i left my position in a local comm hosp about 5 years ago. We were the very small outpatient surgical dept called endoscopy – basically if a hollow organ needed to be 'telescoped' they were sent to our dept. We were all registered nurses educated/trained in advanced sedation, a few techs & 1 RN manager all overseen by a Gastroenterologist doc with a rotating group of surgeons/pulmologists requesting & using blocks of time. The issues we had with this dept were as follows: one surgeon didnt follow protocol by NOT doing a complete colonoscopy and not spending enuf time searching for Ca ( protocol mandated that the scope reach/touch the cecum and take 6+ minutes to exit the colon- this surgeon complied with neither). Another newish surgeon was horrible at scoping – she just couldnt negotiate the scope adequately around all the curves of the colon and often took 3 hours to complete a 45 min procedure ensuring the patient got much more sedation than would otherwise be necessary. The GI doc who ran this unit AND was overseeing this surgeon's training in endo started having his patients sign their consent form then after sedation would have the newbie surgeon do the proc for practice as the GI doc sat in his office. The last huge issue was that this GI doc was retiring in 2 years time. Gradually we started assisting in many more EGDs – a scope down the esophagus thru the stom to small bowel – than previously. Some weeks we were scheduling 10 EGDs a week – an increase by more than 50%. The increase was so profound I actually contacted my state's oversight med dept & they were interested in investigating this increase. One day we were so pressured for time with so many procs the GI doc persuaded my patient to have an EGD with NO sedation AND no IV! Pretty much unheard of – EGDs are safe but scary – imagine being awake while having a tube placed in & down your GI track! But the doc was in a hurry & shmoozed my/his patient into consenting. To be clear – this small unit ate lunch/break together every day – our RN manager rolled her eyes at all if it- everyone knew and no one would use or send a loved one to the errant doc – this manager and her manager – the surg svcs manager – were also aware of the incomp surgeon filling in for the GI doc – NONE OF IT WAS A SECRET – and all our documentation attested to it – i.e. ” surgeon visualized cecum did not bring scope to cecum”. and it was mandatory for RN to doc # of minutes taken for proc. None of us lied for these people but no one cared because the unit made $ for the hosp. Fast forward to all this then cuts in staff & increase in patient load – lunches not taken- corners cut- tensions increasing & one day I blew! After 120 hours of call time that week i threw my beeper against the wall & quit. Yesterday i met an ex RN work friend by chance. She mentioned her dad died recently of colon cancer – she was shocked because her dad was a fanatic about getting scopes but a cancer was missed. You guessed it – her dads doc was the errant surgeon – although this RN worked next to our unit – in day surg- she wasnt aware of this surgeons reputation. Now im wondering if I could reopen this with a lawyer & admin of hosp. I basically lost my career because the umbrella corp runs all the facil here but how many other patients have suffered needlessly because of their practices. Am i too late to try to get this investigated. FYI that errant surgeon is now their infomatics head & the surgeon who wasnt 'getting it' wasnt recontracted & the GI doc died. I fell into a pretty deep depression but hearing about my co workers dad has reawakened my anger. Thank you in advance.