Ronald Nickelson

10/19 Job Shadow

I job shadowed the intervention and radiology areas. Specifically, Maria, in the MRI unit,
and a team of individuals in the cardiac intervention unit. First Maria showed me the different
MRI scans she has taken and explained the abnormal things she could see in them. She showed
me different angles of a brain MRI she had taken right before I showed up and pointed to all the
anatomical parts of the brain that I learned in Medical I. For example, the first picture she
showed was a midsagittal scan of the brain and I could clearly make out the medulla oblongata,
pituitary gland, cerebellum, and other parts of the brain. I shadowed Maria until she was finished
with her patient. I noticed Maria made sure the patient was comfortable by giving the patient
music and talking to her every 5-10 minutes. The patient was nervous and asked whether or not it
was safe to get two MRIs within a six month period. Maria calmly addressed this and
professionally told her that it was safe and explained that MRIs use magnets not radiation. Maria
also showed us how powerful the magnet was with a paper ball with 10 paper clips inside of it. I
learned a lot from shadowing Maria like how the health care employees work together. For
example, Maria kept getting calls from a nurse about an appointment for a patient that needed to
be put under anesthesia for an MRI. However, Maria couldn't get a hold of someone who could
apply the anesthesia and decided to move the appointment to Wednesday. This showed me that
the medical field is very flexible which is something I noticed in my other job shadowing
experience with the cardiac intervention team.
After Maria was done with the patient she had told me that it was going to get boring with
her and escorted me to the interventions area. She dropped us off with a cardiac intervention

team that was just getting a patient off the table. At first nothing much was said to me because
one of the team of six were learning to do some of the computer stuff and the rest weren't in the
observation area. After they were finished getting that patient ready for transfer they began
asking me how much I knew about interventions. They told me the basics of how they go in
through the radial artery with a long flexible tube called a catheter. The catheter goes all the way
to the heart through the radial artery and gets in the spot that the doctor wants to check out. Once
in the spot of interest the catheter ejects a contrast that allows the blood vessels to be picked up
on the x-ray. This allows the doctor to determine if a blockage has occurred anywhere in the
heart. After Chris was done explaining, he told me that they were getting ready for another
patient and to stick around. It took about 15 minutes for them to get the next patient into the
room. In the meantime they were listening to music, preparing the room for the next patient, and
learning off each other. Eventually, Chris got up and asked the operating room if they were ready
for the patient and that he'll go get the patient. A doctor had come in to do the actual
catheterization which ended up being the highlight of my day. Melissa (I believe that was her
name) was really nice and tried to explain the steps in the procedure as simply as possible and
what the different screens meant on the observation side. It was all fairly complex but luckily I
had my anatomical and medical words to keep me in the know. I actually managed to score some
points for LakeShore when I told them that when they said LV the first thing that popped into my
mind was left ventricle. This astonished them and they asked me if I was in college. Anyways,
some things I noticed were how close they were interpersonally with each other. The best way I
could describe it was that I felt at home with my friends when they talked to each other. Sadly I
had to leave before the procedure finished but I REALLY didn't want to. Overall, this job

shadowing experience was one of the best things I have ever done. I am so glad I took Medical II
for this awesome experience.
Ronald Nickelson
11/2 Job Shadow
I job shadowed the stress labs this week. I followed Leslie, who was working on the
stress labs at that time. There were only two stress labs that I could have observed during the
time I was there. One was at 9 in the morning and the other was at 9:40 in the morning. So, I was
waiting for an hour and a half in the break room for the first stress lab. All of the nurses who
walked in were very nice to me and talked with me. I noticed some things about the way they
talked to each other and the way they talked to me. For starters, they were all friends. They never
said anything to demoralize each other and were always positive. They managed to find things
that they all could talk about on some level and tried to get everyone involved. Another thing I
noticed was the way they organized things. They used a white board with three different colored
markers to signify the patients that each nurse could take. There wasn't only stress labs up on the
whiteboard, I remember seeing nuclear, tilt, echo, and some other things that I can't recall at the
moment. Luckily this managed to waste enough time to get to the first stress lab.
In the first stress lab I noticed many things. First of all, they asked the patient if I could
observe and luckily she said yes. Next, inside the room there were two major machines that
caught my eye. A treadmill and some kind of scan type of machinery that could look inside the
heart (I never asked what kind of machine it was). They had the patient get up on the treadmill
and had the patient keep pace with the treadmill. Leslie would then say that she was going to
make it rise on an incline and make it go faster. They didn't want the patient to get stressed so

