Who would have thought you’d need a survival guide to assure a safe stay in the hospital? Well, now you know, and after spending four weeks and 2 days (and counting) with my father in the Neuro Progressive Care Unit of one located on the northwest side of San Antonio, I consider myself an authority on the subject. Here is my list of Top 10 Tips to make your or your loved one’s stay a success, or at least not a total disaster.
1. Be your patient’s advocate. Ask the doctors and nurses what’s going. They may not tell you otherwise. Be specific; ask how he was in the night, which doctors have been by to see him, and whether there have been any new doctors on the case. One day you may have a surgeon and an intensivist, and the next your doctor load has increased four-fold, to include a gastroenterologist, a pulmonologist, an internist, and a cardiologist.
2. Don’t let anyone feed you if there’s a sign on the door that says, “NPO.” That’s a Latin abbreviation for “Nothing by Mouth.” Really; it happens.
3. Don’t be alarmed when you discover that the doctor taking care of your loved one is someone you’ve never heard of. This is a new phenomenon in healthcare. Although you may have been admitted for surgery by a doctor you know and trust, he probably will not be your “attending” physician. Now there is someone called a “hospitalist,” or “intensivist,” who contracts with the hospital to oversee the care. Be sure to speak frequently to this person and ask for consults with specialists if you feel they’re needed. And, if a consulting physician causes you to curse violently in the post-op area, it is definitely time to demand a different consultant.
4. Get a second opinion if your gut tells you something doesn’t sound right. For instance, if a doctor tries to talk you into a tracheostomy when your vital signs are stable, it’s time to stall. Or, if a doctor tells you in the pre-op waiting area that he’s going to do a procedure involving insertion of a tube into an organ and you expected it to be inserted into a different organ, definitely stall. Don’t wait until it happens, there will be a complication, and you will have gained an extra week’s stay in your deluxe 9th floor private room.
5. Don’t sign a consent form until you’ve talked to the physician performing the procedure. Common sense, I know, but sometimes the doctor doesn’t want you to bug him with silly questions.
6. Don’t roll your eyes when someone called a “Director of Nursing” comes by the room at a particularly difficult time and cross examines you to see whether the nursing care has been “excellent.” Apparently, this is related to the hospital’s ability to be reimbursed by Medicare, and unless everything is “excellent,” the hospital’s payment for services will be reduced. Apparently, many, many hours of nursing training is taken up with learning this one reality.
7. Don’t be afraid to speak up when you see something that troubles you. If your patient appears unkempt, or is beginning to look like Howard Hughes in his final days, ask the nurse to call occupational therapy to help the patient wash up, comb hair and brush his teeth. If the floor is messy and sticky, ask for housekeeping to come clean up the place.
8. Ask for physical therapy to come work with the patient. If your loved one appears to be wasting away, and his limbs are getting stiff and “feel heavy,” ask the nurse to call physical therapy. And, if a therapist comes in the room and tells you the patient looks too tired, insist that they work with him anyway. Of course he looks tired! He hasn’t been up in 3 weeks! Even if it’s just exercises in bed. Each day spent in bed equals 5 days of rehab, or something like that.
9. Don’t be surprised that you can’t go directly home from the hospital. Today there are social workers employed by the hospital who would like you to extend your stay in one of their comfy rehabilitation facilities where you can learn to “meet your goals,” i.e. go home and live by yourself. Word of warning: these places used to be called “nursing homes.”
10. Be afraid, be very afraid when you see an administrator, a charge nurse and 3 doctors standing outside your loved one’s room. This is usually a sign that something bad has happened and the hospital knows you have a lot of lawyers, and even a doctor, in your family.
I hope none of you will need this list, but if you suddenly find that you do, I hope it empowers you to demand the care that you and your loved one deserve. Keep it in your purse, just in case!