I have spent two shifts in an pediatric emergency department in a major metropolitan city this week and the experience leaves me with a sense of how much reform is needed in health care. Some of the reform that is needed has to do with the structure of the system, but some of the reform we need is within every individual in the system. Each of us needs to look within and change how we interface with the system and our patients. Here are some brief reflections on my experiences:

1. As providers, we must remember that the challenges we face in providing care were not created by our patients. They are trying to have their complex needs met by a system that needs reform.
2. Each time a provider feels compelled to ask why a patient did not do “as they were told” or wonders why a family acts entitled to superior service, they would do better to ask themselves what else they could ask that family in order to address their concerns and equip them with the knowledge and skills they need to cope with the illness.
3. Assumptions and judgments are not part of caring.
4. When we worry about visit times or length of stay, and how many patients we have to see, we will miss opportunities to see the whole person that is the patient in front of us. Just because they are in the Emergency room for a specific problem, doesn’t mean we can narrow our understanding of their health problem.
5. The day will go better if you smile at each and every person, shake their hand, and ask them if there’s anything else they need.
6. If the health care system met their needs, the Emergency Room would not be as crowded.
7. Accept people for who they are and leave blame out of it.