Anesthesia Nursing: Alice Magaw - Essay Example

Anesthesia Nursing The purpose of this paper is to discuss the historical significance of Alice Magaw, the “Mother of anesthesia“, as it is relevant to nursing practices in anesthesiology. Alice Magaw began a practice of humane and effective anesthetization of patients where before there was no such method. She successfully utilized the “open drop” technique of etherization, in order to safely render patients unconscious for invasive and painful surgical procedures. Magaw wrote 5 separate articles in her time and administered anesthesia to 14,000 patients having maintained a mortality rate of zero. (Harris, 2007). Introduction: Alice Magaw is known as the Mother of anesthesia. She served in the capacity of anesthesia nurse from 1989 - 1908. She was aid to Dr. Charles H and Dr. William J. Mayo, the physicians for which the Mayo Clinic was named. Alice Magaw earned her title by responsibly administering anesthesia to roughly 14,000 patients. In all of these instances where Magaw administered anesthesia to patients preparing to undergo surgery, not one patient was lost. Magaw is also noted for multiple journal publications following extensive documentation and study of anesthesia administration. Her skills and knowledge were widely known as she acted as a teacher or tutor to many medical and nursing students. Magaw combined a technique involving both an ether drop and soothing talk, to put patients peacefully to sleep and at ease before surgery. Her work is so well known and revered within the medical community that an award for outstanding nursing in the area of anesthesia has been named after her. The award is known as “Alice Magaw Outstanding Clinician Practitioner Award” and is given to those who are actively involved with patient care and the betterment of anesthetic practices. Impact Analysis: With experience extending over 14,000 patients, Alice Magaw effectively established her name as a permanent part of medical history. Her research was documented in a series of five journal articles. (Harris, 2007). nursing today is impacted by the work pioneered by Magaw, “Certified registered nurse anesthetists (known as CRNAs) specialize in the practice of anesthesia. They were among the first nursing specialty groups recognized within the profession of nursing and in the community, and have been practicing the art of anesthesia for over 100 years. CRNAs administer more than 65% of all the anesthetics administered in the United States. In more than two thirds of all rural hospitals in the United States, CRNAs are the sole providers of all anesthetics administered” (Harris, 2007). Nurses are assigned the task of not only assisting doctors but also seeking the comfort of the patient. Certainly in surgical procedures, The first step is to anesthetize the patient, prior to any surgical procedure. A good nurse will spend time explaining things to the patient as well as soothing them before and after the procedure. Magaw discovered that engaging in soothing and encouraging dialogue with the patient, is integral to the success of anesthetics. Anesthesia in its infancy, was known as an “open drop procedure“. This is precisely the procedure that Magaw utilized to treat her patients prior to surgeries. The “open drop” method of anesthesia is one where ether, chloroform or halothane are the anesthetizing agent. The patient is given a mask made of gauze, to wear while the substance (like the above listed) is made to drip into the mask. What happens here is a very interesting and powerful chemical reaction. The patient inhales air that has passed through the wet mask creating vapors. These vapors when inhaled, act as an incredibly potent anesthesia, “The vaporization lowers mask temperature, resulting in moisture condensation and a drop in anesthetic vapor pressure (vapor pressure is proportional to temperature).…(McGraw - Hill’s Access Medicine, 2008). Alice Magaw was partial to ether as opposed to chloroform as she detailed this in one of her five written articles written between 1899 and 1906, “Since the discovery of ether in 1846 by William Morton, much has been written about anesthetics and their administration, and still ether and better etherization is more in favor today than ever before - Magaw, A “ (Koch, 1999). . Prior to the time of Magaw, the method most commonly used to anesthetize patients was known as the “choking and smothering” method. This method was just as it sounds, the individual anesthetizing the patient would begin choking or smothering the patient until the patient was unconscious. This method was clearly very unsafe and resulted in many patient deaths as a result of its use. Magaw worked diligently not only to change this barbaric method altogether but to isolate one that offered the patient a more relaxing and somewhat pleasant anesthetizing. She revolutionized how surgeries were done as well as the general and most widely accepted method of anesthetization. It was 1846 when ether was actually discovered by an individual by the name of William Morton. (Koch, 1999). Magaw was a veteran to various processing of anesthetizing. She had experimented with methods that included the administration of morphine and/or nitrice oxide prior to a patient’s “etherization” but