Roles of the RN

BBFRN, BSN, PhD · Oct 5, 2007

http://www.discovernursing.com/nursing-careers

Go here for a comprehensive list with descriptions of the different areas of nursing.

TazziRN, RN · Oct 5, 2007

don't try to decide right now. your clinicals will take you into each area and you'll have a chance to at least observe, if not actually do pt care. that will help you decide more than looking at job descriptions for each specialty.

and don't be surprised if you think you want one area and end up changing your mind one or more times. that's very common!!

keaton90 · Oct 5, 2007

I was mostly just wanting a day to day description if what the RN does in each specific area.

Thanks

BBFRN, BSN, PhD · Oct 6, 2007

That's going to be pretty hard to do in a nutshell. This is one reason why the general public doesn't understand what we do- it's often difficult to quantify. I'll try, though. An example of a typical day for me when I was an ICU nurse (hearts):

0645- get report on my 1 or 2 patients. 1 if the patient was on continuous dialysis, a balloon pump, a fresh post-op heart, or really sick. Check chart with off-going nurse to make sure no orders were missed.

0700- quick check on my patients (check airway, vitals, etc.). Hourly vitals. Hourly blood sugars and insulin drip titration.

0730- check labs to make sure patient doesn't need any potassium, magnesium, calcium, blood, etc. Write down meds for the day. Check results on any films done that morning. Check for any culture results done.

0800- Assessments on my patients. Check vitals again. Check blood sugar and titrate insulin drip. Check all tubes, monitors, drips, wires, transducers, etc. Zero out transducers. Check urine output, and chest tube output. 'Shoot numbers' (check cardiac output, systemic vascular resistance, etc.). Turn patient. Make sure everything is timed/dated.

0830- Pass meds, round with and update docs, take off and carry out new orders.

0900- Check vitals again. Check BS and titrate insulin again. Bathe patients/change linens. Chart meds, vitals, assessment, etc. Oral care and ET tube care. Care done on all other tubes/lines. Incision and chest tube dressing changes. Change ET tube ties.

1000- Check vitals again. Check BS and titrate insulin again. Turn patient. Straighten up patient's room. Update family on plan for the day, and patient progress. Turn patient. Document. Follow up labs for any potassium, magnesium, etc. given.

1100- Vitals, BS/Insulin. Pass meds. Document meds, vitals, glucose levels, etc. Oral care and ET tube care again. Re-check chart for any orders. Change any lines that need to be changed.

1200- Vitals, BS/Insulin. More meds. Turn patient. Recheck lines, tubes, etc. Re-assess patient. Zero out transducers again. Shoot numbers again.

1300- Vitals, BS/Insulin. Oral care and ET tube care again. Chart assessment, meds, etc. Hopefully, lunch.

1400- Vitals, BS/Insulin. I's and O's: clear out pumps, empty drains. Meds. Turn patient.

1500- Vitals, BS/Insulin. Oral/ET tube care. Document.

1600- Vitals, BS/Insulin. Re-assess. Turn patient. Zero out transducers. Shoot numbers. Recheck lines, tubes, transducers, etc.

1700- Vitals, BS/Insulin. Oral/ET tube care. Make sure room is stocked for night shift. Order any meds that might be needed for night shift. Straighten room again.

1800- Vitals, BS/Insulin. Oral/ET tube care. Meds. Turn patient. Check lines, transducers, tubes, etc. Document.

1845- Report off to night shift.

Throw in some other medication titrations, orders, tests and procedures, visitors, phone calls, complications, and other things like pulling lines, getting people up if they are stable and not on a vent, suctioning, etc. Mix it all in a bowl, and hope everything turns out as you hoped. Go home, fall into bed, and repeat in the AM.

That was the best I could tell it. I hope it gave you some kind of idea!

time4meRN · Oct 6, 2007

Just start with school first. That is enough to worry about . Decide on your choice of career path latter. There's pleny of time for that. I went into school thinking I wanted to do OB, I disliked critical care. When I graduated and got my first job in OB, I loathed it. Now I've done critical care/ ER for almost 30 years. Love it still !

keaton90 · Oct 6, 2007

Thanks Baptized By Fire for your last post it was exactly what I was looking for...

Is there anyone else that wouldnt mind to explain what there job is like in the same way that Baptized By Fire did?? I would really like to have different aspects from all RN's in all different areas.

Thanks

patwil73 · Oct 6, 2007

I can give you a run-down from when I was doing agency (I'll skip ICU since you go a pretty good one of that)

Tele:

1900 - arrive and get report on 5-6 patients (usually group, but sometimes nurse to nurse). Group is longer since you get report on everyone, not just your own.

1930 -- do a quick walk through and check on each patient, making sure they are ok (ie still breathing, not lying on the floor, etc.)

1945 -- review charts to see if any immediate orders or meds need to be given. Quickly review rhythms.

2000 -- start assessing each patient - depending on whether they are in pain, need to be cleaned up or any other time consuming detail this can last and hour or up to 2 hours.

2100 -- pass night time meds, check BS, help turn anyone who can't turn on their own.

2200 -- another quick walk-through, concentrating on pain, bathroom needs, etc. I will also empty foley's now, clear IV pumps and determine if tubing needs to be changed. Chart all I&O's.

2300 -- any room work (tubing, new urinals, more clean-up.

2400 -- Any meds that need to be given, BS checks, then start reviewing the chart and signing off for the last 24 hours. Some hospitals require a cost sheet check where you list activities you did (IV starts, accuchecks, foley insertions, tele monitoring, etc). Make sure rhythms are charted, everything up to date.

0100 - lunch, quick check of patients (pain, bathroom needs, turning anyone who needs it)

0200 -- Review notes written by doctor, see if patient is meeting goals.

0300 -- check patients again (pain, bathroom, turning)

0400 -- morning lab draws, reasses every patient, any meds that need to be given.

0500 -- check labs and call doctor if necessary, finish any charting I hadn't finished yet. Make sure that all IV bags have enough to last at least 2 hours into the next shift.

0600 - morning meds, bs checks, pain meds, bathroom needs, turning, weights, I&O's again, write out what I want to report on.

0700 -- give report

0730 -- home

If no patient is truly needing a lot or calling on the call bell, it can mostly work out like this. The more you get interrupted the longer everything takes.

PCU is mostly the same except less patients.

Med-Surg is mostly the same except more patients, with a lot more opportunity to be interrupted.

Just remember, any time slot can be fatefully interrupted if you have to deal with any emergency or even family calls - little things take up the longest time.

Hope this helps,

Pat