job description

GIRN · Jan 27, 2008

The hours for a GI Lab are pretty much M-F, 7-5. All hospital based units will have on-call hours for emergency cases. So the scheduled cases are M-F, but if someone comes through the ER and needs a scope, nurses or techs from the unit would be called in extra. Most staff there work their regular hours and are then placed on call one or two days a week. (In larger hospitals with more staff, you may only have 3-4 days a month to take call.) In free-standing Centers, there wouldn't be any cases in the evening or on the weekend unless you have a very ambitious, motivated doctor that wants to provide that timeframe to his patients.

The hospital GI Labs usually provide Colonoscopies, EGDs, Flexible Sigmoidoscopies, Banding, Sclerotherapy, Electrical Coagulation Therapy, PEG placement, Perc Trach's, Bronchoscopies, and ERCPs. The staff in a hospital unit has to have more indepth skills than a free-standing unit because of the acuity of the patients they see and the more complicated procedures. Free-standing centers, on the other hand, deal with the healthy, walking outpatient population that are receiving simple colonoscopies and EGDs.

As far as responsibilities, the RN would admit the patient, including the med reconcilliation, do a nursing assessment, and start the IV. (They may also do a Pre-admission screening phone call a day or two before the procedure.)

During the procedure, the responsiblities vary according to the process of that facility. Some facilities use CRNAs to administer propofol. In that case, a Tech or a nurse would scrub with the doctor and handle the specimens while the CRNA takes complete control of the patient. (Some facilities have a Tech and a nurse in the room, and some have two nurses.) Other facilities use moderate sedation rather than propofol. (versed and fentanyl.) A Tech or nurse scrubs with the doctor while another RN provides moderate sedation for the patient. If the RN is providing moderate sedation, guidelines tell us that the RN should have no other responsibilities besides monitoring the patient.

The post-op nurse would assess the patient after the procedure, provide their care while they come out of the effects of anesthesia, and then go over discharge instructions. The post op nurses also make a Post Op Phone Call the day after the patient's procedure to make sure everything is going well. (JCHACO's requirement.)

As far as pay scales, they are the same as any other position in the hospital. Most hospitals have a scale based on year's of experience as an RN. These scales change in different states. Look at other threads to see what the average rate of pay for RN's is in different states. If the RN has a BSN, she may make slightly more money than an ADN would. Also, there is certification that can be attained in this field. It's through the Society of Gastroenterology Nurses Association. (SGNA) With this certification, you may earn a little more money, though your knowledge base is far greater making you a more valuable resource for your unit.

This is just a general synopsis of what GI nurses do. As in any field, the job description and duties may be somewhat different in different facilities. This is a great area to work in, especially if you enjoy the education part of nursing. There's a lot of opportunity to interact with your patient and emphasize the importance of regular screening exams and diet. And it's very rewarding to find a small cancer and know that because you found it early, the outcome is much more favorable for that patient. I may be biased but I feel that we beat cancer a lot more in our arena than in any other! Good luck with school!

rconstudent · Jan 28, 2008

thanks so much for your input, it will be very helpful for my little presentation.

i do have a quick question if you dont mind. do all of the nurses in the unit have the same responsibilities or are they separated. I am under the assumption that typically the pre and post procedure responsibilities are taken care of by the same pool of RNs, and that the nurses in on the procedure, typically just work in the procedure rooms--is this correct?

thanks again so much for your help, this information is exactly what I was looking for.

GIRN · Jan 29, 2008

It depends on your facility and the number of staff that they have. Usually all the nurses do all the duties in Pre Post and in the Procedure Rooms. (Which is nice to keep the job interesting.) In some facilities, they use Techs to scrub in the rooms instead of nurses. That's really the wave of the future. Techs are cheaper labor than RNs and the only skill that a scrub does that a Tech couldn't do is to use Epi for Sclerotherapy, and even that can be done under the doctor's license if it's set up that way. Glad this is what you were looking for.

tonka3 · Jun 9, 2009

do the GI LPNs you know close the snare over the polyps and remove them by closing the snare per the speed of the dr.'s instructions to "cut-cut"? just curious if that is within scope of practice cause that's what the doc i work for does