{"id":9891,"date":"2017-03-14T08:35:18","date_gmt":"2017-03-14T14:35:18","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=9891"},"modified":"2020-06-16T09:59:36","modified_gmt":"2020-06-16T15:59:36","slug":"a-morning-in-their-shoes","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/a-morning-in-their-shoes\/","title":{"rendered":"A morning in their shoes"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_9893\" aria-describedby=\"caption-attachment-9893\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-9893 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway.webp\" alt=\"First-year resident Austin Fain is shown with RN Jimi Killen in this photo during a morning in the Medical Unit at Poudre Valley Hospital as part of the residency program there.\" width=\"300\" height=\"215\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway-300x215.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway-1024x732.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway-768x549.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway-150x107.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13080013\/resident_shadowing_nurse_hospital-hallway-200x143.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-9893\" class=\"wp-caption-text\">First-year resident Austin Fain, center, shadows RN Jimi Killen for a morning in the Medical Unit at Poudre Valley Hospital as part of the residency program there. Photo by Kati Blocker, UCHealth.<\/figcaption><\/figure>\n<p>After only a few hours working the floor as nurses, a handful of aspiring physicians realized their hospital colleagues handle a lot more than they ever imagined.<\/p>\n<p>\u201cI was amazed by the logistics of their workflow and how they prioritized all their patients\u2019 needs,\u201d said Beth Johnson, a first-year resident with the <a href=\"https:\/\/www.uchealth.org\/professionals\/residencies\/family-medicine-residency-program\/\" target=\"_blank\" rel=\"noopener noreferrer\">UCHealth Family Medicine Residency Program<\/a> \u2013 <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-poudre-valley-hospital\/\" target=\"_blank\" rel=\"noopener noreferrer\">Poudre Valley Hospital<\/a>.<\/p>\n<p>Early on a Tuesday morning, seven first-year residents \u2014 fresh out of medical school \u2014 met with Transitional Care Registered Nurses Andrea Hooley and Jennifer Nolte to discuss the plan for the day. Each resident would be working with an RN that morning \u2014 not as a provider, but as an observer.<\/p>\n<p>\u201cPhysician education has developed so separately from nursing,\u201d said <a href=\"https:\/\/www.uchealth.org\/professionals\/residencies\/family-medicine-residency-program\/\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Kristin Andreen<\/a>, a faculty physician. \u201cWe want these residents to understand what it\u2019s like to be a nurse, and by gaining an appreciation for that role, it fosters better communication and better patient care.\u201d<\/p>\n<p>The residents arrived to meet their respective nurses after the 7 a.m. shift change. Resident Austin Fain watched Registered Nurse Jimi Killen look over the charts for the medical unit. \u00a0Killen explained how he looks for sepsis markers, described how he scores patients and the tools he uses when the unit becomes exceptionally busy.<\/p>\n<p>\u201cIt\u2019s about looking ahead to anticipate the patient\u2019s needs,\u201d Killen told Fain. \u201cAnd it\u2019s about making sure basic needs, like eating breakfast, are met, not just the nitty gritty.\u201d<\/p>\n<p>Killen has worked at PVH for five years. He participated in the shadowing program last year as well.<\/p>\n<p>\u201cI think it\u2019s helpful for the residents to understand how the nurse workflow works,\u201d he said. \u201cWe are part of the entire spectrum of patient care, from medications and assessments to basic activity and daily lifting. We are not just going in and giving meds. There is a lot of patient contact involved with feeding and helping them with the bathroom as well.\u201d<\/p>\n<p>That point wasn\u2019t lost on the residents, who debriefed with Andreen and the Transitional Care nurse team after their morning shift.<\/p>\n<p>\u201cThe time they spend (with patients) is so much more than we get,\u201d said first-year resident Audrey Hall. \u201cIt\u2019s so much more of a caregiver role \u2026 and they are charting a lot.\u201d<\/p>\n<p>To this end, the residents related thoughts on how to use that patient-nurse relationship to help improve patient care.<\/p>\n<figure id=\"attachment_9892\" aria-describedby=\"caption-attachment-9892\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-9892 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer.webp\" alt=\"PVH Medical Unit RN Jimi Killen is shown in this photo discussing his job with shadowing first-year resident Austin Fain and UNC nursing student Julia Knox.\" width=\"300\" height=\"203\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer-300x203.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer-1024x692.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer-768x519.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer-150x101.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/03\/13075939\/Resident-shadowing-nurse_computer-200x135.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-9892\" class=\"wp-caption-text\">PVH Medical Unit RN Jimi Killen, center, discusses his job with shadowing first-year resident Austin Fain, left, and UNC nursing student Julia Knox. Photo by Kati Blocker, UCHealth.<\/figcaption><\/figure>\n<p>\u201cI didn\u2019t know nurses did such thorough physical assessments,\u201d commented one resident. \u201cI thought they just listened to the patient\u2019s heart and lungs. I could use that information later in the day when I have a lot going on to see how the patient is doing.\u201d<\/p>\n<p>The group discussed document flowsheets or possible rounding solutions to foster that communication between nurses and physicians. Another resident said they weren\u2019t aware of SBAR until that morning.<\/p>\n<p>SBAR \u2014 or Situation, Background, Assessment, Recommendation \u2014 is a tool nurses learn in school to effectively communicate to doctors and other medical professionals the status of a patient or their situation, Andreen explained.<\/p>\n<p>The residents agreed they could use this tool by asking a nurse to give them the \u201cSBAR\u201d when things become unclear during a conversation.<\/p>\n<p>The residents also realized how they may be able to make nurses\u2019 jobs a bit easier as well \u2014 at least when placing orders.<\/p>\n<p>\u201cI learned that if I can just put in diet and pain medication orders, and code status for new admits, it would make the nurse\u2019s job a lot easier,\u201d said one resident in the debriefing.<\/p>\n<p>An order is much more than just pressing a button, they agreed.<\/p>\n<p>\u201cI was surprised by the amount of time it took to perform one order,\u201d said resident Mia Snapp. \u201cFrom acknowledging down to the explanation to the patient, it\u2019s very tedious.\u201d<\/p>\n<p>It was something that resident Anna Bagby learned last year while shadowing a nurse and has adopted into her daily practice as a second-year resident.<\/p>\n<p>\u201cAfter seeing the nurses run back and forth to fill different orders, I decided that I would keep in mind the timeline,\u201d she said. \u201cIt seems so simple, but making sure I put in orders at the same time so that medications can be taken together is important, and it was something I ignored before shadowing.<\/p>\n<p>\u201cAnd, I also always remember to thank them.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>After only a few hours working the floor as nurses, a handful of aspiring physicians realized their hospital colleagues handle a lot more than they ever imagined. \u201cI was amazed by the logistics of their workflow and how they prioritized all their patients\u2019 needs,\u201d said Beth Johnson, a first-year resident with the UCHealth Family Medicine [&hellip;]<\/p>\n","protected":false},"author":2164,"featured_media":9893,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[401,2182],"class_list":["post-9891","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-family-medicine-residency-program","tag-uchealth-poudre-valley-hospital"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - 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