Insight into endoscopy nursing

brownbook · Sep 9, 2016

I am not sure exactly what a day surgery ward is? (Are you from the UK? They speak funny English there, ha ha).

I work in an out patient surgery clinic that combines surgery patients and endoscopy patients. It can also be called ambulatory surgery clinic, or same say surgery clinic.

Patients are admitted for surgery or endoscopy in the morning and discharged home in the afternoon. We are closed nights, weekends, holidays, etc. I have always worked where surgery and endoscopy patients are in the same clinic. I have never worked in a clinic that was only Endoscopy.

Kind of, sort of, maybe a nurse with surgery clinic experience has more skills, a better resume, than a nurse that has only worked endoscopy???

What is your current job? Do you admit patients for surgery or work in discharge, or do both? Why do you want to change?

Endoscopy clinics alone can be very busy, depending on how many Dr.'s are working, how many GI rooms you have. You can be admitting 20 patients between 7 and 8 in pre-op, and conversely discharging 20 patients between 9 and 10. But a smaller clinic with only 2 Dr's. of course will be less hectic.

Again I'm really curious why you want to change, what are you looking for. Surgery clinics and endoscopy clinics are similar and both have pros and cons.

Metrorphan · Sep 9, 2016

I am not sure exactly what a day surgery ward is? (Are you from the UK? They speak funny English there, ha ha).
I work in an out patient surgery clinic that combines surgery patients and endoscopy patients. It can also be called ambulatory surgery clinic, or same say surgery clinic.
Patients are admitted for surgery or endoscopy in the morning and discharged home in the afternoon. We are closed nights, weekends, holidays, etc. I have always worked where surgery and endoscopy patients are in the same clinic. I have never worked in a clinic that was only Endoscopy.
Kind of, sort of, maybe a nurse with surgery clinic experience has more skills, a better resume, than a nurse that has only worked endoscopy???
What is your current job? Do you admit patients for surgery or work in discharge, or do both? Why do you want to change?
Endoscopy clinics alone can be very busy, depending on how many Dr.'s are working, how many GI rooms you have. You can be admitting 20 patients between 7 and 8 in pre-op, and conversely discharging 20 patients between 9 and 10. But a smaller clinic with only 2 Dr's. of course will be less hectic.
Again I'm really curious why you want to change, what are you looking for. Surgery clinics and endoscopy clinics are similar and both have pros and cons.

We speak proper here in the UK excuse me. Jk haha.. yeah I suppose 'day surgery ward' = same day surgery unit more or less.

Your job sounds similar to mine but with slight differences. The actual specialty is day case eye surgeries only. I admit patients, take them to theatre, collect them from recovery and then discharge them home. I want to change because I want to try a different specialty, but also go to a place where what I've been doing in my current job can be used as a strength hence endoscopy. In my current job I have to work 12 hour shifts, work Saturdays now and again too. I like that Endoscopy is 9-5, I'd also get the chance to pick up completely new skills.

I guess to be brutally honest I'm looking for a less stressful version of what I do now, AND something that's more stimulating at the same time. Ive been seeing adverts to work in purely endoscopy units alone. I've read job descriptions saying that you're typically assigned to different roles throughout the working week. One day you could be doing pre-op, another day you'll be in recovery dealing with post op, and then actually assisting the doctor with the procedure itself. So this already sounds ALOT more varied than what I do.

PS: tired of giving eye drops. So very tired.

brownbook · Sep 9, 2016

Yes, only doing eye surgeries (we do a lot of cataracts also) would be tedious. I can understand now why you would like to make a switch, do endoscopy.

Pre op and discharge for endoscopy should be, would be, pretty similar to eye surgeries. Just make sure colonoscopy patients took all their their prep.

I don't find admitting or discharging cataract or endoscopy patients to be stressful. Is it the fast pace, a lot of patients, eye drops, etc., that is stressful for you? For sure you would not be giving eye drops!

