By Tom Clegg
The new Hunterdon Reflux and Motility Center at Hunterdon Medical Center in Flemington, N.J., led by gastroenterologist Anubha Sinha, MD, is helping some long-suffering patients finally resolve their health problems.
Instrumental to that process are the nurses under the direction of Assistant Nurse Manager Doreen Fair, RN, who say their most important role is gaining the trust of patients undergoing sometimes uncomfortable procedures. Fair said more than half of her nurses are certified by the Society of Gastroenterology Nurses and Associates. The center handles adult outpatients and inpatients showing symptoms such as heartburn, swallowing disorders, gastroesophogeal reflux disease — known as GERD — and chest pain not caused by cardiac issues.
“The patients are very excited they’re getting help,” said Lorraine Casterline, RN. “They’re not getting relief or answers, so these tests are providing raw information to the doctors and a path they can follow to get help for their problems.”
Ellen McCusker, RN, said the testing procedures the nurses have learned, or are in the process of learning, include esophageal manometry, to assess pressure and motor functions of the esophagus; 24-hour pH monitoring, to determine whether a patient has GERD, laryngopharyngeal reflux disease or nonacid reflux disease; and wireless Bravo pH monitoring, to test for GERD. The test results are analyzed by Sinha before recommendations for treatment are made.
“So far, I’ve been very surprised how cooperative the patients are [with the procedures],” McCusker said. “They really want answers.”
With esophageal manometry, a flexible probe is passed through the patient’s nose and into the stomach to measure the function of the lower esophageal sphincter.
“As we’re running the program, they can only swallow so often,” said Henri Ryan, RN. “It’s not a difficult thing, but it really takes concentration on their part. So they need a lot of reassurance.”
To keep patients from swallowing too often during manometry, after each swallow, the nurses tell patients to put their tongue to the roof of their mouth. This makes it impossible for them to swallow until told to do so again.
The need to make patients feel at ease is a big reason two nurses are involved with each patient during a procedure. Fair said that allows one nurse to always be focused on the patient’s comfort level while the other is focused on carrying out and completing the test.
With the 24-hour pH monitoring, a probe is passed through the patient’s nose and into the stomach, but with this procedure the probe remains inside the patient for a full day. Casterline said as unpleasant as that sounds, it does have a bright side.
“The nice thing about that,” she said, “is we tell the patient if you’ve been avoiding alcohol, chocolate, caffeine, whatever makes your acid reflux flare up, we say go ahead and try those things because we want to see what’s happening.”
Tom Clegg is a freelance writer.
Nurses help Hunterdon patients find relief at new reflux center
By Tom Clegg