Broaden Your Horizons - from Heartburn to Hemorrhoids! Life as an Endoscopy RN

I was a new grad who wanted to broaden my horizons that included something that provided a procedural component.

Broaden Your Horizons - from Heartburn to Hemorrhoids! Life as an Endoscopy RN

To set the scene, I was a new grad working in the hospital, the Mayo Clinic to be exact, and although the general medical-surgical floor I was working on provided challenge, variety, and fantastic training as a newbie nurse - I was not a fan of the work-life balance. Enduring the typical evening / overnight shift rotation that left me without sleep, with an abundance of frustration since I was going to work when everyone else with "normal jobs" was getting off work, and I wanted something that provided a procedural component.

I thought of the operating room, cardiac catheterization lab, interventional radiology, etc. My friend at the time was working at a different hospital in the endoscopy center - which I truthfully at time knew very little about aside from the humorous component of experiencing post-colonoscopy patient's farting during clinicals in nursing school and sometimes in hospital wings I walked by. Or, to be professionally sensitive, the "passing of air" after the exam. This was not the huge pull-factor that brought me to endoscopy, but I can vouch for you now that it does provide some comic relief to the recovery component of working at a GI center as I do at the current day.

The Training

The training involved to work at a typical endoscopy center, using mine as an example, usually requires 1 year or more of hospital experience (no specific area needed), and a BSN degree. Training typically involves 4-6 weeks of working with a preceptor nurse and orienting yourself in a more detailed sense of the digestive tract, specifically the colon since the majority of our exams involve colonoscopy or flexible sigmoidoscopy (condensed version of colonoscopy). We perform upper endoscopies as well, so being oriented with the upper GI tract is helpful, and is a big part of orientation. Most centers have a break down of an admitting, procedural, and recovery area. You flow through these during the week, which helps to provide variety. It is a unique way to liven up a job that for some people over time would become easily and understandably mundane and dull if you worked in the very same area each and every or on a not-so-even rotation.

Admitting

Admitting patient's involves going through a medical questionnaire with them to rule out any critical cardiac, respiratory, renal, etc. issues as well as any difficulties or complications receiving anesthesia in the past. Most centers use Propofol sedation now with the aid of CRNA's, which is a unique and positive component of this job, as you get to really get know that staff rather than be just a nameless nurse in navy blue to them. This occurs in the procedure room, where you work with them 8-10 hours a day. Anyway, back to admitting, where you interview patient's about their specific health history, typical bowel habits, prep results (which always provides some comic relief and tends to help ease anxiety as you ask of them to describe their bowel movements color and consistency). We want clear yellow. Think pooping urine. That makes us happy and gives us good results. Starting IV's is the trickiest, yet most rewarding component of admitting in my opinion. These patient's are tremendously dehydrated, "hangry" from the fasting and the prep, and present quite the IV initiation challenge. It is a great place to really hone in on that skill.

Procedure Room

Next up, procedure room. Will keep it short and sweet. It is awesome. Work with GI doc's all day as well as CRNA's. We perform colonoscopies, flexible sigmoidoscopes, and upper endoscopies. Working alongside the physician, you assist with polyp removal - which takes on many various forms that you become very well acquainted with in training - as well as perform various other interventions: esophageal dilation, cauterization, biopsies, colonic tattoos - that's right, I said tattoo's in the colon. To mark polyp sites. All interesting, ever-changing, and provides upbeat challenge as many patient's present with various symptoms, potential diagnoses, and always a balancing act when working with CRNA and physician to keep the patient safe, sedated, comfortable, and ensuring complete interventions during procedures.

Recovery

We will end it with a bang, or a "toot" - recovery. Fart nation. Just kidding - but the first week in this area you do find yourself smirking as patient's shift over to their side and let out large gusts of room air that we insert in their colon during the procedure. This is where another big nursing skill comes out of the woodwork - EDUCATION. Patient education in this area, enforcing compliance with routine screenings, explaining the "what's next" of their new diagnosis, discussing new medications we have prescribed or suggest, genetic counseling, management of patient's who come out of the exam with complications. One big melting pot and variety pack and allows for great growth in independence and the ability to manage several patient's at once and the reward of seeing patient's leave with answers, polyps removed, cancer prevented... all in one day's work.

Endoscopy / gastroenterology is a hidden gem of nursing I feel. Dare I say, it is the "polyp in the rough" of specialties. Terrible joke, but an absolutely awesome area to work in. Great teamwork with staff, passionate individuals, job security, providing Crohn's / colitis care to the ever-growing population who are unfortunately dealing with those illnesses, colon cancer prevention every single day in a multitude of ways... I am happy and thankful to be working in such an area and I hope this description answers many questions for you and provides you with a thorough look at the day as a endoscopy RN - who is not afraid of a little butts 'n guts!

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camelbakhi

About camelbakhi, BSN, RN

BSN, RN - Endoscopy / gastroenterology

1 Article   18 Posts

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Specializes in Surgical, quality,management.

You mention CRNAs which don't exist in Australia but we do have nurse endoscopists. Do you have any nurse endoscopists? They do a lot of screening scopes for NBCSP and don't do EMRs or HALOs, or active IBD flares- I work in an acute hospital with a very active endoscopy unit.

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Specializes in RNC-MNN & Operating Room.

Nice article. I have been wanting to try this specialty, and now I think I might! ?

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Great article. I work in an outpatient endo center too. Only physicians do the procedures where I work. CRNAs give propofol for sedation and it works soooo much better than the old versed/fentanyl sedation. The only difference I see is that we don't use room air for inflation. We use CO2 which almost totally prevents the "toots" afterwards. The CO2 mostly reabsorbs in the system and the patient is much more comfortable post-procedure.

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Specializes in Endoscopy / gastroenterology.

Thank you for the feedback guys! One of the newest sites for my work is utilizing CO2 during exams too - and I completely agree. The removal of the post procedure "toot" out of the equation makes for such a more seamless discharge process. That is awesome. I hope we get on board with that soon, too! Thanks again for all the comments. Appreciate it.

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Specializes in PICU, Pediatrics, Trauma.

Other than many places requiring the BSN in principle, now that you have worked there for some time, do you see a true need for the BSN in this specialty as opposed to say a large degree of nursing experience?

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Specializes in Endoscopy / gastroenterology.

Very good question. Truthfully, no. I have a few co workers who have their 2 year and working on 4 year BSN currently just because of the new regularity of requiring that, but a good amount of nursing experience and more specialized studying / knowledge of GI helps. Hospital experience helps for the rapid fire nature of our endoscopy center in terms of patient prioritization, critical thinking, etc. IV starts are killer - on most days I start 15-17 a day on very dehydrated people so some experience or focused training there helps. Collaboration ability with the health care team is good too since close knit with MD and CRNA.

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Specializes in Endoscopy/Gastroenterology, General Surgery.

thanks for your effort for writing this article. I have been working outpatient endoscopy for 8 months and I just got hired into the hospital for the endoscopy unit. Your article give me a brief idea what to expect. I personally love what I am doing and knowing that I can make a difference (in turn of, dx and treatment) is really rewarding.

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