Second OpinionsEndoscopy Staffing

Endoscopy Staffing

Do you think it is acceptable to not have an RN in the endoscopy suite while doing endoscopies with an anesthesia provider using propofol?

Started by: gregory Rendelman (Anesthesiologist/Nurse Anesthetist) at July 25, 2015 (6:15 am)

Comments and Responses

 

In NYS, are techs allowed to be in the procedure room without an RN? I thought they were not allowed to document, label specimens, inject anything (such as epi, normal saline or SPOT) or clips since its considered an implant. I work in a hospital setting and we have an RN and a tech in the room. My friend runs an outpt Endo Center (JCAHO accredited) which only uses an RN in the room, but the MD owners want to go to just a tech in the room. She is having a hard time finding what the rules and regs are for NYS in this matter. If anyone can help, I would appreciate it !! Thanks !!

Danielle G. (Other) at December 16, 2016 (2:16 pm)

There is always an RN in the room with the anesthetist. This is to provide assistance to the anesthesia provider,tech, surgeon and to be able to assess pt condition and chart as well as label. In our state only an RN can assess, not a tech.

Jeanette S. (OR Manager/Supervisor) at December 22, 2015 (3:58 pm)

I would refer to your state requirements; many states require a registered nurse for every invasive procedure in addition to the nurse providing moderate sedation. SGNA and AORN also recommend a circulator for every surgical or invasive procedure; take a look at the position statements.

Accrediting agencies may also require 'adequate staffing', including the physician performing the procedure not having involvement in the management of the sedation.

https://www.sgna.org/Portals/0/Education/PDF/Position-Statements/SGNA_Minimum_RN_Staffing.pdf

http://www.aorn.org/Clinical_Practice/Position_Statements/Position_Statements.aspx

Marie D. (Director, Surgical Services/Director of Nursing) at November 4, 2015 (2:04 pm)

Thank you for all your insight

gregory Rendelman (Anesthesiologist/Nurse Anesthetist) at September 29, 2015 (6:01 am)

We have an anesthesiologist to monitor the patient and give Propofol and a tech to assist the endoscopist.

Wendy F. (Other) at August 5, 2015 (3:00 pm)

At our center we provide the physician an Endo Tech, an RN who circulates the case and a SRNA to provide sedation under the CRNA/Anesthesiologist supervision.

I. Morris (Director, Surgical Services/Director of Nursing) at August 4, 2015 (10:30 am)

In our facility we use nurse, anesthesiologist in room when using propofol. When using conscious sedation just one nurse. Our techs are not endo techs just scope techs. I've been doing this for over 15 years and there is no need for a second RN in the room for most cases. If there is we have our rr staff help out.






Carol D

Carol D. (Administrator/Director/Manager/Owner/Exec. Officer) at August 1, 2015 (9:20 pm)

I have always provided anesthesia for endoscopies in settings with the CRNA, the gastroenterologist, an RN circulator, and a scrub tech.

The gastroenterologist performs the procedure, and the scrub tech assists the gastroenterologist. The RN circulator documents the procedure and is available to assist in case of an emergency. The CRNA is responsible for administration of anesthesia, airway management, hemodynamic support and resuscitation (if needed), and documentation of the anesthetic. Both the RN and CRNA have patient advocacy roles.

In my opinion, GI sedation is one of the most difficult anesthetics that are administered. Many stories have surfaced in the media about patients who have suffered brain damage or death during their routine colonoscopies and EGDs, for instance. I think these procedures are often underestimated and thought of as 'easy' compared to others, but in reality there is great risk. Therefore, I would recommend having both an anesthesia provider and RN circulator during these cases.

R. Dixon (Anesthesiologist/Nurse Anesthetist) at July 29, 2015 (4:04 pm)

We have the MD, the CRNA monitoring the patient, and an Endo tech assisting the physician. A circulating assistant is not needed. The tech is able to do everything required. An RN is always available if needed.

J. Heim (OR Manager/Supervisor) at July 29, 2015 (2:03 pm)

We have an anesthesia provider the endoscopist a RN and a tech

C. Brisset (OR Manager/Supervisor) at July 28, 2015 (6:22 pm)

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