Essay Example on Endoscopy Dept: Understanding & Implementing Patient Prep & Care

Part 1

1. How would you describe the role of Endoscopy department (BE SPECIFIC)

The Endoscopy department in the hospital plays a very significant role. It is dedicated to medical procedures involving endoscopes, such as the cameras used in the visualization of human body structures, like the genitourinary system and the digestive tract. The key personnel in the endoscopy department include nurses, endoscopy technicians, room assistants, patient care assistant, endoscopy scheduler, and inventory clerk. There are several functions performed in the endoscopy department, and among them include Endoscopic retrograde cholangiopancreatography (ERCP), push enteroscopy, colonoscopy, rigid sigmoidoscopy, flexible sigmoidoscopy, variceal band ligation, esophageal balloon dilatation, esophageal bougie dilatation, and percutaneous endoscopic gastrostomy.

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2. How did this differ from what you anticipated the role would be?

Before visiting the endoscopy department, I had very different expectations as to the role of the unit within the hospital. I was not conversant with most of the functions or therapies conducted in the unit, and I got to learn lots of new things after visiting it. Contrary to my expectations, I also got to learn that Endoscopy is used for several other functions other than just to see what is happening in the inside of the human body. Other roles that I got to learn for the first time included the use of Endoscopy in Primary Sclerosing Cholangitis, inflammatory bowel disease, and in other areas such as in the diagnosis and treatment of inflammatory pancreatic fluid collections.

3. What type of procedures did you observe (BE SPECIFIC AND LIST ALL)

On the clinical visit day, I got the opportunity to observe three types of procedures: esophagogastroduodenoscopy (EGD), colonoscopy and endoscopic retrograde cholangiopancreatography (ERCP) procedures. I got to observe a patient undergo the colonoscopy where the doctors were screening for cancer cells. The doctor used a colonoscope which transmitted images of the inside of the colon, and we were able to view it on the screen for any abnormalities. The tube got inserted through the rectum, then advanced to other large intestine ends where it was able to take the images of the inside and display them to us. For the ERCP, a bendable lighted tube was used (endoscope), placed through the mouth and then into the stomach, and then to the duodenum.

4. What were the benefits, risks, side effects, and/or adverse reaction possible? Did any of these occur to your patient and if so explain?

A lot of risks were involved during the endoscopy procedures. The patient may develop a reaction to the sedation used during the procedure. There might also be a tear in the gut wall resulting from the tube inserted into the patient through the mouth or bottom. As a result of such tears, the patient may also get infected or may develop internal bleeding that may call for surgery to get treatment. However, there were also benefits, as the patients were able to know the cause of their complications and get medication. During my time in the endoscopy department, I was lucky that none of my patients experienced any of these adverse effects.

5. Were your learning objectives met? If not, why not?

I was indeed able to meet my learning objectives. First, I was able to understand the functions of the Endoscopy department as described above, and this was through the first-hand experience, observing and engaging in the roles performed within the department. I also gained skills in the nurse role by getting to implement my responsibilities as a nurse through the preparation of the patients who were about to go through the endoscopy procedures. Lastly, I also achieved my last objective of providing knowledge to patients prior to the procedure so as to reduce their levels of anxiety.

6. After looking up the procedures you observed in one of your textbooks or resource was it performed according to what was written? Explain your answer.

There was indeed a very close connection between the procedures that were performed by the specialists during the endoscopy sessions and those prescribed in my textbooks. One of the procedures that were performed exactly the way it is described in my sources was the colonoscopy procedure. According to the textbook, the procedure should last approximately 30-60 minutes, and medications should be given to the vain to make the patient relaxed. The patient then lies down their left side, and the doctor inserts the tube to examine the patient. That was the exact procedure that was used by the doctor during my clinical observation.

7. Who did you follow in Endoscopy and what was/ were their role(s)? List everyone if you followed more than one person.

In the Endoscopy department, the person I followed closely in all her procedures was a nurse, who intensively engaged in the unit. The nurse was responsible for the preparation of the equipment needed for the procedure, and also cleaned them up thereafter. One amazing thing about this nurse was her level of expertise and the zeal with which she went about her roles. She was very careful, had a lot of knowledge, and was very nice as she taught me all the things she did. She showed me the room where to take the used equipment and the other room where already sterilized equipment were taken to be used for the procedure.

