Endoscopy new RN orientation help

[Gi rn acm, BSN]

I was curious about what the orientation process is for RNs starting in endoscopy units. 

We are a medium-sized unit running 4 soon-to-be 5 procedure rooms a day. Each room is staffed by at least one RN and either a second RN or a Tech. Expectations for us are to be proficience in the circulating role as well as the "tech" (scrub) role. We are looking to add some more structure to our orientation process. Currently, the primary concern with new RNs is to get them trained to circulate first and then work toward the scrub role. typical orientation is anywhere from 6-8 weeks with a few weeks of buddy call. We have found that our orientation process could use more structure. Just curious to know what other endoscopy departments do out there, and if you have any tips, or insights that we may adopt. 

 

Thanks  

[Rose_Queen, BSN, MSN, RN]

My previous employer did a 12 week orientation, 5 weeks circulating, 5 weeks teching, 1 week pre/post, and 1 week orientee choice, whichever they felt they needed more time in. The week in pre/post is for on call hours, when there is no pre/post nurse.

[Gi rn acm, BSN]

Thank you so much Rose_Queen this sounds like a great idea and is something that would be extremely helpful in providing more structure. I will bring this idea up to management to see if we could adopt something like this. 

[Epidural, BSN, RN]

It depends on whether or not your unit does ERCPs . This procedure takes a little bit longer to learn (especially the tech role). And what other advanced procedures do your physicians do? Do you use an actual OR for some of these cases? Circulating and teching for EGDs and colonoscopies is pretty easy to learn. ERCPs and POEMS, etc. are more complicated.

[Gi rn acm, BSN]

Currently, the only advanced procedure we are doing is ERCPs. Other than that, we also do motility studies and, of course, EGD, and Colonoscopies. Looking at a 6-8 week orientation for primarily the EGD and Colonoscopies with a little ERCP training in there as well. 

[Epidural, BSN, RN]

Do you regularly do pre/post procedure or do you have nurses who only work in pre/post. Do you have an anesthesia team on your unit? ( for: propofol drips-intubations)

• Pre: good IV start skills-a checklist that clearly shows reasons to cancel procedures- a list of mandatory screening questions -A day or two
• Post: list of discharge criteria that must be met-most common complications-post procedure teaching review-hospital policy for discharging patients post General Anesthesia-follow up appts. needed-Two or three days
• Circulating for EGDs and Colonoscopies: Time-out policies- how to deal with severe GI bleeds-most common lab specimens obtained-abdominal splinting protocols-how to deal with possible aspiration and assist anesthesia if necessary (crash intubations,etc.)-Where all of the specialty equipment and supplies are kept (ablation machines-Minnesota tubes) Two weeks
• How to tech: assist with biopsies-dilations-ablations-set up and take down scopes with proper pre-cleaning- Two weeks
• ERCP- how to circulate for an ERCP: At least one week-more if the docs use "spy glass", alternate routes to the common bile duct to bypass pancreatic carcinomas-etc.-many different brands and types of stents depending on which doc is doing the procedure-
• Teching for an ERCP: totally depends on which doc you are teching for-some are really easy to follow and talk you through each step of the procedure-some are "blazing new trails" and need a personal "scrub tech" who always works with them -A few weeks to a few months
• Motility studies: That always seemed to take a long time to learn-our motility department was separate from Endoscopy

Orientation: set up according to previous nursing experience

Six to eight weeks sounds about right.

And: the best "You Tube" channel for learning how to start IVs is:  ABCs of Anaesthesia. This anesthesiologist has posted about 20 videos on how to start IVs; they are all excellent. Watch a couple of them. Do exactly what he says, and you will soon become an expert.