What to Expect on Your Shadow Day: Foot-in-the-Door post #5

keywords:  hospital practice, prospective hospital-practice integrative health practitioners, students of East Asian Medicine (acupuncture), integrative health students, shadowing health care practitioners, preparing for hospital practice, shadowing in hospital practice setting, shadowing hospital-based providers, the tradition of clinical observation

This is the fifth in the blogpost series answering the question:

"How do I get my foot in the door of hospital practice?"

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Quick overview

• First, make sure you have the basic requirements covered
• Then, preparation.  
• You must enrich your foundation, pack a trail bag, and find your trail guides.
• Your first expeditions are to develop the basic stepping stones into successful hospital practice, shadowing and volunteering.  
• These stepping stones are used throughout your hospital practice career to learn and grow.  So, become familiar with these stones and do not neglect how much easier they make crossing streams or rivers vs. wading in without a trail guide or path to follow.

Acronyms and Definitions
Shadow = a unique and very old tradition of clinical observation, often short-term.  Not the same as an internship.
EAM = East Asian Medicine.  Broad term that includes Traditional Chinese Medicine (TCM) and related disciplines.
EAMP, and L.Ac. = terms for a practitioner who has completed an ACAOM-accredited master's or doctorate program and has a current state license.  EAMP = East Asian Medicine Practitioner.  L.Ac. = Licensed Acupuncturist.  L.Ac. is the most common state license title in the U.S.
MD = medical doctor, physician
PHI = protected health information
Patient Privacy Laws = laws that protect patient privacy.  There is U.S. federal law and then, usually, more specific or detailed laws at the state level that add on to the federal law.
HIPAA = U.S. federal law on health information privacy, accountability, and accessibility.  It is the Health Insurance Portability and Accountability Act (HIPAA).  For more information, go to this post.
Minimum Necessary = Usually refers to the "minimum necessary standard", a standard within the HIPAA Law.  Refers to restricting communication about PHI to the minimum need-to-know elements.  

What is Shadowing?
Shadowing is the unique and very old tradition of, with pre-approval, quietly observing a professional working a typical shift/day.  In this case, shadowing is clinical observation of a health care professional.  Shadowing is usually short-term and not the same as an internship.

www.thehospitalhandbook.com

What to Expect on Your Shadow Day

So, you have connected with your hospital-practice mentors and other hospital-practice providers you are interested in following through a full or partial typical clinic day.  And, you have set a date and time to shadow this provider.

While every facility varies, here is what to expect on your first day shadowing a hospital-based healthcare practitioner/provider:

• First, have very clear permission from the practitioner to do this.
• The practitioner will direct you to where to park and sign in and meet them.¹
• Dress professionally for your shadow.  
• To review, basic professional dress for this situation is: dress pants and dress shirt, closed-toed shoes, hair pulled away from your face, and no strong smells that may trigger patient allergies (perfume, cologne, essential oils, some shampoos, lotions, and food odors).
• Identification badge.  Many facilities require you to sign some privacy policy paperwork and wear an identification badge, even if the badge just says "visitor".  
• Privacy paperwork will include HIPAA compliance paperwork.
• Bring a print book to read.
• Bring a blank notebook and pen. 
• Then, follow closely (shadow) your practitioner.  They are responsible for you and your behavior.  Be polite and respectful.
• Do not ask questions in front of patients.
• Be prepared to wait.
• Do ask questions in the appropriate space, like in the provider's office, outside of the provider-patient direct interaction.  

¹If you shadow in a federal facility located on a base, an entirely separate set of rules applies.  

Discuss with your mentor-shadow how to have access/permission to enter the base as well as permission to shadow.

Bring a book to read in case your shadow-day involves more waiting than shadowing.  It is likely you will need to leave your smart phone/cell phone in your car or locker, so don't depend on having it available for any down-time. 

Bring a blank notebook on your shadow day.

You can bring a notebook to take notes for yourself, but you cannot write anything in it that falls under the privacy laws like protected health information (PHI).  

At the end of your shadow time, double-check that you have no PHI in your notebook.  If you do, just inform your practitioner and ask where the nearest office shredder or burn bag is for those items.

Do not take such notes home with you—that would be a Privacy Law (likely also HIPAA) violation and you or your shadowed practitioner could be fined.  Violations of Privacy Law carry hefty fines.

The Waiting Place:  When the Patient Says "No"

The provider you are shadowing is required to introduce you to each patient and request patient permission/consent for you to observe.  Sometimes the patient will say "no"  to you entering the room and you will not be allowed to observe that patient-provider interaction.  Sometimes an office situation will come up that is private or confidential and you don't need to know. In that case, the provider may tell you to wait outside the room or in the provider's office.

While you are waiting, review your notes or read that book or research paper or the latest issue of Meridians you brought along.

Post-Shadow Observation Day

After shadowing, write your provider a thank you note.

Repeat the shadow (clinical observation) process regularly.  I recommend shadowing any practitioner whose work you are interested in.

Stay tuned for the next post, As a New Employee, Shadow Your Team Before You Start Clinical Work.

copyright Megan Kingsley Gale.  all rights reserved.

Do not reproduce without author's written permission

Review the previous posts in this series

1. Basic education and licensing requirements before applying for hospital-practice work
2. Benefits of shadowing healthcare practitioners
3. Pack Your Trail Bag--tools you need for the journey and how to develop stepping stones
4. Find Your Trail Guide--the importance of having in hospital-based practice mentors and introduction to the stepping stones of shadowing/clinical observation and hospital-based volunteer work

Want to pre-order a pdf of this entire blogpost series?  Order here.

Today's resource recommendations

• Review the previous posts in this series (see the list in above paragraph)
• Need some reading material to help pass the waiting time on your shadow day?  
• Check out these books

• Learn about the philanthropic movement of integrative medicine into mainstream medicine
• Recommendations for the health care provider or graduate student learning about hospital-based integrative health basics and analogies for the East <-->West paradigm bridges
• For keeping up with research:
• Subscribe to Meridians print edition
• Subscribe to Evidence-based Acupuncture's EBA Connect program and print one
  of their papers to read on your shadow day. 
• Review HIPAA, and what is defined as "protected health information (PHI)"
• Sign up for the Hospital-practice Handbook Project email newsletter

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