8. Who were in the room when your procedure was performed and describe their roles?

There were five people in the room at the time when my procedure was being performed. One of them was an MD, a gastroenterology specialist or gastroenterology who played the central role of performing the procedure. There was also one anesthetist whose role was to administer a sedative to the patient through injection into the vein. The sedative was meant to relax the patient and give them a light sleep during the procedure. The last set of specialists in the room were three registered nurses. One of the nurses prepared the equipment to be used before the procedure, and also cleaned them up afterwards. The second one was responsible for documenting and labelling the biopsy cups, and the last one took care and repositioned the patient.

9. What type of precautions in regards to Infection Control was taken?

The type of precaution taken in regards to the control of infection was the Standard Precaution where all the attendants in the room cleaned their hands and wore gloves to prevent any possible infections or contamination to the equipment and the patient. The equipment also got sterilized prior to the procedure to ensure that they were free of any infections from the previous procedure.

10. What type of precautions in regards to Safety was taken?

The precautions regarding safety included mechanical cleaning of the endoscope with special liquids to eliminate potentially harmful viruses and other microbes that may infect the patient. There was also leakage testing for the endoscope to allow immediate detection of internal defects to the equipment that could potentially cause infection. There was also a reliable and adequate source of oxygen for any emergency. They also ensured there was an interruptible source of power during the procedure, and this was supplied by a generator.

Part 2: Reflective Clinical Journal

Before reporting to the clinical area for the practice, I had my own personal learning objectives that I aimed at achieving during the clinical. The following were the objectives that I wanted to achieve after finishing the clinical. Firstly, I wanted to learn how to achieve personal organization as a nurse for clinical tasks and duties. These included all the steps and procedures to be undertaken before and after any endoscopy procedure. Secondly, the other objective was to achieve effective and efficient communication with other healthcare professionals within the room and in the hospital at large, as well as my instructor regarding my patient. Communication would be effective in learning first-hand information on how to handle real patients as opposed to theoretical classwork.

The following were my experiences at the end of the clinical day. I learnt how to do the sterilization of the medical equipment before any endoscopy procedure, and after. The process of cleaning the equipment is important as it helps in preventing any risks and maintaining safety during the procedure, such as the prevention of infection to the patient. I also learnt some procedures regarding infection control in the room, and in this case, we used the Standard Precaution where all the attendants in the room cleaned their hands and wore gloves to prevent any possible infections or contamination to the equipment and the patient. Administration of anesthetics to the patient before the procedure was another important thing I was able to learn.

During the clinical visit, I was able to meet my personal learning objectives. Everything went out smoothly, as I was surrounded by people who have high skills and experience. They were open and ready to share with me, and that played a key role in being able to meet my expected learning objectives. On the communication bit, I think this was the most important aspect, and it came out to be the best experience I had. I was able to achieve effective communication with the doctor, registered nurses and the other professionals who were in the room. Through such communications, I managed to learn a lot of new ideas and knowledge that I believe will be important for my future career.

My best experience of the day was when I aided the anesthetist in administering sedatives to a patient who was about to undergo the endoscopy procedure, and the results turned out to be good when the patient managed to have a light sleep. I also had several good experiences in sterilizing the equipment, and professionally interacting with the people in the room. My worst experience of the day was when I was to give a patient a throat spray, but instead, the spray went to the jaws of the patient instead of his throat. I felt like I had messed up the entire process. However, the doctor managed to salvage the situation by putting the sedation in the patient's IV, and he got okay.

The thing that I would do the same next time to ensure that I meet my objectives is paying close attention to the instructions given to me by the doctors and the registered nurses so that I may be able to deliver accurately with minimum or no mistakes. I would also ensure that I get every bit of the procedures conducted in the room so that I can be able to deliver next time without any guidance.

There were two major therapeutic communication styles that I used, and they included active listening and seeking clarification. I employed active listening to show interest to the patient on whatever they are saying and used cues such as nodding my head and saying "I see" to ensure that the patients knew I was indeed listening. I also did seek clarification on the parts I did not understand or when the patient said something confusing. Such styles had positive impacts on my patients as they felt I was there to listen to them, and that did care about their feelings and w...