The expanding role of gastrointestinal nurses—from nursing to professional healthcare
Collins English Dictionary defines a ‘nurse’ as a person who tends the sick, injured, or infirm. This is a stereotypical view of a nurse, and I too collective this thought about the profession until a few years ago.
However, having worked as the editor on a journal dedicated to gastrointestinal (GI) nursing, I have realized that there is much more to the role of gastroenterology and stoma care nurses than tending the sick. To begin with, the field of GI nursing is extensive: it involves gastroenterology, endoscopy, inflammatory bowel disease (IBD), stoma care, and liver nursing. As these nurses build up practice in their field or pursue higher studies, they can go on to become Clinical Nurse Specialists. A specialist nurse provides high-quality, patient-centered, timely, and cost-effective care (Royal College of Nursing (RCN), 2013). And some go a step further.
In the UK, nurse endoscopists are non-medical health professionals who perform minimally invasive procedures (particularly, lithe sigmoidoscopies and upper GI endoscopies) (Swarbrick et al, 2005), removing the necessity of a doctor to perform these, unless complications arise during the procedure. Such a setup has helped increase patient uptake for endoscopic procedures and liberated up the availability of gastroenterologists/consultants to concentrate on high-risk patients and therapeutic procedures (Matthews, 2001).
Another example of specialist nurses who are experts in their field is that of stoma care nurses. Stoma surgery is performed on patients with bowel cancer, IBD, or abdominal injuries, and there are over 100,000 people in the UK living with a stoma (RCN, 2009). In the UK, before a patient undergoes stoma surgery, the nurse explains the entire procedure and outcome to the patient and the site for the stoma on the patient’s abdomen is marked by the nurse. After the surgery is performed, the nurse trains the patient in post-operative care, for example, how to use the necessary stoma appliances and accessories. This surgery can have serious physical and psychological effects on patients, and the nurse helps the patient through the post-operative transition. In the UK’s National Health Service (NHS), since the 1970s, the prescription of stoma care products and education of stoma patients have been performed almost exclusively by the nurse (RCN, 2009).
Nurse specialist roles for IBD and liver care are relatively fresh in the field of gastroenterology in the UK, and with intensive courses in prescribing in their specialty, many of these nurses can become non-medical prescribers, who are licensed to prescribe particular medication.
The role of a GI nurse has evolved considerably. Many times, gastroenterology and stoma care nurses are the only health-care professionals looking after a patient, and this care-giving can proceed for a number of years for patients with chronic diseases. The nurse today has certainly moved away from the stereotypes to not only provide excellent care but also share some of the fountain of the consultants. Florence Nightingale would be proud!
Matthews P (2001) Developing the role of the nurse endoscopist. Nurs Times 97(44): 56
Royal College of Nursing (2009) Clinical nurse specialists Stoma care. https://www.rcn.org.uk/__data/assets/pdf_file/0010/272854/003520.pdf (accessed 25 September 2014)
Royal College of Nursing (2013) RCN Factsheet: Specialist nursing in the UK. http://www.rcn.org.uk/__data/assets/pdf_file/0018/501921/Four.13_RCN_Factsheet_on_Specialist_nursing_in_UK_-_2013.pdf (accessed 25 September 2014)
Swarbrick E, Harnden A, Hodson R et al (2005) Non-Medical Endoscopists. A Report of the Working Party of the British Society of Gastroenterology. http://www.bsg.org.uk/photos/stories/docs/clinical/guidelines/endoscopy/endo_%20nonmed.pdf (accessed 25 September 2014)
Photo: Wikimedia Commons