Quote from GIRN
Thanks for your input. We've thought about the personalities that will be working there because you're right....that sets the tone for place. Does your Center use Anesthesia-delivered Propofol or nurse-delivered conscious sedation? We're also worried that if the docs are our bosses and they say to give more sedation when we're not comfortable that it's a safe practice....we won't have the hospital policy to back us up. What do you guys use? Does that ever become a conflict?
What do you do when the docs take vacations and a room is not needed? Are your people salaried or hourly? Do you get your hours every week?
We use sedation. There is no real market in an outpatient setting for Propofol. There are some centers in the midwest that use nurse administered propofol, but our doc's don't see any real advantage. In an endoscopy center you get a flat rate per procedure so using more expensive drugs comes out of you pocket. I have not seen there is that much difference between propofol and sedation.
As far as doing the sedation we have policies and procedures just like in the hospital. Any accredited facility has to have those. It mostly comes down to trusting the physician that you work with.
As far as scheduling I really don't get involved with that, but I think there are a core group of full time nurses and then some that work part time to fill in so everyone gets there hours. As far as vacations, if we have someone on vacation then the manager pulls someone from clinic to get it covered. Essentially filling the endoscopy center has priority and it is up to the doc on vacation to get coverage. Also on those rare days that we have free rooms the nurses can get caught up on paperwork etc. I think most of the nurses are hourly with our CNO and a few of the charge nurses salaried.
I think the best statistic is that our core group of nurses have been there since the center opened five years ago and we haven't had an opening in more than a year.
David Carpenter, PA-C