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pmcgregor

Dr. Wang is right on the mark. They could not have done an adequate exam on the pull out, no matter how fast they got to the end point, the ileum. I feel really sorry for these patients, and disgusted with the 'gastroenterologists' who sacrificed speed for accuracy, with death standing at the door, for many. As an endoscopy nurse, I am really grateful for the integrity of the physicians with whom I worked. They received a 'stipend' to direct the medical affairs of the department; I doubt if it went above $30,000 annually. But the hospital also had a nurse director (me), on salary, and most of the day to day details were handled this way, leaving only purely medical decisions to the medical director. Very efficient, and kept self interest at a standstill.

First, I worked in endoscopy for over 20 years. I am floored that this physician was able to perform 50-60 procedures per day with just 2 procedure rooms. We allowed a minimum of one hour per patient, to allow for anesthesia, the procedure, clean up, patient stabilization, and to allow for high level disinfection of endoscopes (takes 40 minutes at least if done correctly)

By using certified nurse anesthetists, he is sure that patients are completely 'out', not aware of their surroundings, and can be moved in and out so quickly. (I'd like to say like cattle) They know more than the average nurse, but even the average nurse knows how anti principled their techniques were. Patient advocacy was not in control here, and for that, they deserve the worst they can get. No amount of pressure will drive an ethical empathetic nurse to these actions.

I would absolutely suggest that an authority look into the cleaning techniques of the endoscopes. They need to be dismantled as much as possible, all parts scrubbed with a cleaning solution to remove particulate matter, then rinsed and soaked in a highly disinfectant solution for close to an hour after each use. With the patient volume suggested, and the penny pinching attitude that prevailed, I wonder if the nurses were allowed adequate time for scope disinfection, or did they reuse these also from one patient to the next? Did the clinics spend adequate funds to purchase high pressure cleaning/soaking machines (the standard today)?

With the lady who suffered a perforation--I am not surprised with this. Although a perforation can occur with the best performed endoscopies, this kind of volume invites disaster. Was the object to perform safe endoscopies with efficacy, or was the object to run as many patients through the clinic as possible?

First, I worked in endoscopy for over 20 years. I am floored that this physician was able to perform 50-60 procedures per day with just 2 procedure rooms. We allowed a minimum of one hour per patient, to allow for anesthesia, the procedure, clean up, patient stabilization, and to allow for high level disinfection of endoscopes (takes 40 minutes at least if done correctly)

By using cerified nurse anesthetists, he is sure that patients are completely 'out', not aware of their surroundings, and can be moved in and out so quickly. (I'd like to say like cattle) They know more than the average nurse, but even the average nurse knows how anti principled their techniques were. Patient advocacy was not in control here, and for that, they deserve the worst they can get. No amount of pressure will drive an ethical empathetic nurse to these actions.

I would absolutely suggest that an authority look into the cleaning techniques of the endoscopes. They need to be dismantled as much as possible, all parts scrubbed with a cleaning solution to remove particulate matter, then rinsed and soaked in a highly disinfectant solution for close to an hour after each use. With the patient volume suggested, and the penny pinching attitude that prevailed, I wonder if the nurses were allowed adequate time for scope disinfection, or did they reuse these also from one patient to the next? Did the clinics spend adequate funds to purchase high pressure cleaning/soaking machines (the standard today)?

With the lady who suffered a perforation--I am not surprised with this. Although a perforation can occur with the best performed endoscopies, this kind of volume invites disaster. Was the object to perform safe endoscopies with efficacy, or was the object to run as many patients through the clinic as possible?