found ultimately that ultimately, ether administered through the “open drop” method work the best with no risk of mortality as far as Magaw had experienced. One of Magaw’s main points in her writings about her experiences, is the ultimate safety and comfort of her patients. She details and explains methods for positioning the patient so that the head is resting in such a way that the patient receives a maximum amount of air, “ It is a mistake to think that the same elevation of the head will do for all patients. The anesthetist should elevate the chin to such a position as not to bend the neck too far back or approximate the jaw too near the sternum. Proper elevation of the head will relax all tissues of the neck and give more freedom in breathing” -Magaw, A (Koch, 1999). Additionally she explains techniques for how the arms of the patient may be gently bound with gauze, to protect them from falling over the sides of the table. Today’s anesthesia is typically administered via intervenes drip (IV drip). In the time of Alice Magaw, the patient may see a can or two which contained the ether for the anesthetization. The can of ether was usually fitted with a cork which was cut in such a way that gauze could be placed within the can allowing ether to drip out of the can via the gauze. The first can which Magaw would use would allow a somewhat quick ether drip to escape the can thereby quickly lulling the patient into a deep sleep. The second can was then used once the patient was rendered anesthetized by the first can of ether. The second can did not allow for quick drip of ether but rather a slow and steady drip, “As it requires very little ether to keep a patient surgically etherized, one can change to the smaller dropper during the operation. A much deeper narcosis is required to start an operation or to make the incision than later on, when the operation is in progress” - Magaw, Alice (Koch, 1999). Another valuable and effective technique employed by Magaw was assessment of the patient as an individual prior ro the procedure. She felt that by meeting with the patient and developing a rapore with them, she would be able to gain their trust while eleviating some of their fears concerning the surgery and anesthetization process. Once the patient was initially anesthetized, Magaw would also pay close attention to the respiration and pulse of the patient thereby determining if the amount of anesthetic was satisfactory or of an unsatisfactorily small amount. Magaw was extremely focused on the needs and individuality of the patient before during and after surgical procedures, “ Suggestion is a great aid in producing a comfortable narcosis. The anesthetist must be able to inspire confidence in the patient, and a great deal depends on the manner of the approach. One must be quick to notice the temperament, and decide which mode of suggestion will be the most effective in the particular case: the abrupt, crude, and very firm, or the reasonable, sensible, and natural” -Magaw, A.(Koch, 1999). Magaw even recognized the power of the subconscious and how easily patients could be either frightened away by meeting with their anesthetist or encouraged to be at ease with her. Prior to the work and findings of Alice Magaw, patients were subject to an extremely terrifying, and often life threatening experience when requiring surgery. The element of humanity and practicality introduced by Magaw into the field of nursing anesthetization was fundamentally crucial to shaping nursing and anesthesiology of today. Magaw effectively paved the way for the future of effective and humane anesthesiology. In conclusion, it is truly remarkable how Alice Magaw almost single handedly, reshaped and invented an entire aspect of the medical field. Certainly, in order to perform life saving surgeries, the aspect of anesthesiology is entirely crucial and fundamental. Having practically invented a means by which to safely anesthetize patients while preserving the patient’s feelings and concerns, Alice Magaw remains forever in history as the “mother of anesthesia”. References: American Association of American Anesthetists, (2008), The Alice Magaw Outstanding Clinician Practitioner Award, retrieved 16 June 2008 from website at: http://www.aana.com/AboutAANA.aspx?ucNavMenu_TSMenuTargetID=15&ucN avMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=932 Harris PhD., Nancy, (July 14, 2007) Alice Magaw, the Mother of Anesthesia, University of Iowa Hospitals and Clinics, retrieved 16 June 2008 from website at: http://stti.confex.com/stti/congrs07/techprogram/paper_32925.htm Koch MSN, Evan, (1999), Alice Magaw and the Great Secret of Open Drop Anesthesia, AANA Journal February 1999; 67:33-38, retrieved 16 June 2008 from website at: http://www.aana.com/uploadedFiles/Resources/Archives_- _Library/Historical_Resources/Imagining_In_Time/magaw_feb1999.pdf Leske K, Jane K., (2007), Roles for the Advanced Practice of Nursing Research, Perioperative Nursing Clinics, Vol 2 Issue 1, retrieved 16 June 2008 at : http://www.periopnursing.theclinics.com/article/S1556-7931(06)00104-5/abstract McGraw- Hill’s Access Medicine, (2008),Open Drop Anesthesia ,Clinical Anesthesiology 4e, retrieved 16 June 2008 from website at: http://www.accessmedicine.com/content.aspx?aid=886023 Read More