they talked and laughed about an older movie they had all seen. Once the patient's heart rate hit a
certain high number, they asked the patient to roll onto the bed to get some scans quick.
Throughout the entire thing they kept asking the patient if they were experiencing any chest or
back pain to which the patient responded with a yes. After it was all done Leslie showed me how
to read the electrocardiogram for any indications of a bad heart. She told me that the patient
didn't show any significant signs of heart problems. She explained that since there wasn't a
severe drop in any of the humps on the electrocardiogram that the patient was showing normal
heart behavior and that the chest problems were probably just musculoskeletal problems. She
charted the findings on the patient and got ready for the next one. The next one was also being
observed by the doctor who prescribed a stress lab. Sadly, I had to leave during the time they
were doing the patient's stress lab so I didn't get to see it all the way through. However, I still
learned a lot from this experience in how the nurses treated their patients, each other, and even
me.

Ronald Nickelson
11/16 Job Shadow

Today I job shadowed the hemodialysis unit. Immediately upon arrival I realized this job
shadow was going to be unique because the unit was comprised of people from the Phillipines.
The two that I would follow were named Laurni and Arnold and they both spoke real quick. It
was something you had to really get used to in order to understand them clearly. When I first
arrived all they were doing was setting up the machines used for hemodialysis and making sure
they worked. We waited awhile for the first patient to arrive so they started to talk to me. I had to
listen very carefully due to how quickly Arnold liked to speak. Something I noticed was that he
and Laurni had a very close interpersonal connection and that he liked speaking to everyone.
Eventually, the first patient began to be on his way to where we were and Arnold told me what he
needed me to do. He told me that I needed to don my own PPE when I went into the room with
him. Then after we were done he expected me to wash my hands before leaving that room.
The first patient eventually arrived with some guys who were transporting him. I started
to panic when Arnold handed me the gown because I hadnt put one on in a long time. I watched
and mimicked the two I was job shadowing and I succeeded in putting it on. Arnold told me that
the gown was all I needed for this patient because I wasnt going to be touching anything in that
room. He explained to me how the patients that all needed to be in the hemodialysis unit were
victims of chronic renal failure or acute renal failure. He also said that the two main causes of
renal failure were diabetes and hypertension. He then preceded to show me the machinery that he
was hooking the patient up to. He explained that there were two color coded tubes that he was
using to hook the patient up to the machine. The one with a red colored strip on it was for taking

blood from the body and the one with a blue strip took the filtered blood back into the body. I
made the connection that the red was like an artery taking blood away from the heart and the
blue one was like a vein taking it back. Anyways, he explained the mechanics of the machine
that allowed the blood to be pushed through it towards a filtering device. The filtering device was
a cylinder with what looked like to be fabric that had a special solution in it that would cleanse
the blood. Then the blood would be sent back to the patient with some other mechanical part of
the machine. He also explained that hemodialysis patients usually have to stay on the machine
for 3 to 3 and a half hours a day and that younger people dont like committing to that and they
end up dying because they never got treatment. The patient he had then was older and had lost
both of their legs. The patient sometimes sounded like he had so much fluid in his lungs that it
sounded like he was gargling at times. I noticed how the patient couldnt speak when asked
questions so Laurni would go up real close to them and ask the question clearly and repeat it
again. The patient stared at her for a bit and slowly understood what she was saying and finally
nodded their head. When we got done setting the patient up Arnold explained to me that all they
had to do now was monitor the patient from a monitor in the other room. I washed my hands and
dumped my gown in the linens basket and waited for the next patient to come in. It was a real
cool experience to meet them. They were both real nice and showed me some real cool things in
hemodialysis.

Ronald Nickelson
12/7 Job Shadow

Yesterday, I job shadowed John at the biomedical department. He explained that the
biomedical field dealt with all the troubleshooting problems of all the equipment used in the
hospital. That includes all the EKGs and all the patient health monitors that could possibly break.
He told me that in order to figure out the problem he needs good people skills because a lot of
the time the person complaining of the problem doesn't give enough information that could help
him figure out what exactly is causing the issue. He told me the issue could be due to an
environmental interruption, human error, or mechanical error. In the powerpoint he showed me a
lot of things that I didn't fully understand because I'm not up to date on my technology circuit
type of stuff. However, he explained everything fairly well and told me some basic things that
came with the job. He told me that you needed people skills because of situations described
above. Also, he mentioned that you needed an interest in problem solving and a desire to figure
out how things work. It was all pretty interesting but then he took me on a tour of the background
workings of a hospital.
During the tour, I felt as if I had entered an entirely new building. I didn't 100% believe
that we were still in the hospital. He took me through machinery rooms that made sure the
hospital would never stop working to keep the patients safe. He showed me the things you
probably don't ever think about in a hospital. He showed me the engine that would push the
water needed in case of a fire all the way through the building. He then showed me the back up
generators which were needed in case of power failure. He also told me with them that they are

put on a sort of stress test that made sure they could run under long periods of time and still
work. Throughout the tour he took me to different departments that led to the different areas the
machinery was in. I thought it was kind of funny because of how it was basically like we were
going through secret passages. Near the end of the tour he showed me the machine that was
needed to clean the air used in the hospital. It used ultraviolet light to kill bacteria in the air and
redispersed it back into the hospital so the patients and the visitors all got clean air to breathe. I
thought that the inner workings of the hospital was pretty neat and that it was pretty cool that
they had a huge part in the stability of the hospital.

Ronald Nickelson
1/4 Job Shadow

Today I shadowed a nurse, named Angi, who worked in orthopedics. Ill be honest, we
didnt get to see that much. The first thing we did was watch her do a blood sugar test on a
patient. We still had to don gowns when we went in there though. I noticed that Angi had a nice
patient nurse relationship that showed how well she was with people. She talked to the patient
and said what she was doing and then proceeded to talk to the patient and make jokes. She tried
to make the patient as comfortable as possible while she was there and never really rushed
anything. Next, we needed to find someone to help her lift a patient out of bed and onto a seat.
They lifted the patient close to their bodies and carefully set him down on the seat. We left and
started making rounds around the floor. She showed us where all the patients from surgeries
would come for physical therapy and where all the more long term patients were staying. She
told us that the mornings are usually slow for orthopedics and that it isnt until the get the rush of
patients from surgeries that it gets somewhat intense there. Eventually, as we were making our
rounds two new nurses came up to us and asked when they could take a break. She told them to
just take a break whenever and just wait for the call light to be pressed or go check on your
patients from time to time. After that little encounter she sent me and Ashley on break because
there was not much for her to show us.
Later, she got us again and took us to one of her patients rooms. She asked us to just
check up on him every once in awhile and make sure that he doesnt start walking around. Then
the charge nurse saw us and decided to take us on her morning rounds. That was where she
would meet and greet the patients and ask if they have any problems with anything. I noticed that

the charge nurse was really busy. It took us nearly an hour to do the 45 second long chat with
about 8 patients because of how busy she was. She would walk out of one of the patients rooms
and she would need to go do something else for someone. She was stopped a lot by her
coworkers and asked questions. It seemed kind of stressful, but she managed to handle all of it
good. Other than that there wasnt too much to say about orthopedics. We really didnt get to see
much of anything while we were there except for the way the nurses work which was still kind of
interesting for me.

Ronald Nickelson
2/1 Job Shadow

Today I job shadowed nurses in the emergency room (ER). When I first got to the ER I
was dropped off to a nurse who got rid of me the first moment she could. She dropped me off
with another nurse who actually understood what it was like to job shadow since she had to do it
when she was at Lakeshore too. There werent any patients at that moment so we went to a part
of the ER that was setup to learn about caring and documenting for trauma patients through a
printed out powerpoint. There was also a quiz that everyone had to take to make sure that
everyone knew what to do with certain trauma patients. She took one and started to do it while I
read all the powerpoints and tried my best to make sense of it all. We didnt get too far when a
patient came in complaining of chest pain and possibly close to having a heart attack. He was
sent there to be prepared for catheterization in interventions. I was sent to the room he was being
prepared in and was asked to stand in the corner. The best way to explain what was going on is
that it was hectic. There were about five to six people in the room, some of them setting the
patient up for catheterization, some of them getting him ready for transport, some checking his
EKG and explaining what is going to happen. Everyone knew what the other was doing and they
worked fast on their feet. Supposedly that was one of the faster cases that they had with
preparing the patient for catheterization. It was cool to see them working as a team without even
really having to talk to each other. They transported him out and that was the end of that. The
nurse I was shadowing had to do a bunch of documentation after that so I decided to take it upon
myself to try to learn some things with the quiz and the powerpoint that they had.
The powerpoint had a lot of information that challenged my knowledge of common
medical abbreviations and terminology. I really had to know what to look for in order to decipher
the questions and the answers. Luckily, in medical careers we went over a lot of the terminology
and words that I needed to know and I learned a lot. Eventually, she came back and laughed at

me because I was taking the quiz too. When she came back I was close to the same section that
she was in. It was a section where we had to determine if a specific case was a level one, level
two, or non alert trauma patient. We discussed and figured out what trauma levels each one were.
Some of them were very interesting and we didnt really know if it would be classified as a one
or two. One of them had a motor vehicle collision with the person being ejected but that person
had normal vital signs. By the classification sheet it was supposed to be a level two but we
wanted to argue with that and call it a level one. I ended up learning a lot about trauma care that I
had no idea about before. Then something scary happened. A patient came in and was
complaining that he was supposed to get a ride home because of his health insurance. When he
was told to wait in the waiting room he got angry and appeared to be reaching around his waist
and then towards his back. Eventually, the charge nurse got him to leave and everything settled
down but the tension was still there. That was an experience that I would prefer not to happen
again. After that I had to leave and say my goodbyes to my new friends. I had a great time
learning things in the ER that I never thought I would learn.

Ronald Nickelson
3/21 Job Shadow

Today I job shadowed some nurses in the pre op unit. It was extremely slow in the pre op
unit so the nurse that we were going to follow sent us to the recovery unit also known as post op.
This is the unit that handles the patients after surgery. When we got there they had one patient
who had just come out of surgery. He was under some anaesthetics so he was passed out. The
nurse in charge of him had to make keep checking his vitals were all good and that his breathing
was normal. She watched a computer monitor that had his heart rate, the saturated amount of
oxygen in his blood, and respirations. She had told me that the oxygen saturation in blood should
be above 95% or it is a problem. Eventually, the patient woke up very fast. He almost tried to sit
up but the nurse coaxed him back down and explained to him where he was. Luckily, he was
conscious enough to understand that. However, he closed his eyes again and rested for another
minute or two. She told us during that time that the patient must be able to remain conscious for
more than a few minutes and to have normal vital signs and respirations without assistance in
order to be let into the next phase. Eventually, he passed that phase and he was sent to a room
where he had to recuperate a little longer and give a urine sample in order to go home. After that
a lady who used to go take the medical careers class 10 years ago took us back to recovery and
we watched another patient with her.
This patient helped me realize how important communication and patience is. This
patient was older and the anesthetics gave her short term memory loss. The nurses had to talk
clearly and directly to her in order for her to hear what they were saying. However, she would
forget what she was doing and she would ask the same questions over again. The nurse told me
that most patients would not remember anything from recovery and that it is good to just be
patient with all of them. It was cool to see people act calmly and patiently with a person and not
lose their temper over something small like the patient asking the same question over again.

Even though it wasnt an exciting day it still had tons of things to learn and experience if I did
not job shadow.

Ronald Nickelson
4/18 Job Shadow
Today I job shadowed the radiology unit. It was kind of slow so the nurse we were
following just talked to us. She told us that her job has a relaxed pace but it could get busy from

time to time. She showed us the machine and how it can move its angle up or down in order to
take certain x-rays. Then she showed us the lead suits that they had to wear when giving the xray to reduce radiation damage. The suit was about 25 pounds which doesnt seem that bad but
can be an annoyance when standing for hours upon a time. She told us that the only
overwhelming part of her job was when she was assigned to help the OR and the doctors wanted
everything to be perfect. She said sometimes at the OR it is very demanding work. After that a
doctor came in and wanted to take an x-ray of a patients digestive tract. He was checking for
any reflux or blockages. It was really cool because I got to watch as the patient drank a solution
that allowed the x-ray to see what was happening in the digestive tract. The doctor followed the
liquid as it went down the patients esophagus and settled in his stomach. The doctor had the
patient tighten up some muscles to slow down the liquid at certain points probably to get the
pictures for the x-ray more easily. After that we went to the MRI unit to watch Maria.
I was already in the MRI before so we didnt stay there for long. Again it was very laid
back with Maria checking up on her patient every once in awhile. She showed us the magnetic
pull on the small paperclip ball. She told us though that if something as big as a wheelchair got
sucked in there though you could not take it off. The pull would have been too strong to take the
wheelchair off. After, she was done showing us that she sent us back to the interventional unit. I
was extremely happy. We got to observe them using a catheter to check the right pulmonary
artery for any blockages. I learned this time that if they dont hook the catheter right and spray
the solution that helps you see the arteries too hard, then you make rupture an artery and kill the
patient. You have to be very careful when checking if you are hooked on the right spot or not.
Sadly, we didnt get to stay long, but, I thought it was very cool that I got to finish my job
shadowing experience with the same exact route I did when I started back in October.