A stay in a hospital is almost by definition a stressful and anxiety provoking experience. You are there because you are ill or incapacitated in some way. There are countless staff people coming in and out of your room, 24 hours a day. Some introduce themselves, many do not. The amount of information being continuously gathered, updated and disseminated is immense. Much of it is now done on computer but many notes and scripts are handwritten and difficult to decipher. Any mistake can be painful, dangerous and costly to the patient, family and facility.
For an elderly patient who may have vision, hearing, or memory deficits, being in the hospital can increase their confusion and possibly orientation as well.
Oh, did I mention the germs found in hospitals?
Overall though, if your aging parent or loved one must be hospitalized for surgery or treatment there are some guidelines to help get through the experience and home safely.
1. Have a family member or trusted person be your advocate. This person should visit daily, making themselves known to the nurses and other staff at the nurse’s station. This person will be your eyes, ears and voice to your family and to the hospital personnel. They should have a working knowledge of your condition, treatment and discharge plan. Hopefully they can visit when the doctor is making rounds.
2. Have a notebook and pen at your bedside. Record the names of your nurses each day – especially a.m. and p.m. shifts. List your medications and doses, and what each is for. Record any tests or procedures/treatments you have. Make sure to write down what your doctor says each day so you can track your progress. Otherwise have your advocate record the notes.
3. Medication errors are common in hospitals. This is a fact today. When you record your medications, note the shape and color of each pill, what it is for, the dosage and when you are supposed to take it. This can include liquid medications and IV bags hanging by your bed. If you have any doubt or a question, ask the nurse before taking the medicine. Be clear on any allergies you have and make sure it is recorded in your nurse’s log and even written on your wall board.
4. