Gut Check | Thursday, September 10, 2020

The Many Roles of GI and Endoscopy

Responses collected by Rhoda Redulla, DNP RN-BC

From the outside, it may appear that those in the GI and endoscopy units assisting patients are all just nurses, there to take care of patients and help them on their way. In reality, the people who work in these units have many different roles and responsibilities, all aimed at bettering the unit as a whole. SGNA recently spoke with Michele A. Bachman, MSN RN CGRN, Janet Golden, MSN RN NPD-BC CGRN, and Andrea Marie Herr, ANP-BC, about their specific roles and how their roles effect the duties and tasks of their day-to-days.

What is your current role?

Michele A. Bachman (MAB): My current role is clinical nurse director of East Ann Arbor Medical Procedures Center at Michigan Medicine.

Janet Golden (JG): I currently work as a nurse educator in the endoscopy department at the University of Vermont Medical Center in Burlington, Vermont.  

Andrea Marie Herr (AMH): I am currently the senior clinical practice nurse practitioner for advanced endoscopy clinical coordinator of Bariatric and Metabolic Endoscopy.

How did you come about being in this role? Was this a role you always wanted?

MAB: I have been in my current role for 10 years. My history in GI is very long. In 1985, I started out as an endoscopy technician. When I completed nursing school, I worked a few years in the surgical intensive care unit (SICU) and then changed my direction to work in a GI clinic as a clinical coordinator. My affinity for GI became apparent as I delved into the care for Inflammatory Bowel Disease (IBD) patients. While working as a GI clinical coordinator, I went to grad school for a master’s in health administration. One of the physicians who I worked with when I was an endoscopy technician was the medical director for EAA-MPC.  We reconnected and I became a clinical nurse director for an endoscopy unit. Becoming a nurse leader was an evolutionary process for me. It took time for me to figure out what my specific niche was, but GI was always a front runner.

JG: I started this role 10 years ago, but I believe I’ve always been an educator at heart. I wasn’t even aware a nurse could be an educator within the hospital setting until I started working at UVMMC.

AMH: When I decided I wanted to be a nurse, I also knew at that time I would pursue a career as a nurse practitioner. I have worked at NYP for now 15.5 years. I started as a nurse on the general medicine/gastroenterology floor, then worked as an inpatient nurse practitioner in the amenities unit working with both medicine and surgery patients. Eventually, this led me to my current outpatient role as an advanced endoscopy nurse practitioner for the past seven years. My current role is the perfect combination of a medical/procedure-based patient population that is interesting, challenging and constantly evolving. I have also had the opportunity to take on the role in clinical coordination and patient management with our bariatric and metabolic endoscopy patient population. This is an area I have a true passion for.

What are some of the duties and tasks that are specific to your role?

MAB: As a clinical nurse director for the Medical Procedures Center, I am responsible for the daily operation, which includes but is not limited to: staffing and scheduling, hiring, payroll, staff development and education, infection control, regulatory readiness, patient relations and multidisciplinary collaboration.

JG: This hospital has the rare structure of having a nurse educator in all inpatient and some outpatient units. The role is responsible for onboarding new hires, ensuring competence of endoscopy employees, providing and facilitating education to staff members and ensuring quality in the unit.

AMH: My role involves patient care, management and coordination of our advanced endoscopy outpatient practice. I have my own template/schedule in which I see our patients for a new visit, follow-up and colon consults as well. I manage and see the patients within the bariatric and metabolic endoscopy in conjunction with the director of advanced and therapeutic endoscopy. I am also involved in research and coordinate/manage in conjunction with the research coordinator and PI.

How is your role different than other roles in GI?

MAB: The role of the clinical nurse director is different than other roles in GI by means of the administrative focus versus patient care delivery.

JG: Our unit does not have a clinical specialist, but some units do as well as having an educator. I report directly to our department’s director and work with the endoscopy leadership team. I believe I work for staff, patients and physicians.  

AMH: My role is different than other roles in GI because of the unique practice/population we see in advanced/therapeutic endoscopy. The doctors perform unique, interesting and more invasive procedures, from endoscopic weight loss procedures to endoscopic resection of a mass to stents placed in the bile duct to biopsies of pancreatic cysts.

What does your day-to-day look like in your current role?

MAB: My daily workflow starts early and ends late. I’m accountable to the unit and the team I work with 24 hours a day. I am a resource for the staff and faculty while maintaining daily operations.

JG: No day as a nurse educator is truly the same and [that] is part of the reason I enjoy it so much. One day I may be teaching a class on how to interpret ECGs, the next day I may be ensuring endoscopy technicians are competent with the scope cleaning process. Another day, I may be helping out in a procedure room or researching best practices. Regardless of what I do, my bottom line is ensuring our patients are safe and well cared for by ensuring the staff are the best endoscopy nurses and technicians possible. 

AMH: My current day-to-day varies. Some days I am seeing patients in the office all day for visits, some days I am calling with results, follow-ups, post-procedure calls, coordinating the research study I am involved in, doing peer-to-peer calls, ordering procedures, imaging, managing acute patient symptoms and supporting the attending and clinical staff in whatever capacity is needed that day. I am also involved in research and I am a co-investigator on the MERIT trial with Dr. Sharaiha.

Anything else you would like to share about your role?

MAB: As a nurse leader, the rewards of the role are not always apparent like they can be when providing nursing care for a patient. The rewards are overarching over time and are visible in the success of the team and outcomes of the patients.