Key Responsibilities and Required Skills for Upper GI Assistant

🎯 Role Definition

The Upper GI Assistant provides specialized perioperative and procedural support for upper gastrointestinal (esophagus, stomach, duodenum) services. This role works across endoscopy, elective and emergency upper GI surgery (open, laparoscopic, and robotic), inpatient wards and ambulatory clinics to deliver safe, efficient, patient-centered care. The assistant partners with surgeons, gastroenterologists, anesthesiologists, nursing and allied health teams to prepare patients, facilitate complex procedures, maintain sterile fields, anticipate surgical needs, document clinical activity, and support quality, training and service improvement initiatives.

📈 Career Progression

Typical Career Path

Entry Point From:

Registered Nurse (RN) with perioperative or endoscopy experience
Physician Assistant (PA) or Surgical Care Practitioner transitioning to GI surgery
Certified Surgical Technologist (CST) or Operating Department Practitioner

Advancement To:

Senior Upper GI Surgical Assistant / First Assistant
Clinical Nurse Specialist — Upper GI / Endoscopy Lead
Physician Assistant specializing in Upper GI Surgery
Nurse Practitioner in Gastroenterology
Clinical Lead for Perioperative Services / Service Manager

Lateral Moves:

Endoscopy Unit Manager / Advanced Endoscopy Technician
Hepatopancreatobiliary (HPB) Assistant
Bariatric Surgical Assistant
Operating Room Educator / Simulation Trainer

Core Responsibilities

Primary Functions

Lead pre-operative assessment and preparation for upper GI patients: perform focused clinical assessments, review imaging and investigations (CT, MRI, endoscopy reports), confirm consent and surgical plans, escalate clinical concerns to the operating surgeon or consultant, and optimize comorbidities prior to anesthesia and procedures.
Set up and maintain the sterile field for upper GI operations and complex endoscopic procedures: select and arrange instruments, laparoscopic towers, insufflation/irrigation systems, endoscopes, retrieval devices and specialty stapling or sealing equipment according to procedural checklists.
Provide intra-operative technical assistance during upper GI procedures (open, laparoscopic, robotic): anticipate surgeon needs, provide atraumatic tissue retraction, assist with exposure, suctioning, electrosurgery usage, pass instruments, assist with stapling devices and vessel sealing, and help control intra-operative bleeding.
Perform advanced surgical-assisting tasks under delegation and local policy: assist with suture placement, knot tying, fascial closure, drain and catheter placement, staple line reinforcement, and facilitate anastomosis creation (when credentialed as a first assistant).
Assist and coordinate complex upper GI endoscopic procedures (EGD, enteroscopy, endoscopic biopsies, hemostasis procedures, and diagnostic therapeutic adjuncts): manage endoscope towers, biopsy forceps, snares, clips, injection devices, and ensure reprocessing and traceability of endoscopic equipment.
Manage perioperative airway and monitoring support in collaboration with anesthesia: ensure positioning, endotracheal tube/tape security, intra-operative patient monitoring, assist with rapid changes in patient status and follow institutional escalation protocols.
Triage and manage intra- and post-operative complications: identify bleeding, leak suspicion, hemodynamic instability or respiratory compromise and coordinate immediate interventions with surgical, anesthesia and critical care teams.
Provide consistent, accurate electronic documentation for all perioperative and procedural care: update operative notes, instrument counts, anesthetic and monitoring records, specimen labelling, and discharge instructions in the EHR in compliance with institutional and regulatory standards.
Coordinate multidisciplinary care pathways for upper GI patients: liaise with oncology, radiology, dietetics, physiotherapy, social work and stoma services to streamline pre-op optimization and post-op rehabilitation, ensuring seamless transitions of care.
Implement and maintain infection control, instrument reprocessing, and equipment safety checks specific to endoscopy and GI surgery: validate traceability logs, sterilization records, and participate in root cause analyses for any breaches.
Lead or support procedural scheduling and theatre planning: prioritize cases, optimize list efficiency, coordinate with anesthetic and recovery units, and manage specialty equipment logistics for complex upper GI lists.
Teach and mentor junior staff, surgical technologists, trainees, and student nurses in upper GI-specific techniques: deliver in-service education, simulation sessions, and competency assessments for instrument handling, laparoscopic set-up and endoscopy preparation.
Participate in clinical governance, morbidity & mortality reviews and quality improvement projects: collect procedural outcomes data, contribute to audit cycles (e.g., anastomotic leak rates, re-admission rates), and lead small projects to improve safety and efficiency.
Assist with specimen handling, pathology submission and chain-of-custody procedures: ensure correct labelling, fixation, documentation of biopsy or resection specimens, and liaise with pathology for urgent processing or intra-operative frozen section needs.
Provide patient education and discharge planning specific to upper GI operations: counsel on wound care, drain management, dietary progression, activity restrictions and red-flag symptoms, and prepare clear, accessible written instructions for patients and families.
Participate in enhanced recovery after surgery (ERAS) protocols for upper GI patients: implement multimodal pain strategies, early feeding and mobilization plans, and monitor adherence to ERAS metrics.
Support emergency upper GI theatre coverage and on-call duties: be prepared to assist in urgent presentations such as bleeding varices, perforated ulcer, or acute obstructive presentations, coordinating rapid theatre mobilisation.
Maintain and credential clinical competencies: keep current with certifications (BLS/ACLS), device-specific training, and hospital privileging requirements for first assisting or endoscopy support.
Use data and informatics tools to track caseload, outcomes, and resource utilization: compile procedure logs, help prepare outcome reports for MDT meetings, and feed data for national audits where applicable.
Ensure compassionate, culturally competent communication with patients and families during pre-op and post-op encounters: deliver bad news sensitively, support informed decision-making and respect patient autonomy and consent processes.

