How is your GI Lab ran?

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I recently started in the GI Lab and have previously worked the floor. I'm slowly getting use to the environment but some days I have anxiety due to the fast pace of the unit. There seems to be a rush to get the patient in the room and out the room for the doctors. I feel as though I have to rush through charting at the expense of the patient just to please the doctor. One doctor in particular even berated me for clarifying for documentation purposes (the doctor stated something and noone was sure so I simply asked and was told off for asking). I've dealt with difficult doctors in the past ad that's not a problem but what gets me is pampering the doctors and having to step over pins and needles throughout my work day. I feel like its a lot to do in the time frame at times. I have to document the specimen in several places, complete a lab req, monitor my patient and document it, keep them stable and from fighting at some points, and medicate. Its doable in perfect cases when nothing goes wrong but when I have a pt desatting or fighting throughout the procedure I don't have time to document at that point. And since I'm not to be an eye sore to the doctor I told to chart later on in the day. I have to constantly recheck charts and consents behind doctors. Sorry to complain guys. Just needed to vent. But what is your procedure area like?

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Unfortunately it sounds like a normal busy GI clinic/lab, with rude doctors.

I know you are just venting, and not specifically asking for advice.....but...are you charting too much? Ideally most of the charting is checking boxes and charting vitals with little narrative charting needed. A momentary desaturating or patient fighting doesn't need any special charting if it only lasts a few seconds and the patient is back to sleep or the sats go right back up.

Is there anything you can think of to get paperwork done before the case starts? Are you able to get as much labeling, paperwork, patient name, etc., stuff done, ready to go, before the procedure starts? Simple little things can help. I relieved a nurse and saw how she put the patient's insurance information and face sheet in the slot on the specimen bag before the case started.

One doctor always took the same specimens in the same order and he was extremely fast. We would make notations on the specimen labels and lab sheet before the procedure started. Sure there is the chance for a mix up....but exactly the same chance for a mix up as when you're hurriedly trying to keep up with him labeling each specimen as the gets them!

I'm sorry if my advice is annoying.... I know you're just venting. It is hard to do a good job when you're always rushed. You don't really need or want my two cents worth of advice!

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Thanks for your comment! I know a momentary desatting doesn't need charting. What I meant is sometimes we can spend almost all the case trying to get the sats to pop up, finding different sites to put the probe on or getting erratic pts to calm down that I don't even get to chart at all. I'm only charting the vitals q5min and specimens, medication and time given. Sometimes I have to prepare the chart of another pt while in the middle of another pts case. Just because if a pt comes in during another case I'm not allowed to put it in between cases. This charting includes adding the time out info, attendees and a template for medication. Specimens vary from case to case so it's hard to prefill out the lab req and computer chart with the specimen details. I can only prefill minimum things like date and drs name.

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I know what you mean....fiddling with the sat probe is so much fun :(. Or a patient who won't settle down....been there. I hope those are infrequent occurrences.

To be honest with you...as I said I hate charting...I don't even care if I don't get time exactly correct...like time out...I am fine with guesstimating. I might guestimate time out before we actually do it...just to get something down on the paper....the only way to survive!

Even vitals...if the vitals are okay between 0900 and 0910 and I missed charting exactly what it was at 0905 I will "average" them out. You kind of have to take what reasonably safe shortcuts you can to get through a busy GI day.

But that's just me and my "unsafe" nursing practice. I do try to, want to, follow the protocol....but sometimes you just can't.

It is "just" paperwork. I'd rather have the patient fine and healthy, the doctor reasonably happy, and my stress level down than a perfectly pretty, perfectly timed, patient care record. And me and the doctor in a stressed out mood!

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Hope you check this post. Do you know the pulse oximeter works great on toes? Sometimes (not always) the toe works with restless patients and you can't keep the pulse oximeter on. Put it on a toe and put their sock over it.

Unfortunately it is not a magic fix, but sometimes it works.

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