1. Wright, Kathy B. PhD(c), RN, CGRN, CS

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As a nursing faculty member, I must tell you nursing programs in the United States are confronting tremendous challenges to provide students practical, valuable learning experiences within a very short period of time. Nursing courses typically focus on medical-surgical, parent-child, pediatric, psychiatric, community, and nursing management in both classroom and clinical settings. Tight staffing, higher patient acuities, shorter patient stays, and transitions from inpatient to outpatient community settings have provided a challenge for academic educators to consistently and efficiently provide effective clinical experiences for nursing students. The gastroenterology specialty, however, provides many of the opportunities undergraduate students need to experience a broad perspective of nursing practice. During my former responsibilities as a clinical instructor, I facilitated gastrointestinal (GI) endoscopy experiences for each one of my clinical students, regardless of the course I was teaching. The experience was a win-win for all involved.


The GI clinic setting offers opportunities for students to see focused physical assessment, problem identification and management, facilitation of interventions for lifestyle management, and a mix of both acute and chronic patient needs. In the GI endoscopy setting, students are exposed to both the independent and collaborative roles of the registered nurse. The students participate in nursing process in a very tangible way as they assist in admission assessment and preprocedure teaching, participate in intraprocedure assessment and interventions, and monitor patients postprocedure, providing discharge instructions and referrals as indicated.


Students are able to practice technical skills such as medication administration, intravenous catheter placement and therapy, enema administration, and nasogastric tube placement. The application of standard precautions and infection control procedures is demonstrated with students often verbalizing great insight and appreciation for use of these protocols in a "real-life" clinical environment. Teaching opportunities for the management role include exposure to time management; financial issues related to budget preparation, purchasing, and staffing; personnel issues; quality management; coordination of supplies and personnel; systems, and change theories; group dynamics; and communication.


Students in the GI setting are also exposed to the use of research in decision-making as the members of the GI team discuss research findings related to all aspects of patient care. My students often commented on the value of the team approach they witnessed in the endoscopy unit. In many GI settings, not only do students benefit from working side-by-side with a registered nurse, but they are introduced to the contributions other members of the team such as licensed practical nurses, technicians, support staff, and medical staff. One of my clinical students wrote in her clinical evaluation, "Everyone's contribution is valued here. The doctors, nurses, and staff all respect one another and participate together in the patient's care. The teamwork seems to really make a difference." Other students mentioned the vast amount of knowledge the nurses have in the GI specialty. This inspires the students to be active in consistently reading the nursing and medical literature in their own areas of interest.


Another advantage for students who have an opportunity to be in the GI setting is the exposure to nurses involved in professional organizations such as the Society of Gastroenterology Nurses and Associates (SGNA), the Society of International Gastroenterological Nurses and Endoscopy Associates (SIGNEA), and the Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN). References such as Gastroenterology Nursing, SGNA procedure manuals, monographs, and guidelines routinely used within the specialty offer students an opportunity to understand the important role of professional organizations in shaping nursing practice. Nursing staff also role model professional commitment to students as they discuss their professional activities such as certification, poster and paper presentations, publications, and committee involvement both within their hospital setting as well as in the professional organizations they support.


Students are not the only winners in this situation, however. Nursing staff also benefit from the student experience. Despite a hectic pace and workload, the endoscopy nurses who mentored my students stated they felt they were contributing to the development of the discipline as they mentored each student. They saw an opportunity to make a direct impact on the student's practice through role modeling and providing useful insights into patient care. One nurse who specializes in therapeutic endoscopy voiced his satisfaction at being able to facilitate a practical look at how rewarding clinical practice can be, even in a demanding environment.


Working with students provides nurse preceptors a unique opportunity to market the GI specialty to students who may consider incorporating GI nursing practice as a future career goal. Nurses also find student questions challenge them to justify their actions and motivate them to stay current with standards, guidelines, and nursing literature. Students are also a wonderful source of information for the new ideas and paradigms that are occurring currently in nursing.


As the need for professional nurses continues to increase at an alarming rate, nursing faculty will continue to search for meaningful clinical experiences. The GI setting provides a unique environment for nursing students to experience a broad application of the nursing role. If students are not yet active in your unit, seek out nursing faculty who are interested in the benefits the GI setting offers to students. Market the learning opportunities available to students in the GI setting and actively recruit students to your unit. I suspect you'll find that not only do the students have a fantastic and memorable experience, but you will enjoy some rewards along the way!