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Chuckie's Latest Activity

  1. Chuckie

    flight nursing in the air force?

    I've been retired from the 446 th AES sq. McChord AFB Wa. for nearly 15 years now. It sounds like it has changed a lot I was on the C 130 and C 141 with some C 9 experience Loved it
  2. Chuckie

    Esophageal manometry start-up

    I do all my manometry and ph H&P's in our Provations computer system
  3. Chuckie

    Input from Endoscopy nurses, Please

    I've worked GI for ten years we pull a lot of call and have a multitude of different physicians that like sedation given a different way. One hospital the Anesthesiologists have written the procedural sedation policy and for the most part it is fine. One hospital is different in the sedation and how it is given. The physician tells you how much you give at a given time. I also work in an out patient setting that has different rules. The sedation thing mainly goes with gut feeling and a good patien assessment. The assessment thing is sometimes challenging because I am not always the one that admits the patient and a lot of the times I am walking in after the physician and he is ordering me to give sedation without knowing the patient. You just have to step up and say wait. I'm 55 years old and I would just say hang in there that GI lab is usually the best hours of any other area in the hospital and things rarely go wrong. I've worked the floor before and was always scared that something wasn't done or that I take problems home with me. Like what did I forget to do on my shift. I feel GI is something that you go home at the end of the day and can leave work at work. Hang in there you'll love GI
  4. Chuckie

    Health Homes

    Anyone do the group sessions for Health Homes yet in the Clinical Setting. I just talked with some areas of clinical Nursing which are looking at getting some group sessions together for Diabetes, COPD, Hypertension and someother disease processes where the patients can discuss there problems in group in place of an office visit.
  5. Chuckie

    GI lab phase2 recovery room

    Phase 2 are all conscious sedation gi patients or bronch patients usually Demeral/Versed, Fentanyl Versed and nearly all get Benedryl for sedation. We are free standing somewhat across the street from the hospital. The OR patients go to phase I they are sedated by the Anesthesiologist and not the procedure nurse. Phase II only has one person in the room with 6-8 or even more patients. I would like to add a person to the room but the understanding is that it is always 6 patients to one nurse everywhere. That is the law. Only other place is ICU,ER and Phase I recovery where it is 3 patients to one Nurse. This is a nationally set and written in stone everywhere in our hospital. They figure since it is a recovery room and most of the patients are asleep then they do not need extra help. That the patients are requesting a lot of help and you just get your vitals for 30 minutes and either discharge them or send them back to there room
  6. Chuckie

    GI lab phase 2 recovery room

    We are somewhat free standing. We are in a hospital but only admit and recover our patients GI lab and Bronchs. We have one person RN in the room with 6-8 beds this person answers phones admits discharges recovers and calls the floors for patients to come over from the hospital. They are all conscious sedation usually demeral/Versed, Fentanyl/Versed and nearly all of them get Benedryl for sedation. By 1000 am it is full and they are all fairly heavy sedated especially if they have had Benedryl.
  7. What is the nurse patient ratio in aPhase 2 GI lab. Recovery room? We have one RN with 6-8 patient slots. Usually full with post bronch and gi patients. The rn is responsible for admitting in patients and recovering all patients with no other support from anyone else. She is unable to leave the area and rarely gets lunch or breaks. I was wondering if there were any guidelines for the ratio in the phase 2 recovery. Most patients are very sleepy and I know a lot of phase 1 recovery will have a 2-1 ratio for heavy sedated patients.
  8. Chuckie

    GI lab phase 2 recovery room

    What is the nurse patient ratio in the phase 2 recovery room. We have 6 to eight slots in the gi lab. And one Rn. The rn admits all in patients and recovers and discharges all out patient. This is somewhat dangerous and. I was wondering if all facilities use the 6 to1 ratio for phase 2 recovery.
  9. Chuckie

    Staffing in ASC

    We run two rooms a day 10 hour days 18 cases per room each day. Two Nurses in recovery room 1 RN at least other is PCA, Ma, or LPN Two admit nurses either RN or LPN One RN in each room and one either LPN,MA or Surgical Assistant, PCA One Scope washer Scope washer takes down the dirty scope and the assist person washes down every thing between cases and sets up for next case while the RN takes patient out to recovery room and gives report. Admit person brings next pt in to room and hooks them up. Works well if we are short a person then the assist person usally floats from room to room most colons are pretty easy with one RN in the room unless Snaring when we do uppers we usually need two in the room to help. Two secretaries usually one to break down charts and set up followup apointments . One to check patients in. We do 0700start 0730 Colon 0800 Colon 0830 Upper 0900 Colon 0930 Colon 1000 Upper 1030 Colon 1100 Colon 1130 Upper 1200 lunch 1230 Colon 1300 Colon 1330 Upper 1400 Colon 1430 Colon 1500 Upper 1530 Colon 1600 Colon 1630 Upper 1700 Clean up go home
  10. In washington state the only thing an OR tech is able to do in the GI Lab is clean scopes. They have worked in our GI lab for the past 10 years doing nearly everything but sedate the patient which takes an RN. About 6 months back someone found a piece of paper that said that they can not sever tissue which was to understand that the could not biopsy inject, or snare or cut on and ERCP or clip so they trained all the RNS to do there jobs and they were eliminated from our GI LAB. Now the same paper that was found somewhere says that an RN is not allowed to sever tissue. So does that eliminate our jobs too? We also do the cuts for PEGs which on bad days we are told we are not allowed to do and on good days we are told we are allowed to do. go figure
  11. Chuckie

    how many colonoscopies per day?

    Two Rooms Two Doctors One Admit Nurse, Per room RN or LPN Sedation RN Per Room, 1 tech per room or if short Floats most of the time Most often this person doesn't exist. One Scope tech 2 Recovery room Nurses either RN or LPN All meds drawn up at beginning of day by sedation nurse
  12. Chuckie

    Surgical techs in GI LAB

    We sit on our butts and eat bonbons.
  13. Who makes the cut for a Peg placement at your facility? What is the scope of practie in your state for RN;s making a cut in the skin? What state are you from? We have been making the cut for over ten years. We have gone through several managment types, mostly interims or temps. We do have a temp now but she isn't any good. They feel we are as RN's working out of our scope of practice by making a cut for PEG placements. This has been the standard of pracitce in Washington state for over the last 10 years that I have worked GI. My question is if we are not allowed to make a cut in the tissue ( excise tissue) then why are we allowed to snare a polyp, make the cut on an ERCP, Biopsy, jcold snare or nearly anything in the GI department?
  14. Chuckie

    Good Sam Hosp onsite daycare?

    Day care at Good Sam is from 0630 to 1800 for infants to kindergarten. After Kindergarten they have a summer program that the kids love. Summer program goes up to age 12.
  15. Chuckie

    how many colonoscopies per day?

    we do18 cases per room per day 0730 colon 0800 colon 0830 egd 0900 colon 0930 colon 1000 egd 1030 colon 1100 colon 1130 egd lunch hopefully 1230 colon 1300 colon 1330 egd 1400 colon 1430 colon 1500 egd 1530 colon 1600 colon 1630 egd 1700 clean up go home Patients are asked to come in 45 minutes prior to procedure time for IV and admission. If they are late they get rescheduled even if prepped. There rides are not allowed to leave the building and Recovery time is 30 minutes. Very efficient business. Yes it is a business an endoscopy business not a hospital.
  16. Oh yes, LPNs can not sedate in the state of Washington. However they can work in GI doing to Physician assistant side of things. This does free up the RN to do the Sedation and monitoring of patients.