Trial shift at an endoscopy clinic

brownbook · Jan 15, 2014

The bottom line of recovery nurse in an endoscopy clinic is (to be blunt) get the patient out the door ASAP.

The patient is screened by the GI doctor and the anesthesiologist prior to the procedure and deemed healthy. In recovery they may get 1 - 2 set of vitals, maybe some juice and crackers, (some clinics don't even give refreshments), and are wheeled out the door to their ride home.

You may rarely use a stethoscope, may never listen to lung or heart sounds, not even listen for borborygmus, (that is the first time I used that word, had to look up the spelling!) The emphasis will be speed, get the paperwork done.

I would stop by the clinic prior to your trial shift, maybe they will let you just "observe" how the staff/nurses function. Or ask for a blank recovery nurses form/paperwork so you will be familiar with it. Realize the form may have many areas that do not need to be filled in, areas that are routinely left blank or the nurse writes NA.

This is what I have observed in my GI recovery nursing. I don't want you to look like a "bad nurse." Maybe this particular clinic is different, the nurses do a head to toe assessment of each patient in recovery, listen to lung sounds, etc.? But I would be really surprised if that happens.

RPN_2012 · Jan 15, 2014

Thank you for your respomse and bluntness, I dont like in sugarcoated :)

Im not trying to be the best nurse.... Im just trying to fnd a job so I can get out of my curremt nightshift job that is taking it's toll on my life...

We didnt learn anything about endo nursing (just the digestive system and briefly went over some gi diseases but I wanna know more!!)

Is there any mends I should be very familiar with that pertain to endo nursing?

brownbook · Jan 15, 2014

I have seldom given meds in GI recovery.

Rarely patients get nauseated from the anesthetic.... Zofran, reglan, etc., the "usual" routine anti-emetics can be given IV. Just more IV fluids can relieve mild nausea.

You are "recovering" patient from sedation so there is the rare over sedated patient. (Your patient has a better chance of winning the lottery than being overdosed but just in case.) Do they want you to have ACLS?

If they are obtunded (I love to use these "big" medical terms) due to the sedation give supportive care, chin tilt head lift (open the airway), support the blood pressure, fluid bolus.

THIS IS REALLY REALLY RARE STUFF I am getting into, I have never had to do this, drugs for hypotension, ephedrine or phenylphrine IV.

There is no antidote for propofol which is commonly used for procedurel sedation, just do the supportive care I mentioned above.

If they use versed and fentanyl for the procedural sedation your antidote drugs are Romazicon (for versed) and narcan (for fentanyl.)

If the patient has bad gas pains in recovery have them walk around, sit on the toilet, or kneel on the bed with their head down and butt up.

Good luck, honestly it is really basically "easy" stuff, in and out the door.

After you get the job (positive wishes here) you can research more about endoscopy. Chron's disease, hiatial hernais, polyps, etc., some common or not so common issues the patient might have.

You Tube is great if you want to see how a routine colonoscopy or esophagogastroduodenoscopy (EDG) is done. You could probably find a You Tube of the whole procedure, patient coming into the clinic, the procedure, and being wheeled out the door!

MissChrissy · Jan 30, 2014

Hello all,
I applied for a job at an endoscopy clinic, I don't have any experience in that area, I'm a fairly recent grad (June 2012) and I applied there just tryjng to get out of my current job where I work nights only at a retirement residence. Long story short I was offered a trial shift later this week at the clinic and was told I will be working with the recovery room nurse. I'm not sure if this trial shift is instead of a formal interview or what not... All I would like to ask is any advice you have about this kind of role. What should I expect...and what material should I review from nursing school other than the obvious: the digeative system. I want to be very prepared because I really want this job.
I would really appreciate any advice!!
Thank you.

Pretty much what everyone outlined. And can't stress this enough (assuming this is a busy clinic) get the patients out the door quickly! You'll more than likely be doing it to the point where the patients will comment on how this feels like a "revolving door" or an "assembly line". I do find this aspect of it wrong though, shouldn't be pushing patients out the door so quickly. We don't provide wheel chairs unless the person is disabled (chances are they will have their own anyways) or they are severely weakened by the procedure.

The best advice I can give you is 1) always perform a patient assessment while taking vitals. Don't start the BP machine then walk off somewhere, always watch your patient while they are still under. 2) Document everything! 3) anything you feel is over your control inform the MDs immediately. 4) Do not take the IV out until the patient is alert and awake and verbally tells you that they aren't feeling pain of discomfort. Simple advice, but can be overlooked especially if you're juggling 2-3 patients.

Recovery is at a clinic is generally pretty straight forward.

At our clinic, we help the anesthesiologist wheel the patient into the recovery area. Hook up the BP and O2 sat monitor, take 3 rounds of vitals (resp, BP,hr, o2), more if complications, wake the pt up if needed, offer snacks/drink, make sure pt is well, take out IV, bring pts ride back, bring pts discharge summary, explain discharge information and answer preliminary questions pt wants to know, MD comes in and talks to pt, gets pt up and has them get dressed, have them ding a copy and have them walk out with their ride sTypically that's how it goes.

CaliLoveRN · Jan 31, 2014

I love working in Endoscopy! Most of our patients are relatively healthy, you always hear the latest "colonoscopy" jokes, and the doctors tend to be friendly and easy-going (if they weren't on call all weekend!). I think you will love it! If you are able to work at an ambulatory surgical center, you may only have to work Mon-Fri during daytime hours, and no holidays! If you weren't fabulous at starting IV's before, you will become VERY adept at IV's in no time! I do agree that patient turnaround time is critical, since a few delayed patients can back up the entire schedule---nothing like hungry, tired patients having to WAIT LONGER for their endoscopy! I would encourage you to ask questions about what kind of preps the docs use for their patients, and definitely review the forms the nurses use to ask the patient's assessment questions. Also, get a tour of the facility and become familiar with the locations of the supplies, meds, crash cart, etc....be enthusiastic yet professional, and I am sure you will be welcomed with open arms! Good Luck!! :)

Sam J. · Jan 31, 2014

It's assembly line nursing, like in a factory. In, out. In, out. Clean the bed, in, out. Get them OUT. If the GI tract doesn't bother you and you aren't offended by raucous language, and want to work in a state of the art place that is also one of the most profitable for doctors and nurses alike, you might like it. A great orientation would be for you to vounteer to a colonscopy, in fact. But not in the place you might end up working in- you don't want to be the butt of their jokes!

Starreacher26 · Dec 1, 2018

I'm curious if the pay rate is comparable to med-surg nursing? I am looking to get out of med surg nursing. It has beaten me to a bloody pulp, and I can't do it much longer. Anyhow - any word on the pay comparison from someone who has done both?