Secondary Functions

Act as a liaison between the operating theatre and ward teams to expedite patient flow and bed allocation needs.
Contribute to policy development for upper GI procedural safety, equipment procurement and standard operating procedures to reflect best practices and new technologies.
Participate in clinical research studies and case series: support recruitment, collect procedural data, obtain and document informed consent, and assist with trial-specific procedures under supervision.
Support service-level planning by forecasting instrument, consumable and staff requirements for specialty lists and new service rollouts (e.g., robotic-assisted upper GI surgery).
Provide ad-hoc education to primary care and outpatient clinic staff about post-operative care pathways, expected recovery timelines and red-flag recognition.
Lead or participate in departmental simulation training events to practice rare complications (anastomotic leaks, massive GI bleeding) and improve team coordination and response times.
Support telehealth follow-up clinics for post-operative checks and remote monitoring of recovery when clinically appropriate.
Contribute to vendor evaluations and technical trials for new endoscopic accessories, stapling platforms and energy devices, including collecting user feedback and safety observations.
Help maintain a procedural knowledge repository (checklists, quick reference guides, contraindications) to support continuous learning and cross-covering staff.
Undertake occasional administrative duties: rostering support, procurement sign-off within delegated authority, and preparation of clinical governance documentation.

Required Skills & Competencies

Hard Skills (Technical)

Advanced operative assistance in upper GI procedures (open, laparoscopic, robotic) — instrument handling, exposure, retraction, suctioning and assisting with stapling or anastomotic techniques.
Endoscopy support expertise (EGD, biopsies, therapeutic interventions) — endoscope handling, accessory selection, tower troubleshooting, and reprocessing traceability.
Sterile technique, surgical asepsis and instrument/consumable management for complex GI lists.
Intra-operative hemostasis techniques, electrosurgery familiarity and safe energy device usage.
Suturing and knot-tying under supervision; competency in fascial closure and drain placement procedures where credentialed.
Perioperative patient assessment and optimization — ability to synthesize pre-op investigations and escalate risks.
Proficiency with electronic health records (EHR), operative documentation, theatre logs and outcome registries.
Basic airway and anesthesia assistance skills and perioperative monitoring (ECG, invasive lines awareness) to support anesthetic team.
Familiarity with ERAS protocols, wound and drain management, and post-operative complication recognition.
Data collection for audit and quality improvement — ability to extract, interpret and present procedural metrics.
Device troubleshooting and maintenance for laparoscopic towers, insufflators, robotic platforms and endoscopy towers.
Specimen handling and pathology submission protocols specific to oncologic GI resections.

Soft Skills

Clear and empathetic patient-centered communication for pre-op counselling and post-op education.
Strong situational awareness and anticipation skills to proactively support surgeons and improve OR flow.
Team leadership and multidisciplinary collaboration skills to coordinate complex perioperative pathways.
High attention to detail and consistent documentation practices for safety and regulatory compliance.
Resilience and calm under pressure, particularly during emergencies or rapid patient deterioration.
Teaching and mentoring capability to grow junior staff and trainees in technical and safety competencies.
Problem-solving mindset with a focus on continuous improvement and practical innovation.
Cultural competence and ability to work with diverse patient populations and family dynamics.
Time management and prioritization in a fast-paced clinical environment.
Professional integrity and confidentiality in handling sensitive clinical information.

Education & Experience

Educational Background

Minimum Education:

Associate degree in Nursing (ADN) with current RN registration or
Diploma/Certificate as Certified Surgical Technologist (CST) / Operating Department Practitioner or
Bachelor’s degree in a related allied health field with relevant perioperative experience.

Preferred Education:

Bachelor of Science in Nursing (BSN), or
Physician Assistant degree (PA-C) with surgical experience, or
Postgraduate certificate in Perioperative Nursing / Surgical First Assistant accreditation (e.g., CSFA, CNOR, or local equivalent).

Relevant Fields of Study:

Nursing (Perioperative / Gastroenterology streams)
Surgical Technology / Operating Department Practice
Physician Assistant Studies
Biomedical or Clinical Sciences

Experience Requirements

Typical Experience Range: 2–7 years of clinical experience with at least 1–3 years focused on perioperative, endoscopy or upper GI services.

Preferred:

3+ years assisting in upper GI surgery or advanced endoscopy lists, including experience with laparoscopic and/or robotic platforms.
Demonstrable history of participating in MDTs, ERAS pathways, and clinical audit projects.
Certifications: BLS mandatory; ACLS/PALS preferred; CNOR, CSFA or equivalent desirable; endoscope reprocessing and device-specific manufacturer training an advantage.