Gastroenterology Nursing: Interview with Jalpa Chaudhari
Caring for patients who are undergoing endoscopic procedures
Jalpa Chaudhari, RN
Pomona Valley Hospital Medical Center
Tell us about your nursing career.
My nursing career began nine years ago at a neighboring hospital, where I worked as a med-surg nurse. Six years ago, Pomona Valley Hospital Medical Center (PVHMC) had an opening in GI, so I decided to try it. After five years, I was promoted to clinical supervisor for the GI lab, and that is the position I currently hold.
What types of procedures are performed in your lab?
We perform colonoscopies, endoscopies, placement of gatrostomy tubes, enteroscopy (visualization of the small intestine), capsule endoscopy and common bile duct stone removal via ERCP (endoscopic retrograde cholangiopancretography).
Tell us a little about your responsibilities on the GI lab team.
We have nine nurses, six physicians and four technicians on the team. I’m in charge of patient flow, making sure that the day runs smoothly, and I have a great deal of one-on-one communication with the doctors. I am also in charge of scheduling the staff and sending all payroll information to the hospital’s main payroll department. The technician coordinator handles the ordering of supplies and equipment, although I take part in the decision-making that determines if we acquire new machines or new technologies. We work Monday through Friday, with most of us beginning our days between 7:00 and 9:00 a.m. I enjoy every moment of it.
Have changes in technology impacted your work?
As far as scopes are concerned, they have changed a great deal over the past few years. We now have high- definition scopes and the most up-to-date equipment. We attend seminars and conferences with the different vendors so that we have full understanding of the new technologies that we bring to the team.
What specific skills are needed for your particular specialty?
Being a team player is very important. Good assessment skills are also essential, as is clinical care experience. The technology can be learned on the job.
Are there special certifications required to work in the GI lab?
ACLS is required, and we send our nurses and technicians to conferences so that they can be as up to date as possible. Some nurses pursue their CGRN through the Society of Gastroenterology Nurses and Associates, but it is not required.
What about your work feeds your spirit?
Knowing that I can make a difference in one person’s life — big or small — gets me out of bed every day. Offering a patient comfort, knowledge, compassion or caring is very satisfying.
Is there a patient anecdote you can share to illustrate your work?
We had a patient who was very anxious about a colonoscopy appointment. He was so nervous that after he completed his two-day prep, he refused to go forward with the procedure, even though he was already in his gown and ready to enter the lab. So, I sat him down, explained the procedure, tried to reassure him and even brought in his family so that they could speak with him and support him. I walked him through all of the steps, started the IV and comforted him every step of the way. With orders for extra meds to keep him calm, he went through the procedure without incident. When he was in the recovery room, he remembered my name, looked at me, smiled and yelled, “I did it!” That was my reward at the end.
Any advice for nurses who may be interested in this area of specialty?
I recommend shadowing a nurse in the lab and getting an understanding of what goes on and what it’s like. Nursing students often come through the lab, and some of them find it too repetitious or monotonous. Personally, I love the patient contact and the team effort.
Do you have any further professional aspirations at this time?
I’m currently in the BSN program at California State University, Fullerton. It’s always good to pursue higher education, and I feel it’s important to have that behind me.
Upper gastrointestinal (GI) endoscopy is a procedure that uses a lighted, flexible endoscope to see inside the upper GI tract as images are transmitted to a video monitor. Special tools slide through the endoscope to perform biopsies, stop bleeding and remove abnormal growths.
U.S. Dept. of Health and Human Services
Gastroenterology (GI) nurses, also known as endoscopy nurses, work in acute care facilities, medical offices and outpatient centers specializing in the diagnosis and treatment of gastrointestinal disorders. GI nurses assist physicians in performing colonoscopies, endoscopies, capsule endoscopies, placement of gastrostomy tubes and enteroscopy, as well as other procedures and treatments.
Patients undergoing gastroenterological procedures may present with a variety of conditions, ranging from bleeding, pain, dysphagia and dyspepsia to ulcers, reflux disease, hiatal hernias, cancers and other illnesses. Some patients also present with foreign bodies requiring removal. Procedures are performed for the purposes of screening, treatment and diagnosis.
Roles of the Nurse
The GI nurse must be conversant with all the technologies involved in the diagnostic and treatment procedures the endoscopy lab performs. The nurse is responsible for assisting physicians, patient education, preparation and post-procedure recovery. Patients may include children, adults and the elderly.
The GI nurse may assume the role of staff nurse, supervisor, manager or educator. Another viable career option is employment as a sales representative or researcher with a manufacturer of endoscopic equipment.
Skills of the GI Nurse
The GI nurse must be willing to develop one-on-one relationships with patients and must have excellent communication skills, emphasizing comfort, safety and education since many patients regard GI procedures with great trepidation and anxiety. The nurse must also work closely with physicians, nurses, technicians and other team members.
Nurses can generally seek employment in an endoscopy lab without prior endoscopy experience, but med-surg or other clinical experience is usually required. Some nurses pursue advanced degrees and certifications, but many endoscopy centers do not require certification and will provide on-the-job training. Equipment manufacturers may require prior endoscopic experience for research or sales positions.
Some endoscopy nurses pursue certification through the Society for Gastroenterology Nurses and Associates (SGNA), although certification is not uniformly required by all employers.
Certification can provide validation of a nurse’s competence and professionalism, and may positively influence the potential for employment.
The certification exam is administered by the American Board of Certification for Gastroenterology Nurses (ABCGN). Members of the Society for Gastroenterology Nurses and Associates (SGNA) pay $400 for the computer-based exam, while non-members pay $485. Two years (or 4,000 hours) of employment in GI nursing is required to sit for the exam. LPNs who have become RNs must have two years of experience as an RN (regardless of experience in GI nursing) prior to sitting for the exam.
Society for Gastroenterology Nurses and Associates (SGNA): http://www.sgna.org
American Board of Certification for Gastroenterology Nurses (ABCGN): http://www.abcgn.org
Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN): http://apgnn.org/
Society of International Gastroenterological Nurses and Endoscopy Associates (SIGNEA): http://www.signea.org
Digestive Disease National Coalition (DDNC): http://www.ddnc.org/
Keith Carlson, RN, BSN, has worked as a nurse since 1996 and maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.