Student Shadowing Questions

1. Registered Nurse at Grand Strand Hospital on 3East. 3East is a 40 bed Neuro/Telemetry unit.
Mostly stroke patients and patients with chest pain/ heart arrythmias. It is the RN’s responsibility
to work with the patient, the patient’s family and all other members of the health care team
(doctors, residents, occupational therapy, speech therapy, physical therapy, Respiratory therapy,
radiology etc.) to assess the patient, implement, evaluate and coordinate the patients care plan.
a. A typical day starts with my shift starting at 6:30. Arrive, read up
on your patient’s history and reason for admission into the
hospital. Then receive report from the night nurse about the
patient. In report they will tell me patient specifics- what
brought the patient into the hospital, what symptoms they’ve
had. Most recent set of vital signs- (Heart Rate, Respiratory rate,
Blood Pressure, temperature), If the patient is alert and oriented
(person, place, time and situation), where their IV is placed, and
what gauge it is. How they’re Heart Rate and Rhythm has been
on the telemetry monitoring. Any pain/comfort issues. How the
patient ambulates (independent, with a walker, 2 people assist
etc.), any over night emergencies, tests/procedures planned for
during the day. As you can imagine Nurses need to know their
patients inside and out. After report – the madness begins- you
start Head to Toe assessments on all of your patients, pass
medications, coordinate therapies coming to evaluate your
patient, send them down for any scans or tests for the day. You
also need to educate patients on their diagnosis, their
medications and how they work, the plan of care and what they
can expect while they’re in the hospital and what to expect
when they leave. You also need to document everything you do
with the patient and for the patient in their chart. In-between
you may have to call the doctor about a patient- their vitals
might be off, they may be agitated and require medication, they
may have medication that isn’t helping their pain levels. You
may also have an emergency- a patient may have a stroke and
you need to call a stroke alert to get a Rapid Response Nurse to
the patient’s room to help you in an emergency- if the patient is
having a stroke you need to accompany them down to get a CT
scan (have another nurse watch your other patients) and if
they’re experiencing a brain bleed or something critical you
most likely will need to transfer them to the Neuro ICU. You may
also have a patient experience a heart attack or heart attack like
symptoms. It is the nurses responsibility to call the Rapid
Response nurse again-get an EKG (picture of the patients heart
rhythm), give the patient 2L Oxygen nasal cannula, aspirin and
 morphine, and nitroglycerin and send them down to the heart
cath lab to get any blockages in their coronary arteries cleared.
Then there are little things that may not be a pressing
emergency like a stroke or a heart attack- you many need to put
in a foley catheter because a patient isn’t urinating, a doctor
may update a patients orders and you need to stay on top of
that through out your shift- they may order new medications,
fluids, ambulation orders, consults with neurology or cardiology,
etc. My shifts run from 6:30am-7:00pm but more often times
than not I am there from 6:00am and there until 7:30pm
sometimes as late as 9:00pm if I wasn’t able to get my
documentation done during the day.
2) Working conditions associated with my position are
a. high stress.
b. Physical- lifting and turning/repositioning patients in their bed
as well as holding them up to help them walk. Toileting the
patients. Bathing the patients. Hard on your back!
c. I am responsible to pick up 2 Over time shifts a month
3) What I find most difficult and stressful about my job is lately we have
been understaffed. There is notoriously a huge nursing shortage in the
US. Our unit currently we are often taking 7 patients each when the
recommended nurse to patient ratio is 1 nurse to 5 patients. It can be
very frustrating because having 7 patients your day is non-stop hectic, its
borderline unsafe. No time to sit, eat, drink or pee. You are going for
that full 12 and a half hours. It can be even more frustrating because
when you have that many patients, your patients who are sick but very
stable and able to bathe/ toilet themselves and walk- you don’t get to
see them as much or give them that quality care you would like too
because you are too busy with patients, who are quite frankly, very ill
and on the verge of being transferred to an ICU.
4) What I enjoy most about my job is honestly working with the patients.
Seeing someone with a stroke move their right hand for the first time in
weeks when they previously had no movement in it. Or teaching a
patient about their Atrial Fibrillation (heart arrythmia) and seeing the
light bulb go off and they understand their condition and why they’re on
certain medications. Seeing someone smile who has been grumpy
because they’ve been in the hospital for months. Those are the little
moments that make me happy and truly proud to do what I do.
5) In order to be successful in this career you NEED to be a people person.
You need to be able to talk to people of all walks of life, never be
judgmental, and be able to approach some difficult topics. You need to
have good time management skills as well as being able to multitask. I
think its also very important for a nurse to have a positive attitude and
to work well as part of a team. You lean on your co-workers a lot, and
they’ll lean on you.
6) My role in supervision is that there are many things I delegate to
support staff (CNA’s) to help me manage my time better. So the CNA’s
will get my patient’s vital signs, help them to the restroom and bathe
them for me. I depend on them a lot because sometimes they’ll notice
the patient’s urine is funky and they’re often my first tip-off that my
patient may be developing a UTI. They will take vitals for me and I may
delegate them getting an EKG for me. It is my responsibility to follow up
that tasks are done, as well as making sure that I am assigning them
appropriate tasks. CNA’s cannot assess or educate patients. They can’t
pass medications or give treatments or perform any procedures.