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Remember the Patient: My Shadowing Experience

By IHI Open School | Tuesday, March 19, 2013
Becky Ng

MPH Administrative Fellow

Trinity Health in Livonia, Michigan


Dr. Berwick noted in his 2011 IHI National Forum Keynote that when he first got the job at CMS, the best advice he got was to remember the patient.


My background is non-clinical. My MPH is in health policy and management.  My work as an Administrative Fellow focuses on the finances, the operations, and the politics of a large health system. Still, I strive to remember the patient. This is health care, after all, and we should always remember the patient. Shouldn’t this be obvious?


I recently shadowed two nurses: one in the surgical ICU (SICU) and the other in an emergency department. The SICU nurse I shadowed was seamless in her work. He floated from one task to the next, but he took his time when it came to his patients. He was gentle. He asked what else he could do for each patient. One elderly man, feeble and weak, said to this nurse, “You’re so patient with me.”


Was this one of the few places where this person felt truly cared for?


I then saw the hectic shift of an ED nurse. Her patients’ symptoms ranged from vomiting, to a head injury, to a suicide attempt. She, too, was seamless in her work, and took her time with her patients. One patient was solemn and calm, and then started sobbing. Through her sobs, she communicated why she wanted to take her own life. The nurse cared for her and listened.


My shadowing experience reminded of why I love health care so much. It helped crystallize the fact that the work I do is ultimately meant to support patients and the staff that care for them. My work affects the resources, workflow, and operations of a system that ultimately affects the care provided. This might be a typical day for a nurse, but for someone focused on administration, it is not. I was reminded of the human side of health care. I witnessed — and better appreciated — the love and care that clinicians provide. I would highly recommend that non-clinicians spend some time shadowing clinical staff.


I’m young in my career and I’ve still got a lot to learn. I finished my IHI Open School online modules just last year. I’ve almost completed my Lean Six Sigma Green Belt and am on my way to my Black Belt. Process improvement is the path I’ve chosen to improve health care, and I can’t wait to get better at what I do — for our patients.


Dr. Berwick’s words from that 2011 speech still ring in my head: “Put the patient first. Every single deed – every single change – should protect, preserve, and enhance the well-being of the people who need us. That way – and only that way – we will know waste when we see it."

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