There are many fascinating occupations we rely on in times of trouble that we don’t really talk about in everyday conversation. In our health sector there are so many avenues a nursing student can choose to follow in their career. In general, we only learn about such specialist nursing roles when we need their service. For this Day in the Life we visited Royston Hospital to investigate one of these specific roles. We met with David Prieto to talk about his work as a Capsule Endoscopy Nurse.
How many years have you been an Endoscopy Nurse? Ten years in total, with five of those years specifically as a Capsule Endoscopy Nurse. As an endoscopy nurse you get to work in a variety of situations: theatre, admissions, procedure rooms. Being a Capsule Endoscopy Nurse I work with patients in a nurse-led procedure where the patient swallows a small capsule that takes photos as the capsule moves through the gastrointestinal tract to the bowel.
This is a very specialised procedure, which involves preparing the patient for the capsule, ensuring good photos will be captured on its journey through the body.
I don’t analyse and interpret the results of the pictures – that’s the job of a Gastroenterologist Consultant. I have worked in both the Philippines and New Zealand Gastroenterology Departments.
Why this profession? When I was growing up, my dad was a general practitioner (GP), and I spent a lot of time watching him and working with him in his practice. His doctor’s clinic was in our house, and I was fascinated by patients coming and going and how my dad treated them so kindly. I then started to get more involved by taking patients’ blood pressures and other simple tasks to help Dad get through his patient appointments. I really looked up to him and his influence on me led me to becoming a nurse. When I graduated as a nurse, a vacancy arose to work in Gastroenterology, and once I started working in this field, I found I really loved it.
What’s the biggest change in your profession over the past 10 years? The capsule procedure is the biggest game changer. Using AI tools and the latest technology to help detect abnormalities, particularly in the bowel, is really significant. The sooner we can detect and diagnose a problem, the less invasive and better the outcomes are from treatment.
The capsule procedure is more accurate, efficient and quicker than previous methods, allowing more patients to be diagnosed in a shorter period of time. It is also more convenient and comfortable for the patient. The images that the capsule takes are very clear now and the capsule itself is getting smaller and smaller, meaning it is easier to swallow.
AI is an enabler in this procedure; it is great at highlighting potential issues as it recognises them.
However, the Consultant is always the last person to analyse all the data and set the course of action for treatment.
What has been the most memorable experience for you? Being part of the team to set up the Capsule Endoscopy Service here at Royston has been great. I love that we can see more patients now and how beneficial the service is to the community. This is the first time that this service can be provided to Hawke’s Bay people through a private hospital, so it’s very new to the hospital, as well as to the community. This also means we can reduce the pressure on the public hospital with this service.
What part of your work do you enjoy the most? I particularly like working with the patients and becoming their trusted nurse in the process of diagnosing their potential illness. It can be an uncomfortable illness to talk about and work through, particularly when you are not sure what will be found through the endoscopy analysis. I like that I can make their journey smoother, reassuring them and assisting them through the whole process.
I also enjoy working with the Gastroenterologists; I learn so much from them. Some of this knowledge helps me to relay more information to the patients.
Describe a typical day. I start work at 7.00 am. I begin by reviewing the notes for the patients due in today and then set up the procedure room ready for when they arrive. I explain the procedure to the patient and get them started with the capsule. Each patient is fitted with a belt, which they wear for the day while the capsule moves through the body. This is what holds the images.
At the end of the day the patient comes back, about 4.00 pm, and I remove the belt and download the photos that the capsule has taken. I then send these to the Consultant for diagnosis. In the middle of the day, I oversee and assist in other colonoscopy and gastroscopy procedures. On a typical day, we would see about thirteen patients for these procedures.
What advice would you give an enthusiast who would want to do what you do? It is a very fascinating field to work in; you get to learn so much about what’s inside you. First you need to study and obtain a Bachelor of Nursing. Once qualified, you can apply for endoscopy positions, with further learning happening on the job. There are always extra projects that assist your learning once you start.
What do you find is the most challenging aspect about your job? When we find complications in our patients and managing those complications. For example, the patient may have difficulty swallowing the capsule, or there may be other conditions the patient has that may hinder our procedure plan.
What is the funniest experience you have seen or been part of in your career? My patients always laugh when I tell them about the end life of the capsule. When I am setting up a patient with a capsule procedure, I have to inform them that the capsule is designed to go through the bowel and end up in the toilet: “Please don’t bring it back to me, flush it away. We can’t use them again.”
Some patients’ faces show how relieved they are, as they think they might have to retrieve it!
What do you think the future changes will be in your profession in the next 10 years? I think AI will continue to improve our procedures, with smaller capsules that take even better pictures. I think nurses will be able to participate more in diagnosis, taking some pressure off our Gastroenterologist Consultants. They are currently beginning to do this in some other parts of the world, due to the shortage of Consultants.
