Health-care Provider (HCP) shadowing

My second HCP shadowing visit provided me with profound insights into how patient-centered care operates in a real clinical setting. Walking through the surgical ward, I was immediately struck by how the clinical associate balanced medical expertise with genuine human compassion. Her approach with the first patient, who had undergone ulcer removal and partial gastrectomy, really opened my eyes to what the biopsychosocial model looks like in practice.

What impressed me most was how she didn't just focus on the surgical site and drainage tubes. When checking the abdominal drain for potential leaks from the surgical joints, she simultaneously engaged the patient in conversation about his readiness to progress from clear to mixed fluids. This wasn't just efficient multitasking, it was a deliberate strategy to minimize his discomfort while gathering essential clinical information. The way she actually asked for his opinion before changing his diet plan showed me that good medicine involves patients as active participants rather than passive recipients of care.

The patient's complaint about the nasogastric tube being uncomfortable could have been dismissed as minor post-operative discomfort, but instead, the clinical associate took immediate action to remove it. This taught me that patient comfort isn't secondary to medical protocols – it's an integral part of healing. When she discovered he hadn't received breakfast and went out of her way to get him some Energade, I realized how small acts of advocacy can significantly impact a patient's experience and recovery.

Observing the second patient with the common bile duct stone removal, I appreciated how the clinical associate included me in her explanations while maintaining focus on the patient. Her reassurance that post-operative discomfort was normal, delivered without rushing despite a busy schedule, demonstrated how effective communication doesn't require extensive time but rather intentional presence. This challenged my assumption that quality patient interaction demands lengthy conversations.

The elderly woman with colon cancer presented a more complex situation that really highlighted the importance of seeking senior guidance. When her surgery was cancelled due to weak bone marrow, I watched the clinical associate immediately consult with the patient's physician rather than making independent decisions. This showed me that recognizing the limits of one's expertise and seeking appropriate consultation isn't a sign of weakness but of professional responsibility. The patient's request for a hug and the clinical associate's willing response broke down my preconceived notions about professional boundaries, showing me that appropriate human connection can be therapeutic.

Learning about vital sign monitoring using the dynamap machine introduced me to the systematic nature of post-operative care. The four-times-daily monitoring schedule and the patient's temperature of 38 degrees being considered normal expanded my understanding of what constitutes baseline parameters in different clinical contexts. Discovering that saturation refers to oxygen levels was just one example of how clinical terminology becomes meaningful through practical application.

The patient with suspected Alzheimer's disease challenged my thinking about dignity in healthcare. Watching the nursing staff treat him with childlike gentleness while maintaining respect made me reflect on how we adapt our communication styles for different cognitive states. His presentation with obstructive jaundice showed me how complex medical conditions can coexist with neurological changes, requiring healthcare providers to address multiple dimensions simultaneously.

This experience fundamentally shifted my perspective on what it means to practice medicine. I realized that technical competence must be paired with emotional intelligence, cultural sensitivity, and collaborative skills. The seamless cooperation between the clinical associate and nursing staff during patient care demonstrated that healthcare is inherently a team effort. Moving forward, I want to develop the ability to see patients holistically – considering their physical symptoms alongside their emotional needs and social circumstances. The empathy and advocacy I witnessed will guide my future practice, reminding me that healing involves not just treating disease but caring for people.

My third shadowing session provided a deep dive into the nuanced world of ward rounds, where I observed the delicate balance between clinical procedure and human connection. I followed a hepatologist, a clinical associate, and a nurse as they assessed post-operative patients. The first patient was recovering from liver surgery. The doctor’s approach was immediately notable; he used his stethoscope to check vitals with one hand while resting the other gently on the patient’s shoulder. This simple act of touch seemed to communicate reassurance and empathy even as he focused on the clinical task. He then meticulously updated the patient’s file, advising the nurse on a specific dietary plan and ordering an X-ray. I was impressed by the organized system of folder holders at each room entrance, which ensured every patient’s information was centralized and accessible, promoting seamless continuity of care across shifts and disciplines.

The next patient encounter highlighted the critical role of interprofessional collaboration and ethical decision-making. We visited an elderly female patient who was exceptionally weak. The doctor explained she had a diaphragmatic hernia, a condition where abdominal organs displace into the chest cavity. He softened his tone significantly when speaking to her, demonstrating an adaptive communication style suited to her vulnerability. Another specialist joined the discussion, and together they decided to postpone surgery until the patient was stronger. This decision, prioritizing her overall physiological resilience over immediate surgical intervention, was a powerful example of patient-centered care and clinical ethics. It underscored the principle that the ability to perform a procedure does not always equate to the appropriateness of doing so.

