My Specialty

Advanced Endoscopy, Melodie Bishop, Keck Medicine of USC

Leading a busy GI team and launching a new high-tech facility

Melodie Bishop smiling with arms crossed, in front of trees

Melodie Bishop RN, MSN
Nurse Manager, Endoscopy
Keck Medicine of USC, Los Angeles

Please share with us the arc of your nursing career.

After beginning my career in Connecticut as an ICU nurse, I came to California and have grown within the Keck system. I was a registry nurse here for several years, beginning in 2005, and then signed on as a staff RN in 2014.

Over a year later, I was promoted to nurse coordinator of the outpatient preop/postop unit, and then became a nurse supervisor of three different outpatient preop/postop areas. In 2019, I was promoted to nurse manager of the GI lab pre/post and procedural space, and in 2020, I added the motility lab area to my direct supervision.

Tell us about the Keck facility where you’re located.

Keck Medicine of USC is a tertiary care hospital. Our department is currently on the second floor of the main hospital, but we are in the process of building our own endoscopy facility, which will be called the Center for Advanced Endoscopy.

Keck is a big surgical hospital — we get a lot of transfers, and people come here for a higher level of care. We do screenings, but more often than not, they’re in preparation for surgery or a transplant. We’re part of the main hospital, so while we take care of outpatients, we also care for GI inpatients.

We bring cases down to the GI unit from all the other floors, and we even provide GI services to patients at Norris Cancer Hospital, our sister facility across the street.

Our team is very busy — we’re always needed somewhere. We work with five different service lines: gastroenterology; hepatobiliary/transplant; and surgical services, including colorectal, thoracic and general. We have a separate unit right now for motility studies, but when we move to our new facility, we’re going to merge all of those services.

What are your responsibilities as a nurse manager in the endoscopy suite?

I have oversight of all day-to-day activities of the GI lab. I manage budgets, staff schedules, patient scheduling, direct patient care, employee management, research, education, quality and performance improvement, and professional leadership. I’m also responsible for Kronos timekeeping, documentation and working collaboratively with all members of the healthcare team.

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You have an MSN in nursing leadership. Do you feel it prepared you for the responsibilities you currently carry?

Education prepares you to grasp the big picture when you’re evolving from a staff nurse at the bedside to the role of manager or leader. Managers truly have to take it to the next level in terms of making sure everyone in the unit or facility they’re managing — staff and physician alike — gets what they need to deliver the highest-quality patient care possible.

Having been a staff RN at the same organization where I became a leader, I can now see both sides of certain situations much more clearly. For instance, I was laid off once in the past, and I can now understand from a leadership perspective why that happened. It wasn’t personal, even though it felt that way at the time.

My degree has helped me understand those nuances. However, my education just scratched the surface. My mentors — especially at this hospital — have guided me and helped me grow; I couldn’t have done this without them.

The support I receive continues to be invaluable. When you regularly benefit from this kind of guidance, anyone can be successful.

How did you learn to manage the responsibilities of budgets, HR and everything else you do on a daily basis?

School gave us a few assignments that touched on things like budgets, but it wasn’t real to me at the time. Fortunately, the people at Keck take the time to explain things and work with you.

For instance, if you have a variance in your budget, you can call the business director and they will help walk you through it. We also have a working group that helps me when I’m stumped.

What is the most gratifying aspect of being a nurse leader?

Without a doubt, it’s making a difference not only in patients’ lives, but also in the lives of the team. I love working with everyone to ensure that we have the great teamwork we need to succeed. It thrills me to see patients happy, safe and well cared for.

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Supporting the staff and physicians allows me to reach more patients each day in the most positive manner possible.

How do you and the other leaders work together and collaborate?

We have regularly scheduled huddles with perioperative services to share our thoughts, concerns and observations. This allows us to collaborate on projects and help each other succeed rather than struggle independently. We send each other staff and equipment as needed and give freely of our time. Of all the hospitals where I’ve worked, I find I’m most supported here.

Have recent technological changes impacted this specialty?

Gastroenterology and GI surgery trials introduce many new products and devices that enable us to provide the best possible outcomes for our patients. Most recently, this has included more disposable products and AI technology. My team and I say that in GI, you’re always learning something new, whether it’s devices, equipment or a new technique.

How has the pandemic affected your staff and the functioning of your unit?

Although our department temporarily shut down a few times, we came together, packed and moved, and worked hard to ensure a smooth transition for patients. Everyone stepped up and did something. We floated, and almost everyone cross-trained and learned new skills. People just rolled up their sleeves and went where they were needed. I am so proud to be a part of this team, and this was another sign that I was in the right place.

How do you become a successful leader?

There are many people on our unit who are savvy enough to be leaders, so I ease them into it. When a nurse shows any interest, I give them mini-projects so that they can see what it’s like to lead. For instance, if someone expresses interest, I might give them the responsibility of doing quality control checks for the unit and providing in-services for the rest of the staff. I make sure to guide them along the way.

When it comes to leadership, collegiality helps more than anything — just telling people what to do never works. I encourage them to grow, because that’s what was done for me. I try to pay that forward.

What does your future hold?

The Center for Advanced Endoscopy will be a technologically advanced unit that will increase patient access to advanced endoscopic care and motility studies. Our team will be trained in new procedures that we haven’t previously had the capacity to offer. We’re always learning and growing, and with the new center coming, I’m more than excited!


KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has hosted the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.


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