The scope of things

As I watched the stylish retro movie “Down with Love” starring Renee Zellweger and Ewan McGregor, I briefly longed to return to the past. Briefly.

Back to rigid scopes? Teaching heads? The nurse not being able to see during most of the endoscopies and all of the ERCPs? There was an upside to the past, though.

I ran into SGNA past president Nancy Schlossberg doing her thing at the Olympus booth at this fall’s ACG in Baltimore. Surrounded by the height of technology manifest in the Medusean tangle of scopes, we discussed endonursing of the past.

“I have an old endoscopy nursing guideline from the ‘80s that advocates not cleaning the endoscope between cases,” laughs Nancy Schlossberg, RN, CGRN, manager of curriculum development, Olympus America, Inc. Instructions from The Gastroenterology Assistant: A Laboratory Manual, 2nd Edition, 1981 state that “Disinfection of endoscopic equipment is desirable, but must be practical in a clinical setting. The long method of disinfection is more time consuming and may not be applicable between cases in a very busy unit.”

“Of course, that’s only if the endoscopy nurse was really busy. It would be an unacceptable standard of care today, despite the huge numbers of procedures done by the average endosuite,” adds Ms. Schlossberg. I agree. But it did save time.

My father advised me, when still in training, to open a “fast food” practice of gastroenterology. Only partly joking, he designed my new practice. “You could lease an old fast food joint with a drivethrough window,” he enthused. “Your partners could be a urologist, gynecologist, dentist and ENT. The patients wouldn’t even have to get out of their cars. They could simply roll up to the drive-through window, extend the appropriate orifice out of the window of the vehicle, have it plumbed, then drive themselves on to the managed care check-out window.”

My pop’s name for my practice? “Orifices-R-Us.”

It makes me shudder to think of the combo selections. And let’s not even discuss the Whopper.

Unfortunately, my father’s vision of medical care has come to pass. Patients enter the great endoscopy machine on one end, their clothing is stripped off, their IV placed, we invade one or both “orifi,” they recover briefly and then are shot right out the exit.

This loss of touch, loss of modesty, loss of time to truly “nurse” the patients makes gastroenterology a Styrofoam™- wrapped, no nutritional value, super pseudo-happy value meal profession.

At the same time, there’s a movement afoot to take time. Some strive for slow, savory dining experiences. As boomers mature, more seek massages and facials at the local spa, complete with high thread-count sheets, music and aromatherapy. We in endoscopy can embrace that too.

Why not play soothing music for the patients, lower the lights in the rooms, enhance with soothing aromas, touch gently and lovingly, tuck sheets in to preserve semi-conscious modesty? It doesn’t take much time or cost, but enhances the experience of patients and staff. And if the music, lighting and smells of the endo suite enhance the staff’s pleasure alone, wouldn’t that be a good thing?

At Atlanta’s SGNA show in May 2003, Kimmie Williams, RN, CGRN, of Sharp Memorial Endoscopy Center and Outpatient Pavilion in San Diego, shared her unit’s fun and quirky efforts to enhance patient satisfaction.

Your patients may get juice and crackers after their endoscopy. But is the juice in a champagne goblet, served on a silver tray? Ms. Williams, supervisor Midolie Loyola, RN, CGRN, and their Sharp colleagues strive to offer “Five-Star Care.” Ms. Williams adds, “In addition, we serve a butter mint and a choice of graham or saltine crackers. And on the silver tray, there’s a card on colon cancer risk to share with others, and a moist towelette that we heat as per their preference. If the patient chooses coffee or tea post-procedure, we serve their hot beverages from small silver pots. We also send handwritten thank you notes to all our patients thanking them for their visit.”

Think of the patient smiles, the stories told to their endo-reluctant friends and family. Ms. Williams’ suite has made the endo experience special, using innovation, fun and just a bit of party ware.

Reject super value meal endoscopy. Choose to make your unit a Spa Endo.