Nurses advancing endoscopes

  1. I am interested to find how how many places advance the endoscopes for the Dr.'s, both EGD and Colon.

    I work with surgeons and GI doc. We have 1 surgeon that can not
    manipulate the scope and advance the scope at the same time.
    This Dr. has recently returned to work after an absence and since we have not had to advance scope since he has been gone we are reluctant to do so now.

    As one of our GI doc's said "who ever is driving the scope is doing the exam" and we are not sure we want to be "drivingtthe scope.

    So ,is it common practice for nurses to drive the scope for docs?

    Thanks,
    LMBV
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  2. 44 Comments

  3. by   EndoRN
    We push the scope for several of our docs. I prefer it, actually. The cases seem to go quicker and smoother. The doctor manipulates the controls, so I wouldn't say we are doing the whole procedure alone.
    There is a certain amount of trust and skill involved, though. An inexperienced nurse could go "driving" through the wall of the colon....god forbid!

    Amy
  4. by   MLL
    No! That's definitely one thing our Docs have not asked us to do (yet)!!
    AND, I would have serious reservations about doing it if I WAS asked. No Way, Jose! Too much opportunity for a perforated colon, if you ask me! I'll stick to doing my job, and let the Docs do theirs'. If they're unable to manipulate the controls and push at the same time, it would be my suggestion they are in need of some serious competency recertification of their own.
    Sorry if I sound so incredulous about this, but it blows my mind to think a GI Doc would even ask me to "push". Let's face it, there lies a major portion of the risk for perf. Would the driver of a car be likely to ask you to push the gas pedal for him? MeThinks not!
    Guess you have to check your own facility's Policy and Procedure Manual and your State Nursing ByLaws/Guidelines, and then do what you feel comfortable with.
  5. by   formernurse
    MLL---I agree with you 100%. I have never worked in endoscopy, but have had 4 c-scopes over the last 4 years at a University hospital. Scopes are done only by the attending doctor or a doctor doing a GI fellowship--and he/she is supervised by an attending. It blows my mind when I see or read what nurses are expected to do beyond their scope (no pun intended) of responsibility!!!
  6. by   NurseDennie
    Oh God! I'm having an EGD on Friday - That's ANOTHER question I'll have to ask before they put me under.

    Love

    Dennie
  7. by   susanmary
    I find it hard to believe that advancing an endoscope is within an RN's scope of practice -- check with your state's nurse practice act. GI nurses, what do you think? When you were validated in your area, were you validated in advancing endoscopes -- do you have your hospital's documentation to back this up. Sounds very risky to me -- I'd refuse to do it.
  8. by   CATHYW
    Isn't this considered an invasive procedure? I know that we are allowed to start IV's and PICC lines, EG tubes, NG tubes, foleys, and rectal tubes, but this seems a bit much. Hmmmm
  9. by   patsue53
    In my unit we do have a doctor who expects the nurse to advance the scope. This results in the RN administering conscious sedation and monitoring the patient to also be taking biopsies, snaring polyps, applying external pressure, attaching the polyp trap, applying the grounding pad, etc. It's NOT a good situation but the doc in question is a senior partner and has been practicing this way for 20 years. Theoretically, the advancement is done under his instructions, but in reality he expects the nurse to know when to advance and how much resistance is too much. Noone has perfed a colon yet....THANK GOD!
  10. by   formernurse
    There is absolutely no way I would have a nurse advancing a scope in my colon. I've had several severe bouts with Crohn's Disease, which has resulted in the buildup of scar tissue in many places. Even my gastroenterologist has difficulty at times when she meets resistance from adhesons. As a nurse, I certainly would not want the responsibility of advancing a scope.
  11. by   jaquar
    In New York, the Education Department does allow RN's to advance scopes under direct supervision of MD, and with a competency. This is acceptable within our scope of practice.
  12. by   issa
    In the Endo unit where I work there is one surgeon who has the nurse "drive " the scope too. I have not worked with him but i feel that if God forbid the scope happens to perf. the colon the nurse would be held liable not the Doc.
  13. by   LibraSun
    I have to agree with the comments of MLL, If the GI doc routinely needs to have the nurse advance the scope, then they need some remedial training!! I would definitely check with my state nursing board about doing that. That just seems unsafe. It would also confuse any liability situations. Which may be EXACTLY why the doctor want YOU to do it!
  14. by   JanetO
    I've worked in an OR where we do scopes for over 20 years and the staff there has always passed the scopes for most of the doctors. I can't say we ever had a perforation when the nurse was passing the scope--just the doc. Our doctors are very careful and we know not to push if there is pressure. These are general surgeons. The GI doctors do pass their own scopes and they seem to have the most perforations--but not that often..thank GOD!

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