MissChrissy

I work as a tech in our endoscopy center and I also work in Accreditation....and that would NOT go over well with the powers that be. Ive been in the procedure room many times, and Ive seen when things go wrong and I could not imagine only having the GI physician both administer the medication, closely monitor vitals and perform the procedure. The majority of the time we have our anesthesiologists administering propofol, CRNAs are used if an anesthesiologist can not make it that day.

Lol. That is very ill advised. I assure you that performing a Colonoscopy is NOT a one-person operation. The only reasonable way a doctor can get away with not having any one else in the room is if you have a pristine non-tortorous colon with no polyps, inflammation, bleeding, etc. Besides the general fact that a lot of MDs havent familiarized themselves with where all the equipment is in the procedure room....would you like them to constantly stop the procedure, take off their gloves, fumble through the cart to find what they need, try to maneveur the scope with one hand and push in and manipulation a hot snare or forcep or a hemo clip, or an injector, with the other? Take the risk of losing sight of the polyp because the doctor is jarring the scope around so much trying to do a job that requires two people? You do realize that if you have a tortorous colon, you need someone to provide abdominal pressure to help guide the scope along the colon, how will a doctor do this? How about priming for injections? Or setting up the machine and pads during a polpypectomy that requires a hot snare? Documenting all the times, location and number of biopies and methods of removal in real-time? All nurses, techs, MAs are trained and under the direct supervision of the MD, so I honestly don't see what your adversion is to it.

Congrats on 10 years :). You should come to our clinic next time, we use CO2 for colonic insufflation, rarely have a patient complain of severe gas and cramping.

That sounds about right. Our center uses anesthesiologists and CRNAs to give sedation. Besides what you've listed, techs here do pre-op-Bringing the patient back, identifying the right pt/procedure, asking the questions to place in the report (meds/allergies/time they stopped eating/drinking/etc), start IVs, getting a BS reading on diabetics, administering saline to those that are really dehydrated (i.e., vomiting a lot prior to procedure), getting consents. Then as you said, preparing the room, setting up the equipment, assisting doctors in all aspects of therapeutic interventions, recording the location/method of removal, # of jars, labeling jars and packaging. Also recovery where we monitor/take vitals the patient post-procedure, report any thing amiss to the doctor, administer O2 if the so2 are too low, give the patient something to eat/drink, answer any basic questions the patients may have before the doctor speaks with them, have them get dressed, sign their operative report and have them on their way. The day before, we do the pre calls to remind them of their procedure, and answer any questions about their bowel prep/what meds they need to stop, etc. We prepare the patient's charts for the next day.

If you have a pulse you'll be admitted into the program.

I absolutely HATE the sensation of nausea. Even feeling extremely nauseous (with and without vomiting...mostly a lot of retching) for just a day makes me miserable...to the point where even drinking a little bit of water makes you feel that way....I couldn't imagine experiencing that for an extended amount of time.

I work at an outpatient GI facility and as techs we start IVs. From my experience of having started on IVs on many people the.. dehydrated, the self-proclaimed "difficult sticks/rollers" ...I've done pretty well. Sure there's an occasion were we need to get another person to help, but there are some patients were the anesthesiologists or seasoned folks miss-multiple times. I don't think there is any reason to fill uneasy...I will say proper training is crucial though.

In an outpatient clinic setting... What are the main differences between the job role/responsibilities of an GI technician and a GI nurse (RN)....besides giving sedation?

As others have said, practice makes perfect (Or at least pretty damn good in this case). When I first started doing IVs my hands would visibly shake, so it was definitely embarrassing and did not instill much confidence. Tip 1) Do not get discouraged, you'll start getting far more 'hits' then 'misses' as you practice more. Don't get psyched out by patients that get mad at you for missing either.... It happens, even anesthesiologists that have 20+ years of experience miss. 2) Always flush with saline, even if you get some blood drawback. 3) Patience is key, put the tourniquet on and have the patient lower their arm, then wait a little... you'll be surprised when veins on the hand, that you really couldn't see or palpate before, pop out. 4) For slightly 'crooked/wobbly' veins, straighten them out! Pull the skin taut... 5) Apply pressure above your insertion so when you pull the needle out to secure the heplock, you don't get a bloody mess. 6) Observe others that are proficient at doing IVs and see what their techniques are.

Are you sure that isn't MA school? I mean not to be rude, but if you're willing to spend that much money and time for just a CNA cert, then you deserve that....

Tbh, I believe being an MA isn't worth it-better off getting your ADN. There are some clinics that will pick up CNAs and train them to do MA duties. If you have strong propensity towards learning, then being trained on the job as a MA isn't a difficult endeavor. I've been at my position for about 2 years and I do all roles within the procedure center of our clinic (Pre-op, Post-op, Teching, Scope sanitation), I work front desk/check out, worked the 'nurses' station-(checking in office patients, abundance of telephone encounters, contacting hospitals, etc), and within accreditation (data-collection, QI studies, etc). It is very possible option, but just have to find a place willing to teach you! What I learned in my CNA was virtually useless. I got more out of the 1 week of clinics then I did the didactic portion of the class (watered down, common sense stuff). If you do get hired by a clinic...then they will give you on-the-job training. I was fortunate to be hired by the clinic I work at now because my scope of practice is a quite a deal larger then a CNA. I would say the major downside is that since you are a cost effective option, you may get paid less in comparison to someone that went through the program even though you are have the same roles and responsibilities.

I work within accreditation.....just curious, in what form is the project for hand washing? training? studies? We mainly do documentation errors through chart reviews What's your new IV protocol? I'm actually not sure if we have a protocol for that, would have to check, but we've had a few infiltrations ourselves. We (pre-op) to flush with saline first. Saline infiltration is a lot less painful than propofol :S The current study we're working on is based on what's the most effective bowel prep..

1) ALWAYS ALWAYS change your gloves between patients. Besides the obvious cross contamination issue, the last thing you want is a patient that noticed you did not change your gloves and complains. It can be difficult to do especially if you're juggling three patients at a time..but it has to be done. 2) After the procedure the first things you should do is a obtain a set of vitals/make sure the patient is stable/patient assessment. 3) Try your best NOT to leave your patient unintended in the recovery area until they are awake and at least relatively alert. Again, it can prove to difficult when you're juggling multiple patients. 4) If you need help from a co worker, ASK! 5) I wouldn't take the IV out until the patient is almost ready to go. There have been times when the patient, upon awakening, feels fine then a little later they start feeling abd pain, nausea, etc.

I don't know what you want me to tell you, this has always been the set up at our facility and so far it's worked pretty well. We are an outpatient clinic, not a hospital so we don't deal with ERCP or EUS. The only procedures we do are Colonoscopies/Sigmoidoscopies and EGDs. We have an RN and LPN supervisor but they are not in the procedure room. In the case of an emergency they can potentially come in the room and assist as needed. I'm just saying in this setting (outpatient center that doesn't normally deal with dangerously ill patients) a tech is fine with assisting, pre/post-op. Maybe you're saying they let the techs do too much? but I don't really think so. If we use epi via interject during a polypectomy then it's under direct supervisor of the GI doc and he/she will tell us exactly how much to inject out...same with saline and tattoos. In emergencies, you're right we can't administer medication but we can start a second iv line, assist with suctioning, bagging, CPR..not completely useless..

That's what on the job training is for. Never had a pt complain about me starting an IV because I was a tech, I guess you'd be our first if you came in lol. Why would it be risky when there's a CRNA/Anesthesiologist and the Gastroenterologist present?? You've lost me.