Recent discussions around here reminded me that it’s time again to talk about what it’s like to be in a hospital, and how to survive the experience.
But first, as we move into the last two weeks of our very-successful Donors Choose challenge, I’d like to invite health care professionals in particular to participate. Gifts are tax-deductible and help out needy Michigan school kids with specific, vetted projects that are often useful for several years.
Micro-donation is a great way to go. While big gifts are great, even a couple of bucks add up quickly, especially on challenges with Gates Foundation matching.
The economy has hit health care hard, and many of us in health care have seen our patients disappear and our own incomes drop. But most of us are doing better than the families of these kids. If a couple of bucks helps even one kid get excited about learning and some day join our ranks, it’s worth it. To finish funding my original projects will only cost about $1000.00, an easy goal to make by the end of the month. So c’mon docs and nurses. C’mon CRNAs and EMTs. Fork over a couple of bucks and help the kids. OK, end of digression.
Being ill is a profoundly humbling experience. Even minor illnesses change the way we think, not just about mortality and finances, and other “big things”, but it changes our ability to think. Let’s take a relatively mild illness as an example. Kidney stones are horribly painful, but rarely fatal. The pain is exquisite, and impairs one’s ability to reason. The medication used to treat the pain further impairs one’s memory and judgment. If a little IV fluid and some hydromorphone fixes everything, fine. But let’s say the urologist is asking you whether you want to go through with a stent, a stone-removal via basket, a lithotripsy, or something else. Trying to parse through this complex information when in pain and stoned on Dilaudid is a challenge.
The impaired judgment of illness is no joke, and everyone needs an advocate to help collect and understand information, and also to help insure good care. Hospital safety is undergoing a quite revolution, thanks to initiatives such as Keystone, but it never hurts to have a second set of eyes and ears.
An advocate can help you through your stay, but if you want your caregivers on your side, make sure you pick people who aren’t there to pick a fight. Doctors, nurses, and aides are there to help and to do a job. You can and should help, but you should stay out of the way and avoid antagonizing people. An advocate doesn’t have to be a single person, but it helps to talk to your friends or family before a hospitalization if you can.
So here are some specific recommendations for patients and their advocates, which are unfortunately not evidence-based, but mostly good despite this.
- Try not to be alone: loneliness and fear are not good for you.
- Ask your caregivers in a very non-threatening way if they washed their hands and stethoscope before examining you.
- If you’ve been told not to get out of bed, don’t. People in hospitals fall. If you are ringing for assistance and no one is coming, ask your advocate to go looking for help. It’s terrible to soil oneself, but better that then breaking a hip.
- If you’re told to get up and move around, do it. This prevents blood clots.
- Write down names of doctors with their specialties. Doctors often don’t communicate well with each other, so it helps to know who is who.
- Pain and discomfort is usually treatable and serves no beneficial purpose. It’s OK to ask for pain medicine. Sometimes the answer is no, and for good reason, but usually the answer is “I’ll be there as soon as I can with your medicine.”
- If you have tubes running in and out of you, there are protocols to make sure they are changed appropriately. Feel free to ask if an IV or other tube still needs to be there.
- Write stuff down, but as a courtesy, explain to caregivers that you’re helping your friend remember what happened. If the doctors have a big decision to drop on you, jot down everything you can, including questions. Be prepared to write down questions that come up later. If they don’t have time to answer your questions right away, acknowledge that and ask when they will have time. Be flexible. Your nurse may have someone in the next room falling over, and one across the hall with chest pain—your time is important but so is theirs.
- Don’t bother complaining about the food.