tonka3

I am new to this area of practice and have had a lot of confusion from who does what and now I have more questions. How long does a colonoscopy generally take? I know with my doctor he usually takes at least 20 minutes but today he was doing them in 10-13 minutes and I mean the entire thing from the time the colon was started until they were recieved by the recovery nurse. Isn't that kinda too fast? Also, how long do patients usually stay after recieving demerol and versed which is what we use, I have seen several sites that say 1-2 hrs. for the sedation to wear off but I don't recall seeing any patients stay with us much longer than 30 minutes once they're done, even one who had to have amomnia salts to brign him around? This is really bugging me, so any responses form experienced GI nurses is appreciated. THANKS!!

Hey everyone, I posted this in th LPN corner and got responses but was wondering if some gastro nurses could help me out some more. I was hired to work in a gastro clinic as an LPN, i spent the first month or so doing preop but when it came time to go in the procedure room, i had severe doubts about what i was being asked to do, the doctor has the nurse operate the snare and cut the polyps while he presses the pedal for the current and tells us how fast to "cut-cut" the polyp. I have been advised that this is not with the scope of practice for an LPN in NC and since I will not go back in and do it, they have replaced me with an unlicensed person with no medical bckground and fired me, the other LPN who continued to cut is being palced in pre-op, yet they still continue to say there is nothing wrong with the way the procedures are being performed, the consents only state that the patient gives the doctor permission to biopsy and remove polyps, not the nurse or an unlicensed person, so that maked me wonder not only have i been done wrong but the patients aren't being fully informed. How do others you know perform polypectomies and any suggestions???? THANKS A LOT!!!!

I plan on talking to a very good family friend who is also the attorney for the city his practice is in and see what he thinks about the whole deal, I know attorneys are much better at researching laws governing medical boards and any similar cases and let him file the complaint if he feels it should be and i will be willing to share my experience, I will let you all know what happens but in the meantime, any nurses reading this who are unsure whether or not what a doctor or nurse supervisor is asking you to do is in your scope, please refuse to do it until you find out for sure, obviously they don't care about your license, you have to protect yourselves, again, Thanks ya'll, wish me luck!!

thanks for the responses, i did actually call the state bon and told them what happened and unfortunately, even though the nurse manager and the doctor should have known that cutting polyps was out of an lpn scope before hiring one to do it, they did not and now since i've informed them he has the right to let me go according to the bon, i have considered contacting the medical board as my next step as well as an attorney because it's just not right , if i had sense enough to question this, then certainly you would think the doctor would and now i hate to think of all the patients going in thinkig they have a doctor removing their polyps when it's actually going to be a 20 year old who was considering dental hygiene beore but wasn't really sure and has had about a weeks wrth of training to cut polyps and no other formal medical training, that is VERY scary, especially when the preop nurse there tells the patients and the consent form they sign states the doctor will be removing them. i just wonder how it can be proved if no one else there is willing to speak up. Again, thanks so much for replying and i am proud of myself for sticking up for myself and not being afraid of ******* the doctor off, lol. it is kinda funny that now he's trying to get away with letting his license cover an unlicensed person since i also had to inform them that a doctro's license cannot and does not cover a nurse, we have our own rules to follow and just because they order us to do something does not make it okay. Also scary that a doctor does not know that.

i was working in a gatro clinic where the Doctor wanted LPNs to assist in the procedure room and cut the polyps found while he only pressed the pedal for the electric current, I learned that this was out of my scope of practice in North Carolina and told the nurse manager , I refused to do it anymore and stayed out doing pre-op, while the other LPN there went in and continued to cut the polyps. I started working there 4/13 and was there over amonth before I had to go in the procedure room where I was asked to do this and only cut 2 before I checked the scope because I really felt that the Dovtor should be dong that and I was right. Anyhow, I was informed this past Firday that since I could not do it, I was not needed anymore so basically I was fired for refusing to practice out of my scope. What really upsets me is that it seems like the nurse manger and the Doctor should have known this was out of scope and should have never hired me in the first place to do it, now I'm left without a job hwile he's still making plenty of money and now has an unlicensed 20 year old working as an endoscopic tech and cutting polyps for him while the other LPN who kept on cutting is doing pre-op. Is there anything I can do, what would you do??? Any advice is appreciated.

oh, reminded me of a part in the movie 'tommy boy' when others kept saying oh it's okay anyone can do it...... remember when toomy boy said "hey I can get a stick my head up a bulls a** and look around but that don't make me a butcher":chuckle

Thanks for the reply, I have since found out that it is NOT within the scope of lpn or rn in NC and you can imagine the chaos taking place in our GI clinic now!!! it is going to be interesting to see what happens since now they realize they have too many nurses there and wonder if since i bursted the bubble if i'll be one to go, not empty handed if there's anything i can do about it, i saved them A LOT of problems by sharing that info with them!!!

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

i understand what you are going thru, I am having issues with my Dr. as well, but different, he gets the nurse to close the snare over the polyps and "cut" them per ther speed of his instruction to "cut-cut-cut" if i go too slow will i burn a hole or too fast and make a hole or bleed. i wonder if this is within the scope of paractice for me to do? he has even gotten me to actually place the snare over the polyp by turning the colonscope itself with only my hand guiding it, i'm flattered he considers me able to be a gastro doc with only 3 wks. training and 2 polypectomies under my belt to turn the scope over to my hands but i am an lpn not a dr.

23 is a light load, it is possible, depending on th indiviual nurse, i've done 35 in 2 .5 hrs. you don't have time to chit chat then, if something is not an emergency, don't stop, politely explain to the resident who wants to hold you up that you will come back to them shortly and if they're not coherent, they won't be offended if you politely slip off on them anyway. I always try to go without wasting anytime then i can always go back to the patients that i feel may need my attention first, take notes during your pass re: res. status, prn meds, etc. and it will save time charting

Is it within the scope of practice for an lpn in NC to actually snare a polyp, close the snare, and cut-cut the polyp while the doctor presses the pedal for the current to "cut" the polyp?