The Role of Gastrointestinal (GI) Endoscopy Nurse Guide

Around 1-1.5% of the population requires an upper or lower endoscopic investigation of the gastrointestinal tract each year.¹ Gastrointestinal endoscopic procedures are used as diagnostic, as well as interventional. It includes gastroscopies where the scope is placed inside the oesophagus, stomach and first part of the small bowel; and colonoscopies where the scope is inserted in the large bowel. Nurse’s play an important role in these procedures. In this article we highlight the role of nurses in gastrointestinal endoscopy.

The European Society of Gastroenterology and Endoscopy Nurses and Associates has established a core curriculum for nurses working in these settings.³ Taking that more and more procedures are being performed in endoscopic rooms, in replacement of open surgery, nurses are also required to keep their knowledge and skills up to date after initial training.

Overall, nurses working in gastrointestinal endoscopy have two main roles: assisting the endoscopist during procedures and specialised patient care before, during and after the procedure.^4,5

The role of nurse endoscopists has been developed in several EU countries and studies have shown nurses are at least as good as doctors when performing these procedures.⁵ Since the role became operational, the average time patients on the waiting list reduced from 4 to 5 months to 3 to 4 weeks.¹ Training lasts usually 1 year in most EU countries and is university based.

For most endoscopic procedures, moderate sedation is the standard method of sedation.⁶ The role of nurses in endoscopy sedation has evolved over time and is different in each country. It ranges from nurses administering single drugs, to combinations of benzodiazepines and opioids, and in some countries nurse-led propofol administration.

Irrespective of the type of sedation used, quality management requires pharmacologically appropriate training for all clinical staff involved in sedation practice. European and national societies have developed evidence-based and consensus-based guidelines for sedation and monitoring in gastro-intestinal endoscopy that give a comprehensive outline of structural requirements, medication options, patient monitoring and discharge, and the role of endoscopy staff.⁷

Sedation adverse events and complications are known to occur. These are more likely depending on the type, dose and mode of administration of sedative drugs, patient’s age and underlying chronic conditions Medication side effects, like hypotension, desaturation, bradycardia, hypertension, arrhythmia, aspiration, respiratory depression, vomiting, cardiac arrest, respiratory arrest, angina, hypoglycaemia, and/or allergic reaction, have been reported.⁶ Nurses involved in sedation practice must have adequate training to administer sedative medications, monitor the patient throughout the procedure and recover from possible complications.

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