Further along the rounds, we saw a patient recovering from gall bladder surgery who had experienced a significant drain leak the previous day. The medical team had been concerned, but on this morning, the situation had improved markedly. The doctor did not just acknowledge the clinical improvement; he sat on the edge of her bed, placed a comforting hand on her back, and made a light-hearted joke about her “water breaking.” This use of appropriate humor served to dissolve tension, normalize her experience, and build a trusting rapport. It was a clear illustration of how psychological comfort is actively woven into the fabric of physical care. Finally, we ended with a pancreatic cancer survivor who was in for clip removals after her surgery two weeks ago. She looked healthy and shared a warm hug with the clinical associate, which is a testament to the lasting, meaningful relationships that can form through compassionate clinical encounters.

This experience was a profound lesson in the biopsychosocial model in action. Every interaction addressed not just the biological ailment but also the patient’s psychological and social needs. The doctor’s touch and the use of humor were strategic tools to alleviate anxiety, while the collaborative decision-making for the frail patient ensured her care plan was holistic and safe. The meticulous documentation system exemplified the infrastructure required for effective interprofessional practice, ensuring all team members could contribute to a unified care plan. This session moved beyond showing me what clinicians do, and instead revealed why they do it, highlighting the core values of empathy, safety, and collaboration that all ensure exceptional patient care.

My fourth and final HCP shadowing session provided one of the most impactful clinical experiences yet. I observed a nurse perform stoma care for two different patients. The first was an elderly, tired-looking man with a new stoma following surgery. The nurse gently explained each step before performing it. As she worked, the patient lay with his eyes closed, demonstrating profound trust. I noted she applied an extra layer of waterproof tape to securely seal the stoma bag, explaining that she knew this particular patient needed that extra security for his peace of mind. Most strikingly, she performed the entire procedure without gloves. She explained that when caring for a person in such an intimate way, using bare hands conveys respect and preserves dignity, much like one would do for a family member. She thoroughly washed her hands before and after. The second patient, who had a stoma due to colon cancer, shared a jovial and familiar relationship with the same nurse. They laughed together throughout the procedure, and the patient explicitly praised her skill and caring nature, advising me to learn from her. Later, I accompanied the clinical associate on ward rounds. We saw a sweet elderly lady recovering from a cholecystectomy. The clinical associate checked her bandage, listened attentively to how she was feeling, and placed a gentle, reassuring hand on her belly during the examination. The patient thanked her warmly before we left. 

This experience deeply illustrated the core of patient-centered care. The first nurse’s decision to forgo gloves was not a breach of protocol but a deliberate, humanizing act. It directly aligns with the biopsychosocial model; she was treating the patient’s psychological need for dignity and social need for human connection, not just the biological task of changing the stoma. Her knowledge of the first patient's need for a tight seal demonstrated a level of individualized care that transcends standard procedure and builds immense trust. This trust was visible in the patient's closed eyes—he felt safe. The relationship with the second patient showed how this consistent, respectful care fosters a therapeutic alliance where humour and genuine connection can flourish, significantly reducing the anxiety and stigma associated with a procedure like stoma care. The clinical associate’s gentle touch during the abdominal exam was another powerful non-verbal cue of reassurance, reinforcing the idea that patients need to feel safe and heard as much as they need their physical ailments treated. 

The strengths observed were exceptional. The nurse’s approach to stoma care was a masterclass in compassionate communication and preserving patient dignity. Her method of building trust through personalized care and tactile respect is something I will carry forward. The clinical associate’s attentive listening and reassuring touch were equally powerful examples of holistic care. A potential area for my own growth, which I reflected upon, was my initial surprise at the no-gloves approach. This revealed my own unconscious bias towards a purely clinical, sometimes detached, standard of care. I had to reconcile the textbook protocol with the profound human connection I was witnessing, realizing that true patient-centered care sometimes exists in the space beyond rigid rules. 

This session has fundamentally shaped my understanding of the therapeutic relationship. To integrate these lessons into my future practice, I will always seek ways to preserve patient dignity in intimate care situations.  I will make a conscious effort to learn and remember patient preferences, understanding that small personalizations build immense trust and improve the care experience. This final shadowing experience cemented that technical skill is the foundation of medicine, but it is compassion, respect, and genuine human connection that build the healing space around it.