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:
• 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).
• A good working knowledge of local ECT guidelines, protocols and policies.
• A good working knowledge of the requirements of legal status and consent to treatment, including prescription.
• A good basic knowledge of the following:
• referral process
• indications for ECT
• risks and benefits of ECT
• contraindications to ECT
• pre-ECT investigations and significance of results
• potential drug interactions with ECT
• preparation of the patient for ECT
• requirements for day-case/out-patient ECT
• possible side-effects of ECT
• the anaesthetic procedure for ECT including risks and potential side-effects
• the ECT procedure
• unilateral and bilateral ECT differences, risks and benefits
• continuation or maintenance ECT
• drugs used in ECT and their potential side-effects
• post-ECT observations on return to the ward
• the review process between treatments
• protocol for patients going out on pass following ECT.