Input from Endoscopy nurses, Please

  1. 0
    Hi,

    I just accepted my first RN job in the outpatient endoscopy unit of the facility I work for. I've been an LPN injection nurse for the past 4.5yrs. I finished my RN in December of 2010, and will be 51yrs old next month.

    I accepted the position for two reasons....1) It is one of a few areas I've thought I would like working in. 2) It was the first firm job offer I've gotten since applying for RN positions

    One of my friends has told me NOT to take the job because my license (and patient safety) would be pushed to the limit by the docs when doing conscious sedation. Now I'm a little nervous.

    I would appreciate any input and advice from Endoscopy nurses. How can I prepare myself for success on this unit? Do you agree with what my friend says.

    Thanks in advance!

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  2. 11 Comments...

  3. 0
    If you take the position and get no orientation, no one asks if you have ACLS, you are just told to give fentanyl and versed without anyone questioning if you are trained. If there is not a crash cart close to the unit, if there is not continuous cardiac and oxygen saturation monitoring, no supplemental oxygen available. If your patient is discharged home directly after the procedure without any recovery room monitoring, no discharge instructions, then yes you would be pushing your license to the limit.

    Will you be working in a licensed gastroenterology (endoscopy) clinic that is under the auspices of the "facility" you are currently working in??? Is the facility you are currently working in a legitimate regulated, JCAHO inspected "facility"? If your current facility is licensed, regulated, certified, etc. I can't imagine any way it would have an endoscopy unit that is allowing nurses or doctors to do procedures outside of the regulatory practices for endoscopy units?

    A nurse can give conscious sedation. I don't know all the legalities of what your hospital, clinic, area, state, nursing board, require. Most places require conscious sedation nurses to have ACLS. Some places require a conscious sedation nurse to take a written exam that you have to retake every year. Free standing endoscopy clinics, not connected to a "facility," are less rigid. Only require a nurse have ACLS but don't give any written exam.
  4. 0
    The Endoscopy unit is part of the larger facility. We are under the JCAHO regulations. I was told I will have at least a 3 month training period. My friend, who is an LPN there, loves it and plans on working there when she finishes her RN.
  5. 0
    Good to hear. Sounds great. I enjoy endoscopy nursing. I kept thinking about your question, I realized I forgot, in all my if you don't have... questions, to mention narcan and romazicon.
  6. 0
    Thanks for the input. Do you find you have people going too far under and needing intervention often? Do the docs really push to give more meds than is safe? I find it hard to believe that most docs would put patient at risk like that; but I guess it could happen. Maybe I'm being naive.
  7. 0
    I have never had to use a reversal agent when working as a moderate sedation GI nurse. Doesn't mean it doesn't happen.

    I've seen more cases, but not a lot, where I thought the patient could use MORE sedation than the Dr. gave.

    Try to relax, know about and have handy your reversal agents, then you will never need to use them.

    Your nursing assessment of the patient is vital. Ask if they have had the GI procedure or surgery before and how they did with the sedation. Be sure to ask if they snore or use C-PAP or bi-pap at home. But you will learn all this and more in orientation.

    Don't worry, be happy!!!!!!
  8. 0
    Thanks again for the input and encouragement. It's a little scary going to a new unit...but I'm looking forward to it.
  9. 0
    I've worked GI for ten years we pull a lot of call and have a multitude of different physicians that like sedation given a different way. One hospital the Anesthesiologists have written the procedural sedation policy and for the most part it is fine. One hospital is different in the sedation and how it is given. The physician tells you how much you give at a given time. I also work in an out patient setting that has different rules.

    The sedation thing mainly goes with gut feeling and a good patien assessment. The assessment thing is sometimes challenging because I am not always the one that admits the patient and a lot of the times I am walking in after the physician and he is ordering me to give sedation without knowing the patient.

    You just have to step up and say wait.

    I'm 55 years old and I would just say hang in there that GI lab is usually the best hours of any other area in the hospital and things rarely go wrong.

    I've worked the floor before and was always scared that something wasn't done or that I take problems home with me. Like what did I forget to do on my shift.

    I feel GI is something that you go home at the end of the day and can leave work at work.

    Hang in there you'll love GI
  10. 0
    Thanks for the input and encouragement. It's good to hear from someone around my own age (51). I was thinking the same thing about being able to leave work at the door on my way out Any suggestions for being on my feet for 10hrs. I was wondering what kind of shoe would be good for that.

    I am going into Endoscopy with an open mind. If nothing else, I'll gain RN experience for my resume Any suggestions for things I can study to prepare myself before I start? I have two more weeks.
  11. 0
    I have been an endo nurse for 11 years, and recently got my CGRN. I work at a medical center in NY. 95% of our cases are done with an Anesthesiologist, the other 5% with Conscious Sedation. We recently got approved for 2 RN's to be in the room with conscious sedation. The Docs push the meds, we draw them up. One nurse monitors the pt, one assists the GI Doc, as with our cases with an Anesthesiologist. Don't be afraid, you will be well trained, don't ever do anything you are uncomfortable with. Dont be afraid to speak up. Follow your instincts and you'll be fine.


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