Overcoming challenges in gastrointestinal nursing

It was Benjamin Franklin who famously said that by failing to prepare you are preparing to fail. Financial pressures coupled with increasing demand within the NHS have changed the landscape of the nursing workforce, moving towards a skill mix consisting of vaster numbers of trained but unregistered staff. Within endoscopy these challenges coupled with the introduction of new and ever more complex technologies and quality standards leading to the accreditation of services have resulted in a maelstrom of changes both to the skill mix and culture within the nursing workforce that if not prepared for and managed appropriately risks being catastrophic both for patients and services alike.

When the British Society of Gastroenterology Nurses Association (BSGNA) as representing the endoscopy nursing workforce set about reviewing the outdated workforce guidance document it became quickly apparent that the changes in workforce over the intervening years necessitated a complete rewrite of the document. It was at this juncture that the variances in skill mix between devolved nations and units including how staff were deployed within units was going to make this a challenging task in producing a consensus document. 

The resultant document was reached after addressing issues of considerable complexity and involving many interested parties across the specialty and nations. There was however universal agreement on the basis for the guidance. Firstly that no matter where the service is delivered every patient has the right to be treated with respect and have the right procedure for the right indications that is delivered by people with the knowledge, skills and competence to make judgements that are in their best interests and secondly that there can be ‘no one size fits all’ with regard to staffing in endoscopy but rather that it is based on each individual service (environment, procedure type, patient’s health status). The latter undoubtedly was the most challenging in offering recommendations, points for consideration and signposting service managers and providers struggling to meet both present and future service needs but without being prescriptive as to how that is achieved.