When a service line team wants to keep up with advanced practice and provide the latest, most effective procedures for patients, it’s crucial to make sure that the nurses and technicians supporting these procedures are knowledgeable and confident in their ability to perform at the next level.

When Sibley’s gastroenterology team was ready to perform a higher volume of endoscopy procedures and add more complex procedures such as peroral endoscopic myotomy (POEM) and endoscopic retrograde cholangiopancreatography (ERCP), nurses and technicians worked together to develop a training program where both types of care providers trained side-by-side.

“Medicine is growing—there aren’t any basic procedures anymore,” says Karen Wolfolk, a gastroenterology technical specialist and the department’s technical coordinator. “We needed to facilitate getting all of the nurses and techs on board with this new medicine and where things are going.”

To accomplish this, the team tapped the seasoned expertise of Mary Rose Hess, a veteran gastrointestinal nurse at The Johns Hopkins Hospital. Hess embedded herself in the department for three months, trained the staff on the best practices for common procedures and also introduced advanced ones to some of the more seasoned team members. She helped them establish a process for cooperative education, training and hands-on practice that will last into the future.

One of the biggest changes to the department is the addition of regular cross-functional training. To capture both the technical and nursing points of view, monthly sessions are overseen jointly by Wolfolk and Leila Swayne, a long-time clinical nurse at Sibley.

“We wanted to create something that would help both the nurses and the technicians become more efficient and more comfortable with endoscopy,” Wolfolk notes.

Swayne says one of the biggest barriers for nurses to perform cross-functional tasks is fear. “Building confidence is key. We help them get over fear by giving them more opportunities to practice and learn. I tell them, ‘The only way you’ll get better is if you keep doing it.’”

“We have more nurses today who are comfortable helping out with the technician role,” says Tameika Langston, director of perioperative services at Sibley. If a technician is busy or not available, more of the department’s nurses stand ready to step in to perform technical tasks during a procedure.

Training on advanced procedures like POEM and ERCP is ongoing, but as time goes on, more and more of the staff nurses are eager to watch, listen, learn and practice, because they are more confident in their day-to-day duties.

The emphasis on training together led to an even greater benefit for the department—a more cohesive team. Wolfolk and Swayne report that the nurse-technician relationship has grown because each now has a better idea of what the other’s role should be and how each person on the team is a needed part of the whole.

“We’ve all accomplished something,” says Wolfolk. “Endoscopy is about everybody on the team. This program has been a really positive addition to our department. Now, everyone is working efficiently and can do what needs to be done in any position.”

The education program has been so successful that Wolfolk, Swayne and another GTS were invited by Hess and the Johns Hopkins Medicine GI team to assist at a prestigious annual hands-on training seminar for specialists from around the region. Next year, they hope to bring even more of the team to share what they’ve learned.