I think a switch sounds great. There are a lot of YouTube videos about assisting the gastroenterologist in the endoscopy room. I think it would be a great switch for you. I can't swear it will be less stressful. ALL change is stressful.

There have been a few posts here about the routine duties of an endoscopy nurse. Look in the search box for All nurses.

My BIG question, comment, is we have been using pledgets for our cataract patients for 10 years now. It is sooooo much easier than eye drops.

Whatever eye drops the Dr. orders, routinely it is three different drops every 5 minutes times 3. We take a sterile specimen cup, combine the drops together in the sterile cup. There is a ratio...I don't have the exact formula in front of me....20 of one eye drop solution, 20 of another solution , and 8 of the third.

Then we use sterile scissors to cut a sterile product made by Merocel, it is like a thin gauze, but not really a gauze material. We cut small, 5 millimeters by 2 millimeter, pieces of the Merocel into the cup to soak in the eye drop solution (we just eye ball it, not exact). We take sterile tweezers (or forceps, or pickups, the same thing), take one of the pledgets out of the eye drop solution it has been soaking in and place the pledget in the patient lower lid. They cannot feel it. The surgeon comes along 1/2 hour later ( more time is fine, less time can be a problem) and removes the pledeget. The pupil is dilated and off the go to the theater.

I am kind of in a rush, sorry if this post is messy or confusing or has improper English, ha ha.

Metrorphan · Sep 9, 2016

Yes, only doing eye surgeries (we do a lot of cataracts also) would be tedious. It can understand now why you would like to make a switch, do endoscopy.
Pre op and discharge for endoscopy should be, would be, pretty similar to eye surgeries. Just make sure colonoscopy patients took all their their prep.
I don't find admitting or discharging cataract or endoscopy patients to be stressful. Is it the fast pace, a lot of patients, eye drops, etc., that is stressful for you? For sure you would not be giving eye drops!
I think a switch sounds great. There are a lot of YouTube videos about assisting the gastroenterologist in the endoscopy room. I think it would be a great switch for you. I can't swear it will be less stressful. ALL change is stressful.
There have been a few posts here about the routine duties of an endoscopy nurse. Look in the search box for All nurses.
My BIG question, comment, is we have been using pledgets for our cataract patients for 10 years now. It is sooooo much easier than eye drops.
Whatever eye drops the Dr. orders, routinely it is three different drops every 5 minutes times 3. We take a sterile specimen cup, combine the drops together in the sterile cup. There is a ratio...I don't have the exact formula in front of me....20 of one eye drop solution, 20 of another solution , and 8 of the third.
Then we use sterile scissors to cut a sterile product made by Merocel, it is like a thin gauze, but not really a gauze material. We cut small, 5 millimeters by 2 millimeter, pieces of the Merocel into the cup to soak in the eye drop solution (we just eye ball it, not exact). We take sterile tweezers (or forceps, or pickups, the same thing), take one of the pledgets out of the eye drop solution it has been soaking in and place the pledget in the patient lower lid. They cannot feel it. The surgeon comes along 1/2 hour later ( more time is fine, less time can be a problem) and removes the pledeget. The pupil is dilated and off the go to the theater.
I am kind of in a rush, sorry if this post is messy or confusing or has improper English, ha ha.

It's okay no worries. I suppose the admitting and discharging are the least stressful aspects of the job. I think it's the sheer high volume of things to do at once sometimes. Upwards of 17 admissions in an afternoon shared between 2 nurses and a nursing assistant, and at the same time you have patients from the morning that have to be collected from recovery. And if your patients require a district nurse that's a whole other process haha. In part, I'd be lying if I said some of the stress of my current job has nothing to do with the team I'm working with.. but of course you will meet all sorts of characters which ever specialty you move to.

