Registered Nurse in the ICU Shadowing Proposal

In this proposal, an outline of goals and activities that pertain to shadowing a nurse leader within an ICU setting is presented. The goals and topics of interest are managed in three parts, which are overarching ICU nurse leadership roles, collaboration, conflict resolution in a hospital setting, and professionalism and self-evaluation in performance. Many of the goals are likely to receive a qualitative response, but when possible, a quantitative measurement will be recorded as well. The amount of allowed participation in tasks is uncertain, as such, many of the activities will rely on observation, interviewing, discussion, and possible minimal involvement in assistance tasks.

Shadowing an RN with an advanced degree and a leadership position would be incredibly beneficial. Previous studies have noted improvement in nurse manager and leader involvement after peer-to-peer interaction (Lalleman et al., 2017). This experience would be essential in understanding multiple important aspects of nurse leadership. Some of these goals include comprehending the difference between nurse management and leadership, identification of effective and impactful leader characteristics in a real setting, and observing different leadership types in an actual working environment. There are a number of activities that can facilitate insight into these topics. They can include being present for meetings between the leading nurse and the nursing staff. If possible, interviewing the nurse about their methods of delegation, prioritizing, and evaluation of tasks and staff would be helpful. It would also be important to notice the difference between one-on-one meetings and more general gatherings. To make the goals more quantifiable, it would be crucial to list and contrast the observed leadership characteristics with those that can be found in online and academic sources.

A nurse leader in an ICU setting is the primary focus of this shadowing proposal. Nurse shadowing programs are also likely to assist with defining nursing roles (Johnson et al., 2020). A clinical lead nurse, or CNL, would have a number of responsibilities, but more direct care of a patient in an ICU often presents a one-on-one interaction. The goals would include understanding the approach to patient care in an ICU unit, the methods for task delegations, the reasons for certain health plans, and modes of care evaluation. Evaluation can include the way the CNL assesses their care with available metrics and the care provided by peers and any other staff. Activities that can assist with understanding these processes include observing one-on-one patient care, reviewing and asking questions regarding health care plans implemented by the CNL, and their criteria for evaluations of quality of care and general procedure outcome. If the RN allows it, it would be beneficial to participate in hands-on patient care and attempt a healthcare plan and evaluation based on the RN’s guidelines. It would also be vital to receive feedback.

Nurse leaders are largely responsible for cohesive and advantageous communication within many hospital settings, which can be observed and amplified by shadowing (Walsh, Jolly Inouye, & Goldman, 2017). As such, it would be vital to participate in meetings and activities in which an ICU CNL is interacting with peers and nursing staff. Components of these interactions that are especially important are delegation, conflict prediction and resolution, and strategy formation in response to team dynamics. To better perceive the collaborative working of the ICU, it would be important to ask about and observe the number of daily tasks that are done by the CNL alone and those that are done with other nursing staff or doctors.

Additionally, nurse leaders may have skill sets that allow them to be familiar enough with the work setting to realize what triggers conflict in a collaborative task. This goal would include identifying work barriers, typical causes of conflict, strategies that are already in place that work to resolve it, and other workflow challenges. If possible, it would be helpful to acquire a list of typical colleague-centered conflicts in the ICU and strategies or methods which address them, either through policy or by the CNL’s own initiative. Additionally, asking about their effectiveness and prevention strategies would also allow for important insight.

Another important aspect of collaboration in the ICU would be the formation, development, and management of relationships between the CNL, their peers, and patients (Hailu et al., 2020). The objective would focus on discerning effective techniques for clear communication and workflows that are fair and cohesive. Initially, some of the activities addressing this goal may include partaking in events or meetings which are directed at improving the working relationships between the CNLs and other staff in the ICU. It would also be interesting to ask about strategies that the CNL found effective and if there are any available statistics or sources that can depict the changes in quality of care and collaboration. If it is possible, observing a meeting in which CNLs may discuss transforming methods to improve workplace relationships would further the understanding of their role.

The last topic of inquiry covers professional skills, interpersonal perception, and the self-evaluation of a leading nurse in an ICU. The goals would be to interview about career evolution and development of the shadowed nurse and which workplace tasks assisted most in increasing interprofessional competency (Monahan et al., 2018). From a more technical perspective, it would be vital to understand the responsibilities of a leading nurse in an ICU and to grasp the distinction between tasks the RN will do themselves and which they will delegate. An activity can include observation of daily ICU nursing tasks such as patient observation, recording of specific procedures and medication, assistance to doctors, treatment administration, vital signs monitoring, and ensuring the correct function of feeding tubes, catheters, ventilators, and other life support equipment. It would be beneficial to ask in which cases a CNL may delegate any specific task and their criteria for evaluating the performance of their nursing staff or peers.

Additionally, an observation of the workplace is vital. The ICU is sanitized, well-lit, and adheres to very strict health and safety regulations. As such, questions regarding the work process, upkeep, and challenges of an ICU environment would be important to determine the full spectrum of the CNL’s responsibilities. Another technical activity would be to track the shifting schedules of the ICU and interview about the impact it has on other aspects of the nursing role.

Lastly, one more goal would be focused on exploring the improvement of nurse competency and the factors that influenced it. It would be beneficial to interview the CNL on the elements of the workplace that affected their growth as a professional. These may include a list of technological advancements, learning from senior staff, repeating technical tasks to harness confidence, self-care, and any other aspects. This goal is of a more qualitative nature that can allow insight into the more interpersonal part of a leading nurse in the ICU.


Hailu, T., A., Ginader, A., S., Nigro, A., M., Lee, D., D., & Sze, R., W. (2020). ‘Walk in my shoes’: intradepartmental role shadowing to increase workplace collegiality and wellness in a large pediatric radiology department. Pediatric Radiology, 50, 476–48. Web.

Johnson, C., Khan, A., Stark, S., & Mohammed, S. (2020). A nurse shadowing program for physicians: Bridging the gap in understanding nursing roles. The Journal of Nursing Administration, 50(6), 310-313. Web.

Lalleman, P., Bouma, J., Smid, G., Rasiah, J., & Schuurmans, M. (2017). Peer-to-peer shadowing as a technique for the development of nurse middle managers clinical leadership: An explorative study. Leadership in Health Services, 30(4), 475-490. Web.

Monahan, L., Sparbel, K., Heinschel, J., Wirtz Rugen, K., & Rosenberger, K. (2018). Medical and pharmacy students shadowing advanced practice nurses to develop interprofessional competencies. Applied Nursing Research, 39, 103-108. Web.

Walsh, H., A., Jolly Inouye, A., A., & Goldman, E., F. (2017). Improving Communication Through Resident-Nurse Shadowing. Hospital Pediatrics, 7(11), 660-667. Web.