients for life. While
it's typically possible on any day to get a patient through the surgical
process using heavy sedation and sometimes physical force, that
heavy-handed
approach will terrify
the patient and the
family. Traumatic
inductions can result
in behavior changes,
sleep disruption and
symptoms resembling
post-traumatic stress
disorder. At the very
least, it will make
things much harder
the next time that
patient needs care.
The second reason
is practical. Some of
these patients are very
N O V E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 9