The way you do eye drops where you are sounds sooo much more complex. And interesting. Where I work, a cataract patient will either have their eyes dilated by eye drops (2 ready made/set eye drops to be given as a pair up to 4 times leading up to the surgery) or by a pellet being put into the eye just once, and is then removed prior to surgery by the anaesthetist in the anaesthetic room. So similar to your pledgets actually except we don't have to soak it. It is given straight from its packaging into the lower lids of patients with the tweezers. Your job in relation to eyes sounds overall like a higher difficulty version. like I have it easy! Haha We mostly also administer eye drops as a patient group directive so we dont need the doctors to prescribe them. Wow though. It's like our two jobs are completely different in this way. Yours sounds like it requires heavy math skill, while mine none at all, unless you count calculating paracetamol now and again haha.

I'll definitely take a look around the site but I am feeling more positive about making this change now. Thanks for responding brownbook

brownbook · Sep 9, 2016

Thanks for the helping me learn English, ha ha..yes pellets sounds like what we call pledgets. I think the word pellets describes it better, patients look at me when I say pledget and say....what in the heck is a pledget! And I love the word theater for operating room,, theater sounds so much more exciting in a good way.

Wow, 17 admissions between 2 nurses and an assistant. We would have at least 4 nurses for that amount of admits! And your are watching the recovery patients also!!!!! Crazy.

The change sounds like a good idea, but I am just afraid you will end up in the same scenario? A lot of endoscopy admits for not enough nurses and watching the discharge patients to. I don't know if the the ratio or staffing would be better in an endoscopy clinic, sorry endoscopy ward, ha ha.

We call it jumping from the frying pan into the fire.

BklynHeightsRN · Dec 1, 2016

Very simply, the level of stress depends on how often you work in the rooms. I worked in ambulatory endoscopy and rotated between phone calls, pre procedure and recovery (sounds like you have those skill down already). The phone call nurse was assigned to circulate and head to the rooms if an injection or tattooing was needed, or if her help was needed to break a laryngospasm, if a patient aspirated or something (rare but it happens). She sat at a desk all day making phone calls with a walkie talkie so she could communicate to the charge nurse if she was unavailable due to being on a call, and the charge nurse would cover. Nurses would not constantly be in the rooms - we had endoscopy technicians assist the GI with routine procedures.

Now, the rooms require a lot of technical skills in terms of taking forceps, nets, snares, injection needles, etc. in and out of the endoscope biopsy channel, putting the specimen in the jar and labeling it, etc., but it's not hard at all, just a new skill. Most doctors are patient as you're learning but it requires a bit of speed obviously because the colon may spasm or during an EGD, they don't really want to stay down in there too long. Your responsibilities would involve #1 obtaining specimens, polypectomies, you may tattoo, inject Epi, you may insert clips and use hot forceps and snares with electrocautery to control bleeding, etc. #2 patient positioning, #3 therapeutic maneuvers such as abdominal pressure and #4 help out if they need a jaw thrust, medications drawn or suction or something. It might get more complicated if the place you'll be working at does ERCP (usually not outside hospital but not sure how it works in the UK), EUS, fine needle aspiration, dilation or ablation, etc.

I do not know the eye surgery world at all, but endoscopy definitely is not stress free, I'll say that much. It's usually like a factory and very fast paced. Though it sounds like the weekday schedule would be better for you. I say you go for it - I find GI so fascinating and there's constantly a ton of research surrounding it.

Personally, I find it is what you make of it and there's plenty of room to grow too. I went from a staff nurse at an ambulatory endoscopy center to the manager of an office based endoscopy suite (where I also recovered patients), and now am a clinical coordinator for a small (1 procedure room for now, but we might be expanding to two) endoscopy suite where I manage a recovery room nurse and a scope technician, maintain accreditation, etc. and I'm the one in the room doing the procedures with the GI. We also give remicade IV infusions during cases for IBD patients. They get them 4 times a year but if we can save them a trip, why not?

Hope that helps a bit!