By Julie Kliger, May 16, 2022.
Do you know what you need to know?
Most people, it turns out, have no idea what to do when one of their family members (or themselves) lands in the hospital. Do you know what to do? Ask yourself the following questions:
- Do you know what care activities should happen, when and why?
- Do you know what to ask of the nurses and doctors?
- Do you know what you can and can’t ‘know?’
- Do you know what is ‘standard’ to ask versus, what is considered ‘pushy?’
- Do you know what is the ‘important’ information to share with the doctors or nurses?
- Do you know how to tell if all the right things are taking place?
To have the most successful hospital admission, it is important to understand how hospitals operate, and what to do, if you are placed in the role of the caregiver. First off, let’s discuss how people become patients!
Common route to being admitted
The most common ‘route’ into the hospital usually starts in the emergency room, or ER: Someone feels really terrible or has an accident, and they go (or are taken) to the ER. For example, last week an older aunt started to feel sick—she was losing strength in her arms and legs, she stopped eating or drinking and she was warm to the touch. One of her children thought it best to take her to the ER, where, hours later, she was admitted to the hospital.
Ok. The person has become a patient…Now What?
Hospitals are a chaotic patchwork of part-time workers
First off, it is important to know a few things about the state of hospital care. Hospital care may seem organized but they are not. The hospital setting is actually a patchwork of independent workers who come together in the patient’s room to treat a patient: The doctors most often are not employed by the hospital and might not know each other. Multiple doctors will probably be involved in the patient’s care. So for example, if you have an infection like pneumonia, the hospital-based doctor will prescribe antibiotics and fluids. But if you also have a heart condition, then the patient will be treated by another doctor who specializes in the heart, called a cardiologist, who will order additional tests and medications.
These doctors and nurses also don’t usually know the patient so they don’t know all the unique or ‘weird’ things about the patient that the family member knows: they don’t know the patient’s medical history, if they have allergies to medications, if they’ve been put on new medications or if the patient might have a new, yet-to-be diagnosed condition. Which was the case with my aunt.
Job of the Nurse as the Super-Duper Project Manager
So, don’t expect that everyone in the hospital knows everything about the patient. However, don’t worry just yet—the job of the nurses is to make sense of all the medications, treatments and overall care plans and to help ‘course correct’ when different doctors say contradictory things. Think of nurses as super-duper project managers and the project is the patient’s care while in the hospital.
The job of the ‘Hospital Care Giver’
Given all that, the patient needs their own ‘staff’ of helpers or ‘care givers’ who are usually family members or close friends.
The role of the caregiver is challenging too. A caregiver must be patient since that person will be spending hours in the hospital waiting to talk to doctors or nurses.
The caregiver should also know the patient well enough to share important information with the doctors and nurses, like which medications the patient is on and know about the patient’s conditions.
The caregiver should also know what has been troubling the patient and for how long, such as a loss of appetite, new onset of weakness and the like.
Armed with all of this information, below are a few of the key things to know when you or your loved one gets admitted into the hospital.
Ten Things To Know And Ask:
- Assume doctors and nurses do not know everything about the patient.
- Assume that information you shared with one doctor or nurse is NOT communicated to the other doctors and nurses. Corollary: Assume you will have to repeat yourself.
- Know that it is your right to ask to talk with ‘the doctor in charge.’ It is the doctor in charge that will be overseeing the patient’s care.
- Ask to see this doctor every day. Why? Because every day new information is being generated about the patient so you can learn what is going on with your loved one. Corollary: It is normal to ask what the reasons are for the patient staying in the hospital and what is being done to improve those problems.
- It is normal to ask why these problems (like getting an infection) happened in the first place. It is normal to ask if the patient is doing as well as they’d hope.
- It is normal to ask what the plan of care is for the following day.
- It is normal to ask for another opinion (outside of the hospital) if a big surgery is being recommended. It is normal to wait on big decisions if the patient and family need time to think.
- It is normal to ask that things are explained in a way you can understand.
- It is normal to ask for a social worker to discuss home care and discharge planning.
- It is normal to express concerns like, if you think the nurse forget to administer a medication, or if one of the tubes going into the patient appears blocked or leaking. Corollary: It is normal and “OK” to ask any question.
A Reminder that Patients Are People Too
Sadly, it is not normal for doctors and nurses to have a lot of time to spend with the patient or care giver. They are squeezed for time, which is why care givers need to be organized and have some patience.
Sometimes they get busy and forget that patients are people and that every single patient is a very different person from the person they just saw in the previous hospital bed.
Compassion Goes A Long Way—Still
It is a curse of the work—doctors and nurses get hardened and critical. Doctors and nurses get focused on their ‘job,’ and getting their work ‘done,’ so they can get onto the next patient. It is not an excuse for rudeness or hard-heartedness. It is an explanation.
The most helpful things patients and care givers can do is to view themselves as part of the ‘care team’ by being organized, engaged, assertive and pro-active. Then, to top it all off, sprinkle in some kindness and compassion for everyone who works in hospitals.
Patient Advocacy Sources include: The National Patient Safety Foundation, Patients Like Me.