For the past year, the neonatal intensive care units at the Montreal Children’s Hospital (MCH) and the Royal Victoria Hospital (RVH) have been working on clinical harmonization in preparation for their move to a single NICU facility at the Glen site [1]. As part of the process, MCH nurse Kim Ervens and RVH nurse Marnie Chuipka have been working on new protocols that will help the NICU standardize its processes according to best practice guidelines in neonatal care.

While working together, Kim and Marnie began to see an opportunity that would benefit nurses on both teams, one that would allow nurses from each unit to spend the day at the other NICU [2], effectively ‘shadowing’ Kim or Marnie for the day, observing them work and learning about their practice.

Kim and Marnie proposed the shadowing project to their supervisors at the end of the summer, explaining what they were hoping to achieve. By mid-October, they made their first ‘switch’. “Currently, the shadow day participation is on a voluntary basis,” says Kim, “but now that we’ve had at least a dozen nurses take part, word is starting to spread. Our list is getting longer now.”

The shadowing project ties in well with the clinical harmonization process since shadowing allows more and more nurses to see a wider range of neonatal intensive care. "There are differences in our patient populations,” says Marnie. “So when MCH nurses spend the day at the RVH, they see more maternal-fetal medicine, and RVH nurses going to the MCH see more cases involving pediatric specialists. The shadowing helps demystify concerns and answer questions.”

The nurses are given a questionnaire afterwards to get their input on the project. Kim and Marnie also keep their supervisors and managers up to date on the progress. They have found that each nurse comes away with their own experience, which they are sharing with colleagues afterwards.

There is also strong support from other NICU team members. “The shadowing takes place every Wednesday, with a nurse from each unit spending the day at the other hospital,” says Kim. “The neonatologists and nurse practitioners move freely between both NICUs so it’s fun when you hear one of them welcome a nurse to the unit for the day!”