Our GI Unit is restructuring...could use your help

Specialties Gastroenterology

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Our GI unit is restructuring. We have had the luxury of having 3 RN's in our procedure rooms until now but our hospital administration has decided (due to some benchmarking) that we can scale back to two RN's per room. We know that most GI units do run this way but we are interested in hearing how other units manage the details of performing EGD's/Colonoscopies/Bronchoscopies with 2 RN's. Our main hurdle is a very cumbersome computer charting program and demanding physicians who insist on extremely rapid turnovers. We do approx 25 procedure per day. We have 3 procedure rooms, 2 prep rooms and 8 recovery bays. We have 2 techs to do scope processing. So...how do you manage specimens, what kind of documention are you required to do, how much prep time including paperwork is required, how long do you keep patients after procedures, how do you handle emergent add-ons with minimal staffing. The computer charting is a real time-waster. The program is designed more for supply tracking so there are many screens to navigate through to do our documentation. We have to chart everything on it including all the specimens, all the supplies, all the vital signs. Any ideas for streamlining procedures will be greatly appreciated. Thanks in advance!

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3 RN's sounds like alot. We have 2 per procedure room. We however do not computer chart during the procedure at this time. We have gone to scanning the intraprocedure record into the EHR as we have not discovered a user friendly computer charting program for this facility. All pre procedure and post procedure charting is electronic, where time and multiple tasks is not a factor. Admission takes max 1 hour. Recovery is minimum of 45 mins. We are currently converting to an all RN staff to reduce the duplication of effort (RN assessment, hanging the first dose of ATB) which has helped significantly. Scanning the intraprocedure document into the EHR may be a solution as staring at the computer screen takes an able body away from the procedure.

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Specializes in Dermatology, GI, and PACU.

Until December 2006 I was a charge nurse in a very busy GI lab for four years. We had 3 procedure rooms, 3 prep rooms, and 7 recovery bays. If we had a busy clinic I would staff with 2 nurses in admitting, 2 nurses in recovery, and 1 nurse per procedure room, and if I was really blessed with extra nurses I would have 1 nurse as a float nurse. Our recovery was at least one hour regardless of the procedure performed. We were not doing computer charting.

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Yes, 3 RN's are alot. Originally, the third RN was a concession to the anesthesia department which requested that one nurse have no other responsibilities besides monitoring the patient leaving two to concentrate on the procedure and physician. I used to work in an OR and when we gave conscious sedation we also had this requirement. Right now, due to the computer charting, 3 people in the room comes in mighty handy. I like the idea of scanning the procedure record but I'm not sure our computer program is set up for that. I will find out. Thanks so much for your ideas.

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We have one RN in the room and one OR tech only. We run two rooms with 3 RNs in all One works recovery.

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We have one RN in the room and one OR tech only. We run two rooms with 3 RNs in all One works recovery.

We have three rooms and 12 bays. We have one nurse per room (with a tech to help with specimens), three to admit, three to recover and 1-2 float. That seems to work pretty well for around 40-45 procedures per day.

David Carpenter, PA-C

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Hi there,

Im actually writing from london, Im a deputy charge nurse in a 4 room 16 beeded recovery gi unit performing ugi,colon,ercp bronchs eus+fna procedures, up to 40 a day approx. we mostly have 1 rgn and 1 assistant in ugi/colon rooms and usually 2 rgn in specialist rooms sometimes 3 if we are lucky. Ive actually signed up on here cos i want to work in the USA as im fed up with chronic short staff, over work, stress and no pay (£28,000 gross at the mo for deputy manager post), id love it if people could message me with how things are like job wise in the US with pay examples - standards of living etc etc, id really appreciate this and if you want to know anything about nursing in the UK id ask any questions you have

thanks

Alec

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we have 2 rn's per room most days...we have one lpn who functions like a tech. this seems to work well except for ercps when we really need 3 nurses, but have never had the luxury. we are going to computerized charting in about 1 year and i am curious as to the company your hospital is using for your service. we are using EPIC.

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Specializes in Geriatrics/Family Practice.

Not to change the subject, but when you say nurses in each room, is it just RN's? The reason I'm asking is because I just had an interview today at a GI facility and they want to train me to start IV's, do conscious sedation, assist in procedures and work in recovery. I'm a LPN. I know that I'm capable of learning the above, but how do I find out what is in a LPN scope of practice (Illinois, hard to understand BON information on web site) or is it just that I'm working directly with the physician that I'm able to push meds? And my last question is, am I just cheap labor compared to having a RN do this job? When they told me the pay rate I did have to laugh inside. Can someone share their pay in a GI facility? Thanks for any info? I initiated a thread earlier this week regarding this but noone responded.

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