Carol Arnold, BSN, RN, CGRN and Ellen Ritchie, BSN, RN, CGRN are Certified Gastroenterology Nurses and the dynamic duo of ChristianaCare’s Endoscopy Suites. Carol serves as the Perioperative Services Coordinator and Ellen as a Registered Nurse III in the Endoscopy Suites at ChristianaCare in Delaware. They have a combined experience in gastroenterology (GI) nursing of nearly 40 years. Both Ellen and Carol entered GI nursing after caring for patients early on in their careers. Carol and Ellen enjoy GI nursing because of the dynamic, ever-changing, challenging and interprofessional practice environment.

What is the role of the GI Nurse?

Carol and Ellen work in a highly interprofessional team of anesthesia techs, anesthesiologists, physicians, procedure technicians, and respiratory therapists. They care for a mix of adult inpatients and outpatients in need of endoscopic procedures.

Carol and Ellen say that the “amazing staff” is one of the main reasons they are so satisfied with their work.

Carol, Ellen and the rest of the GI staff rotate between preparing patients for procedures, working in the operating room and recovering patients after their procedures. The most common procedures include colonoscopies, esophagogastroduodenoscopies and bronchoscopies. GI nurses become expert care coordinators due to the constant orchestration of numerous procedures, new equipment, doctors and patients.

Patients often decompensate during or after an endoscopic procedure and the GI nursing team must rapidly respond with life-saving interventions and critical-thinking.

In the Pursuit of Continuous Improvement

Carol and Ellen are curious and continuously looking for ways to innovate, a hallmark behavior of ChristianaCare caregivers. In the GI procedural practice environment, cancellation of cases is a frequent occurrence due to uncompleted lab work and procedure preparation. They are working with partners in Organizational Excellence to apply principles from Lean Six Sigma training to optimize patient preparation and reduce case cancellations. Their work focuses on the optimization of pre-procedure preparation through effective medication orders, placement of intravenous access and bloodwork. They are currently piloting improvements on several inpatient medical units and closely monitoring progress and outcomes.

Raising Awareness of GI Nursing in the Community

The nurses’ work goes far beyond their practice environment. In the community, Carol and Ellen work to raise awareness of GI and perioperative nursing and multiple GI cancers. They are advocates and regular participants in the local 5K walk/run for colon cancer awareness. Additionally, they have organized educational conferences and provided the same support for pancreatic cancer awareness.

Annually, the entire perioperative department of ChristianaCare holds an open house event focused on educating children and families about perioperative equipment, procedures and technology. Carol and Ellen are regular participants in this, highlighting their specialty area and equipment for GI nursing. The children participate in hands-on activities, including using an endoscope and playing “catch the fish” with mechanical controls and technology usually reserved for retrieving colon polyps.

Carol and Ellen also support their local community by volunteering their time helping children at their local churches, fundraising for Paws-For-Life animal shelter, and participating in the Turkey Brigade for the local Rotary club.