Who Should Sedate GI Patients?
Re: "Anesthesia and the New Economics of GI" (October, page 45). As an anesthesiologist who administers sedation for GI procedures, and as an administrator with many years of outcome and safety focus, I am convinced that the participation of an anesthesiologist is not only warranted in many cases, but can definitely improve throughput, safety and (let us not forget) patient comfort. If you ask any patient her preference, most would prefer — and pay for themselves — the added comfort and safety of having an anesthesiologist. All GI RNs with whom I have ever spoken do not wish to participate in the battle to let them give the inherently unsafe propofol. To say that you have had airway instruction from a GI doctor is questionable, especially from a liability perspective. Letting an RN administer propofol with GI oversight is a dangerous practice in my opinion. The hybrid model described in the article is an excellent solution, from both patient care and facility efficiency perspectives.

Name withheld upon request

As a CRNA with 25 years experience, I was skeptical about nurse-administered propofol until I saw trained, certified RNs sedating GI patients at a hospital-based endo center. They have an outstanding track record: 15,000-plus procedures with no adverse outcomes, in part because they're very selective with the patients that they do. It is an art form to deliver propofol for GI work and at this practice they are masters at it. I have seen all types of anesthetists give propofol for endo cases and it is those that do it everyday that give it better and safer.

Gregory P. Rendelman, CRNA
Morpheus Anesthesia
Wichita Falls, Texas
[email protected]

Why Ban Patients' Clothes From the ORs If Nurses Can Wear Scrubs To the Cafeteria?
Re: "Ban Clothing in Surgery Suites" (November, page 8). We wear our scrubs out of our departments to cafeterias, on smoke breaks and to run errands, then return to the surgical department. How is that different from a patient wearing his clothes into the surgical area? Like many facilities, we place a patient gown over the patient's clothes. Keep in mind the jobs that preps, drapes, gowns, gloves, masks and scrubs do. Good hand washing is the best way to prevent post-op infections.

Linda J. Timmons, RN, CNOR
Director of Surgical Services
Bascom Palmer Eye Institute
Miami, Fla.
[email protected]