Job Shadow Application

Your application is reviewed by qualified hospital staff, and is our first experience with you. For this reason, it is important to be thorough and accurate in your answers. Please use proper capitalization and punctuation.

In the application, we use extended response questions to best evaluate comprehension of the materials you need to know before coming into the hospital. Each question requires a response that indicates you've read and understand the material.

Follow these guidelines to ensure your answers are complete and adequate.
  • Use your own words - copying and pasting answers is not acceptable.
  • Answer all questions - your application will not be processed unless it is complete.
  • Submit a full answer rather than a one-word answer or a list when a summary or description is required.

This information will be kept confidential and used only in conjunction with this program.

Salem Health Mission: To improve the health and the well-being of the people and the communities we serve.

Salem Health Vision: Exceptional Experience Every Time

Salem Health Values: Excellence, Accountability, Integrity, Caring, Teamwork

Healthcare Infection Prevention – Best practices for preventing healthcare associated infections (HAI’s) are related to hand hygiene. The single most important factor for preventing the spread of infection is proper hand hygiene to protect our patients and ourselves.

The Joint Commission requires hospital compliance with the World Healthcare Organization (WHO) and the Center for Disease Control (CDC).

All staff including visitors should wash or decontaminate BEFORE and AFTER each patient visit. Hand hygiene should also occur after gloves are removed.

Safety is responsible for managing three areas of the Environment of Care; Safety and Health, Fire Prevention, and Hazardous Materials & Waste. Keeping the hospital in compliance with DEQ, OSHA, EPA and DOT rules is one major component of our safety management program.

Security can be contacted by calling from a Salem Hospital phone to 40311 (routine) or 40911(emergency calls).

Violence Salem Health has a “Zero Tolerance” policy against violence in the workplace. Violence may be in the form of physical altercations as well as verbal (i.e. threats)

All violence is to be reported via;
       – Patient Safety Alert (PSA) – Security – House Supervisor

Visitors do not have the right to visit, they have the privilege which can be revoked for specific reasons (i.e. infection control issues, interference with care, court orders, disruptive behavior, etc. CMS 428.13).

Emergency Codes Each observer will be exposed to the code system and should remain with the person they have been assigned in the case of a code. Said staff person will provide observer additional information as needed.

By clicking the OK button I acknowledge that I have read and understand everything in this window.

Read the following before completing your application.

The mission of Salem Health is to improve the health and well-being of the people and community we serve.

Emergency preparedness: All approved observers will be given a name badge with our emergency codes on the back for the career exploration experience. Should a code be called observers are expected to follow the directions of the healthcare provider. For example, a code blue in the room requires the observer to follow the direction of the person one is observing. In this instance the health care provider will ask the observer to step to the back of the room or out of the room depending on the situation.

Prevent the spread of germs: Our policy is that upon entering and exiting a patient room everyone must use the hand sanitizers located on the outside of door.

Observation experience – This experience is an opportunity for to view a healthcare professional in their work setting. The observer will be able to ask question and view the health care provider’s work. Physical contact and any direct care (i.e. pushing a wheelchair, helping a patient stand up, taking patient blood pressure, etc.) with patients, is not permitted as part of this experience.

Career Goals

School or Organization Information




Your availablity

In the hours available column enter the time you are available on that weekday. For example: 08:00 - 15:00 or 8AM to 3PM

Day of WeekHours Available

Application Questions


What is confidentiality? Why it is important for you to keep patient information confidential at all times?

What is the best way to prevent the spread of germs at the hospital? What steps must you follow to avoid spreading germs during your job shadow?

List up to three areas of the hospital where you would like to job shadow. List your first, second, and third choices. These selections will determine where you are scheduled to job shadow.

What should you do if there is an emergency situation in the area at the hospital where you are job shadowing?

Why do you want this experience? Why should we provide this experience for you?

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