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Vital Signs

"Me and my shadow" is mantra for a new medical student elective

Good doctor-nurse relationships are essential for good health care. But such relationships—often forged in a hectic and stressful environment—have historically been a little rocky. DMS recently established a nurse shadowing program that aims to help medical students build strong relationships with nurses, so they can collaborate more effectively.

The elective course was started by Joseph O'Donnell, M.D., senior advising dean at DMS, and Ellen Ceppetelli, R.N., director of nursing education at DHMC. They got the idea when they co-taught a session of a DMS course called Health, Society, and the Physician. "One of the things that we realized as we were talking to the fourth-year students," says O'Donnell, "was that they really didn't have a good picture of what nurses did and how they added to the health-care team."

Caring: "I started thinking in my mind how could we get these wonderful, caring, holistic young people to think about what role a nurse plays in health care," adds Ceppetelli.

O'Donnell and Ceppetelli wanted the program to be as collaborative as a real doctor-nurse relationship should be. So it was left to the nursing directors, nurses, and participating DMS students to determine how best to structure the shadowing experience. "I think we were afraid of it being too structured—that it would almost be a barrier," Ceppetelli says.

In the course's first offering, this past spring, each medical student had six shadowing experiences—each one lasting between two and four hours. After every two experiences, all parties involved met

Jessica Ash, left, was one of the nurses shadowed by medical students like, here, Rusty Phillips and Laura Shively.

to share information and reactions.

"The biggest asset a physician has is a wise nurse by their side," says Donna Brown, R.N., nursing director of medical specialties, who helped recruit nurses to take part in this initiative. "The nurses were extremely thrilled to know that young med students would be interested in learning about the work of a nurse."

Side by side: Students observed the range of duties that a nurse performs, from monitoring the condition of patients to ascertaining when a palliative-care team should be brought in. "The medical students were encouraged to work side by side with the nurse and to ask as many

questions about what was happening with the patients as well as [about] the processes . . . involved in nursing," says Brown.

Students had a variety of reasons for enrolling in the elective. First-year student Laura Shively was aware of poor doctor-nurse relationships. "I come from a family of doctors and nurses so have heard experiences from both sides," she explains.

"I knew it was going to be clinical time in the hospital, and so I wanted to be able to interact with patients," says Shively's classmate Rusty Phillips. Normally, first-year students don't have a chance to work with hospitalized patients.

Upon completing the six experiences, all participants attended a dinner hosted by emeritus professor Frances Field, M.N. "She was the first nurse on the faculty at DMS and has always been a great advocate of nurses and doctors working together to produce good outcomes," says O'Donnell. "At the dinner, I was blown away by the comments the nurses and students made."

"There was no negative, absolutely no negative—they were just delighted because they had this opportunity to work together," says Ceppetelli.

"I thought it was very useful. I would like to see it as a part of a [required] class versus part of an elective," says Shively.

The nurse shadowing experience will be offered again next year as an elective. "You cannot collaborate with people unless you see them as competent," says Ceppetelli. "This is an opportunity to communicate with people and develop trust."

Sion E. Rogers

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