EndoRN

I went into GI when I had small children. I needed to switch from afternoons to days. 6 years in I moved from a hospital to outpatient setting (no more weekends, holidays, evenings or taking call !!). I've now been in GI for 12 years & still love it! It's fun & the pay is good. :)

I'm not sure what IL law is re: LPN's giving conscious sedation. I know in our GI lab they do not. In regards to the first post, SGNA states if the nurse is doing the sedating (vs. a CRNA) then that should be their ONLY responsibility in the room, to sedate/monitor the pt. I have worked places where it's like you said, we are sedating AND teching. But it's pretty bad practice.

Our docs use the Miralax prep. You mix it w/32 oz gatorade and 32 oz H20. Speaking w/pts that have done different preps in the past (Fleets, Go-Lytely) they say this one is much more tolerable.

It does sound like a micro perforation to me. I mean, if she had absolutely NO pain prior. Was that abcess in her colon? It seems doubtful to me that she developed diverticulitis from the scope if she didn't have it prior. Unless they missed an inflamed tic along the way. It seems that a perf would have shown up on the CT scan, though. Interesting! Hope she's doing OK. You'll have to keep us posted on what you find out.

We use the Miralax prep and it is the same for bariatric pts as regular pts. Patients are instructed to drink the prep as directed. When it is coming out perfectly clear they can stop, tho. Basically at that point it's just the prep coming out the other end. So some pts can get away w/drinking less. :)

I don't know.....I've heard Fellows ask some strange questions re:coloscopies. I've also heard other nurses criticising them behind their backs and saying how they could do the scope in half the time, etc. I've also seen these fellows graduate, continue to practice and develop into awesome GI docs. I don't presume to think I know more than them simply b/c I've done (or assisted, I should say) in more procedures than them. They've also gone to med school and I haven't. This thing w/the NP's is new to me, though I've heard about it coming at SGNA conferences for many years. Guess it's finally happening and we need to change w/the times. If the hospitals are going to embrace it then we are going to need to be flexible, as always in nursing. I've seen nurses b*tch and dig their heels in over change. And, ultimately it never makes a difference. I suppose you can refuse to assist the NP, but it will probably just make you look petty and jealous. It would be nicer if you could share your knowledge. I'm sure he is nervous but willing to learn. Just my .02 :)

Keep your colon healthy with fiber supplementation and a high fiber diet (whole grains, high fiber cereal and some fruits/veggies such as raisins, strawberries, broccoli. Most are actually very low in fiber, tho). They used to advise against a high residue diet with "tics" (diverticuli) saying that peanuts, seeds, etc. get "trapped" and can cause diverticulitis. This has since been found to be a wives' tale. Tho you may still hear it from time to time from old school MD's and nurses. As for the "veins"....maybe hemorrhoids? Or AVM's (arteriovenous malformations) which are vessels close to the colon surface and prone to bleeding. Can't say for sure what he was talking about there. Interesting. Amy :)

I've read those before. They're funny!!

Call is rough when you have kids. That's why I have to work per dieum right now. I have 4 (kids). At the hospital where I work you get called in A LOT! Lots of times when we come in in the AM, the call nurse is up in ICU and has been there since wee hours.

So........did you get the job? How's it going??? Amy :)

I don't have any experience w/Interferon. But I did want to say I hope your husband is doing well !! Amy :)

No. If we are doing someone unsedated or using IVCS then we have them gargle w/4% lidocaine. Otherwise we don't use anything. We have anesthesia sedation and they are so deep there's never any gagging. They also can eat as soon as they wake up. Then leave. :) I'm actually starting a new job (in additon to my current job at the surgery center). I'll be back in a hospital doing GI. I'm curious what they'll be doing. I never saw that methemoglobanemia when I worked in a hospital before. I had actually never heard of it. The one MD who had it happen is our lab director. So when he freaked and told us to stop using it we didn't argue. We rarely used it anyway. Now if we have to numb them up, they gargle. Amy :)

Still debating rectal tubes? Sigh...guess I don't know the "theory" behind them. All I know is the patients seem to have an easier time getting rid of the residual air. Patients can relieve themselves of the air a lot quieter (our recov. area is jam packed and not the most private place in the bldg). "age of the endoscopist" doesn't really seem to be a deciding factor in the placement. About 1 inch of tube is lubricated and inserted. Instant air return. You'd have to go crazy w/the thing to cause damage. I guess I just don't know what else to say about rectal tubes. LOL. Other than I want one when I get scoped!! Amy :)

I'd just as soon avoid it as long as possible. Yes, we can get adverse effects from normal IVCS, but those agents can be reversed. There is no reversal agent for propofol other than "tincture of time". I am ACLS certified and have been in more codes than I cared to be in. But I still don't consider myself in the class of nurse anesthetists, especially when it comes to airway management. Amy :)

Jbahoffman, 2 of our MD's requested we stop using it. Evidently (I've not ever seen this happen) they had some cases of desaturation. I think it was called methiglobinemia (LOL. something like that...the O2 gets displaced from the cells.) Amy :)