You are a staff nurse on a 32-bed cardiac step-down unit. The hospital obtained Magnet recognition last year. You are assigned as the preceptor for Tony, RN, who is a new graduate nurse, who just started his nursing career on your floor.

·          You and Tony just received morning shift report on your patients. You are assigned the following patients. Which patient do you and Tony need to see first? Explain your answer.

Ø  Mr. Dodson, a 52-year-old patient who was admitted yesterday with a diagnosis of angina pectoris. He is scheduled for a cardiac stress test at 0900.

Ø  Mrs. Wallace, a 60-year-old patient who was transferred out of intensive care at 0630 today. She had uncomplicated coronary artery bypass surgery yesterday.

Ø  Mr. Workman, a 45-year-old patient who experienced a myocardial infarction 2 days ago. He is complaining of chest pain rated as 6 on a scale of 0 to 10.

Ø  Mrs. Harris, a 76-year-old patient who had a permanent pacemaker inserted yesterday. She is complaining of incision pain rated as a 5 on a scale of 0 to 10.

·         As you work with Tony, you notice that he has trouble with organizational skills when providing patient care. What strategies will you suggest to Tony to help him improve in organizing his delivery of patient care?

·         Marianne, a NAP, is paired to work with you and Tony. You overhear Tony giving Marianne directions for what she needs to do. Tony says, “Marianne, in the next hour please assist Mrs. Harris in room 418 with her afternoon walk. She needs to walk 200 feet, which is from her room down the hall to the nurses’ station and back to her room. Take her pulse before and after she walks and record it in her chart. I’ll check with you when you’re finished to see how she did. Do you have any questions before you walk her? Thank you for your help.” Based on what you know about delegation, did Tony give appropriate or inappropriate directions to Marianne? Provide rationale for your answer.