photo courtesy of Chris Porsz
Carole Dalton, an upper gastrointestinal (GI) endoscopist, gave Communications Officer, Claire an insight into a typical day in the life of the Endoscopy Team.
I joined Carole as the team were undertaking their afternoon lists. She explained that there are five nurses in the team - three specialise in upper GI and two in lower GI. There are also an additional team of nurse endoscopists at Hinchingbrooke.
The upper GI nurses perform gastroscopies - which are procedures where a thin flexible tube, called an endoscope, is gently passed from the patient’s mouth into their stomach. The image from the endoscope is viewed on a TV monitor and a clear view of their gullet, stomach and duodenum (part of small intestine) can be seen.
When defining endoscopy it could be said that it is any camera going into a hole that doesn’t need cutting – I must state this was my interpretation of a definition!
I was introduced to the team, who were catching up on paperwork, and noted that a lot of their job is taken up with admin. They also have a number of referrals to vet and will often need to go back to GPs for more info. Once the vetting has taken place the patient is allocated to an appropriate endoscopist.
The nurses took the time to explain the procedure and I was looking forward to the afternoon clinics so I could observe.
On our way to see the first patient I was shown a large x-ray room where they perform procedures such as ERCPs, which enable the pancreatic and bile ducts to be examined. They also use the room to put in oesophageal stents, which is when a tube is placed in a blocked area in the oesophagus so a patient can swallow soft food and liquids again. This procedure is often used to help palliative care patients with oesophageal cancer.
The first patient was asked a series of safety questions and given a spray to numb her throat, which I can only assume by her reaction didn’t taste very good!
I was curious to see what the procedure would look like on the screens, after all, not coming from a clinical background it wasn’t the sort of thing I get to see every day! Carole pointed out a hiatus hernia, and I could see (when pointed out) that this was causing part of the stomach to move up into the chest.
What really struck me whilst observing the endoscopists was their ability to multi-task. As well as performing the physical procedures, looking carefully at the screens and taking biopsies they reassured the patients who were nervous, anxious and uncomfortable.
The patients are given their results straight after the procedure. If the nurses or doctors are delivering bad news, often a cancer suspicion, they try to ensure that the patient has someone with them for support.
Carole said: "Specialising as a nurse endoscopist is an interesting role within the gastroenterology team. I particularly enjoy training new gastroscopists, both specialist registrars and new nurse endoscopists. Between scoping we carry out audits, vetting of referrals, work on securing our annual JAG Accreditation, which is awarded to high quality gastrointestinal endoscopy services and support clinicians from other areas with endoscopy queries.”
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