Thursday, April 16, 2009

Insider Tips on Surviving a Hospital Stay

Just visited my husband's grandmother in the hospital today... being a physician gives me a slightly different perspective when I am on the "patient-side".

Being hospitalized is always stressful, even when for a joyous occasion such as for the birth of a child. You're out of familiar surroundings, usually not in the best of health, sometimes in pain, and certainly NOT in control of what happens to you, at least not in the way that you are accustomed to being. You and your family are eager to get home as soon as possible. Under these circumstances, the inefficiencies and "unique" communication issues in our healthcare system can be frustrating at best.

So, here are my insider tips for optimizing communication in the hospital setting.

1) Please be patient. I know, not what you want to hear. But it's important to realize that the physicians and nurses caring for you and your loved ones are also responsible for the medical care of many other patients as well. If they had to drop everything to discuss a patient's treatment according to each individual family's timetable, they would never be able to attend to their most important task- helping your loved one get well!

2) Have your loved one's medical history available at all times- this is easy to do with a flash drive and a .doc file. Include the most essential information: Name, date of birth, active medical conditions, past surgical history, immunization history, food and drug allergies (include what the reaction is), current medication list (include generic names and doses), immediate family medical history (we don't need to know about Aunt Edna's bunion surgery), and names and contact information of primary care physician and specialists. Have the primary care physician review the document for accuracy at least once a year, and note the date of review on the document. Print a few copies to distribute to the ER physicians and consultants who may be asked to see your family member during his/her hospital stay. This will ensure that all doctors have the most accurate, up to date historical medical information- and will free up their time to focus on the issue at hand (and spend more time answering any questions you may have!).

3) Make friends with your nurses! Your R.N. is an integral part of the healthcare team, has a direct line of communication to the physicians, and is trained to be your advocate. Treat your nurse with the respect that his/her training deserves, and you will not be disappointed with the care and valuable information you receive. (Tip- if you have a child or an elderly family member who has delicate veins, kindly ask your nurse if she can hold off on placing the IV line until the physician has determined which labs to order. That way, labs can be drawn from the IV before fluids are infused. This cannot always be done, but if it can, your nurse is usually happy to oblige.)

4) Designate one adult family member as a "point-person" for healthcare communication, preferably someone with a cool temperment and perhaps even a medical background. This person is responsible for relaying information from the healthcare team to other family members. In my opinion, it is unreasonable to ask the physician or nurse come in to repeat the same information each time a new relative comes to visit and wants to know what's going on. As I mentioned earlier, this diverts resources from their primary task- caring for the patients!

5) At your first visit with each of your physicians, ask if they have a window of time during which they expect to round, so you can plan to be present to be apprised of the plan of care, and to ask any questions you may have. Most physicians tend to round on their patients at around the same time each day- usually in the morning, but not always.

6) If no one from the family is available during the times when the healthcare team is rounding, arrange to have a notebook where you can leave your most pressing questions for the doctors. Ask your nurse to have the team look at the notebook each day. Although liability reasons may prevent the team from writing answers to your questions in the notebook, the answers can be relayed to your nurse or "point-person" verbally. Also include in the book the name and contact information of your "point-person", so the team knows who to call.

7) As the time for discharge home approaches, ask your physicians and nurses if there is anything your family can do to facilitate getting home as smoothly as possible. Most hospitals have discharge coordinators who will be happy to discuss the issues with you and ensure that you are as prepared as possible.

I hope you don't have to deal with a hospital admission anytime soon. But if you do, the tips above will help you and your family stay informed, and simulateously improve your relationship with the healthcare team.

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