WORKING NURSE: What is your current role in nursing?

DARLA GILLS, RN, BSN: I am the Night Charge Nurse for ICU/CVICU at Chandler Regional Medical Center in Chandler, Arizona.

What led you into this role and specialty?

After graduating in 1989 from the University of Northern Colorado, I began working on a general medical unit at Porter Adventist Hospital in Denver, Colorado. My best preparation was on that unit, as I was able to learn organizational skills, prioritization, and teamwork. After a year, I enrolled in a three-month critical care course that the hospital offered and transferred to the ICU where I was able to broaden my knowledge and skills as a nurse. Within a year of working as an ICU nurse, I had the opportunity to work with open heart patients. My training consisted of two months of classroom time in addition to on the job experience. I have worked with the recovery of cardiovascular patients for 15 years. Throughout my career as a staff nurse, I have been doing relief charge on a regular basis. Two years ago, I accepted a permanent charge position for ICU/CVICU at Chandler Regional Medical Center.

How did you become involved at Chandler Regional Medical Center?

I came to Chandler Regional Medical Center eight years ago with the anticipation of the hospital’s opening of a new cardiovascular program. I wanted to be part of the development and inception of a brand new CVICU. I had the opportunity to be involved with the initial set-up of the cardiovascular program, including ordering equipment and supplies, training ICU nurses for their role as a CV nurse, and developing new nursing flowsheets that are currently used in the CVICU. The unit has been open for four years now and we have had wonderful success in the recovery of our cardiovascular patients.

What does your actual daily work involve in a role like this?

During a 12-hour shift, I am constantly moving. My night starts out with bedside rounding in each unit. This allows me to be in direct contact with both the patients and staff. I am able to assess if there are any concerns that may require my immediate attention. I then review patient charts for audits, follow up with staff needs, begin the next day’s paperwork, review staffing for the next 24 hours, and obtain patient reports from the nurses. To be an active resource to the staff, I deal with family’s concerns, frustrated physicians and ancillary problems. I also coordinate the throughput of all patients in the units by maintaining close communication with the ICU Intensivist.

Additionally, I provide staff education and in-service training on new policies and procedures to ensure that best practice standards are achieved. As a charge nurse, I am able to assist staff from bathing, turning, and transporting, to being an extra hand in emergent situations. I am also able to assist the primary nurse in the initial recovery phase of a cardiovascular patient, as well as respond to all code blue and critical response calls throughout the house. The management responsibilities of the job consist of scheduling, timecards, writing action plans, and assisting with performance evaluations of the critical care staff. I am also involved in several committees throughout the hospital, including the Ethics Committee, the Pharmacy Performance Improvement Committee, ICU/CVICU Operations Committee, and the Super-user/Informatics Committee, all to help improve overall patient safety goals, satisfaction, and outcomes.

Do you have any favorite aspects of what you do?

One of my favorite aspects of being a charge nurse is assisting a staff nurse. This allows me to be clinically involved with patient care. I also enjoy seeing a post-operative patient sitting up in a chair and talking with their family just hours after surgery. It is an amazing feeling to see a patient improve because we have provided outstanding care.

Is there anything that makes your job particularly difficult?

My least favorite aspect of critical care nursing is the untimely death of a patient. As a nurse, I know that everyone will die, but it is still difficult to recognize that with all the medical technologies available today, not everyone will survive their illness.

What recommendations can you make to nurses in this field of nursing?

An individual entering this field should want to learn and absorb as much information as possible. There is no end to continuing education, due to new equipment, medications, protocols, and procedures. They should ask as many questions as they can of their coworkers and supervisors and never back down from a new challenge. Critical care nursing is in constant flux, so learning to adapt and embrace change will make you an exceptional nurse.

FURTHER REFERENCE:

American Association of Critical-Care Nurses www.aacn.org