Leaving the emergency room for endoscopy

Specialties Gastroenterology

Published

Hey all!

Just wanting to introduce myself and talk about endoscopy. I'm going to be starting a new position in the field in the next two or three weeks. I'm pretty excited - I shadowed for a little while and the area is interesting, lots to learn, and totally different. I presently work night shift in a level 1 ER. I've been in the ER nearing three years and I find the nights and politics of the area wear my body out. I get sick all the time and we are chronically short staffed.

I've had a few naysayers who, when they find out, keep telling me that I'm going to hate it. When I ask why, they simply say I will be bored compared to the ER. Has anyone had this experience? I see mostly people on this forum wanting to go into it - for the hours and type of work load... not people complaining about how boring or how intensely stressful it is. Really, I'm going to start school for my masters soon. I think I could use easier and less stress!

Has anyone had experiences with Endo being very cliquey? Along with the, "you'll hate it," I've also been told that...

I guess the fine point is: If you started somewhere from endo, where did you start? What was the transition like for you? Would you do it again?

Just from meeting people on the unit, once you get in endo... you stay there. Most of everyone had been there for a long time.

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

I think the biggest thing is to let them know what *could* happen (and remind them more than once, for a sedated patient ... it really does take quite a while for your short-term memory to return!). Nobody wants to poop the bed unexpectedly, particularly when they have to explain it to a stranger (and then depend upon that stranger to clean up after them)!

In my case, my "recovery room" nurse (using quote marks b/c I wasn't sedated, so I technically wasn't recovering) told me that it was "just air in there" and it was okay to let it fly. Like I said, I knew better, and the first time I tooted was on a toilet... and it looked like a Jackson Pollock original!

So if they're steady enough to get up to the toilet, or if they want a washcloth or towel to put between their cheeks to catch any skidmarks, or if they're comfortable just letting it all fly and pick up the pieces later, I think the biggest thing is to let them be a participant in the process.

That's one thing that my two decades of dealing with my own medical issues has taught me.... the patient's perspective. Hopefully it makes me a better nurse in the end.

I worked for 4 years in a busy out/inpatient endo unit in a hospital, and I loved it. Endoscopy is truly an interesting field, and I think you will get out what you put in. There is a lot to learn, and the field changes a lot. I was also able to become a float in the department, after I learned pre-op, post-op and PACU, and gained more valuable skills that way. I do think that if you haven't already, you should definitely research the unit and figure out what they're really all about (i.e.: hours, holidays, etc.). I ended up leaving endo recently for all the reasons you seem to think you'll be leaving behind in the ER: non-stop politics, horrible hours, crappy management, incompetent physicians, etc. The endo unit was supposed to be 4 10-hour shifts, but we were chronically understaffed and had to take call, so I was frequently putting in 14-16 hour days. Also, since the schedule was solely census based, we were staffed daily -- meaning I didn't know what time I was coming to work the next day until the previous afternoon/evening. I could be staffed at 0530, or not until 1200. That kind of work environment was not conducive to a happy life, so I got out. The 3 12-hour shifts without call that I work now are such a welcome change!

As for being "clique-y," you have to learn to work really closely with your co-workers and be part of a team. If one member of the team fails, literally you all fail. You depend on one another to make the unit flow smoothly. I also think endo nursing is very unique, and a type of nursing that you can only understand after you enter the field, so that may also contribute to what people perceive as "clique-y."

I know that not all endo units are as dysfunctional as mine was -- I would just encourage you ask as many questions as possible before you commit! Definitely shadow there also. Good luck to you!

Specializes in ICU/NICI/PICU/Pulmonary/GI.

Nurses nurturing nurses....I love that! Thank you all so much for your pearls of wisdom !!!

I especially appreciated knowing more of what the patient experiences per Brillohead....muchas gracias. I LOVE your nursing intervention of "cloth-in-crack"...lol! (So simple yet so effective. I wonder why I haven't seen this offered yet.)

Having never undergone these types of procedures myself, it's INVALUABLE to hear a "nurse-as-patient" perception. I also agree with you that I would be best served by observing each procedure now that I am a little more comfortable in the unit. My unit manager has agreed to allow me the time to do exactly that.

Specializes in GI, ER, ICU, Med/Surg, Stress Test Nurse.

I work in a small out patient clinic where the GI lab is also located, we do GI 3 - 4 days a week, we see aprox 25- 30 patients a week in our small GI lab. I am and LPN soon to sit for my NCLEX RN, I have done preop, assisted with the scopes, and assisted an RN in the recovery area. the flow of our pts are:

1 patient arrives

2 pt signs all consents and discharge instructions, review all home medications, time out is started

3 pt changes into a gown and placed on a stretcher, IV is started and LR is up

4 procedure with sedation by a CRNA we use diprovan to sedate

The nurse assisting also fills out all relevant paper work to the procedure, label specimens, and at end of day deliver all specimens to Lab.

5 recovery

we have one nurse in preop, one nurse in the procedure room, one nurse and a CNA in recovery room, one nurse in the clean room cleaning scopes with evotech, and one nurse to float to assist where needed between the four.

We do any where from 5 to 20 procedures in a day. We are very busy, we are a team. If one doesnt pull their weight then everyone else feels it. Cliques --- I dont know we are a close bunch if one is hurting we all hurt for them, we pull together and act like a family.

I also work in our ER part time when there are staffing issues I find that both are very stimulating.

Medications we use in the GI lab -- we might give a little glucogon, zofran for the occasional nausea

It can be just as stressful as ER at times - GI bleed.....

in short I love Gi nursing

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Nurses nurturing nurses....I love that! Thank you all so much for your pearls of wisdom !!!

I especially appreciated knowing more of what the patient experiences per Brillohead....muchas gracias. I LOVE your nursing intervention of "cloth-in-crack"...lol! (So simple yet so effective. I wonder why I haven't seen this offered yet.)

Having never undergone these types of procedures myself, it's INVALUABLE to hear a "nurse-as-patient" perception. I also agree with you that I would be best served by observing each procedure now that I am a little more comfortable in the unit. My unit manager has agreed to allow me the time to do exactly that.

I'm so glad that my perspective was helpful to you!

As I said, I'm an old pro at EGDs now, plus I've gone the other end as well. If there's anything I can help you with from the patient's perspective, please feel free to ask -- I'm subscribed to this thread, so I'll know when there's a new post here.

cadency-

Your story sounds identical to mine!!! I have been in the ER for 3+ years and desperately wanted a change. I will be starting in an outpatient endoscopy lab in a few weeks!! I am so excited. I have two great friends that work there, and they love it!! One was a prior med-surg nurse and the other worked at a long term acute-care hospital. I hope everything is going well for you!! How do you like it? Any tips for me? Thanks!!

+ Add a Comment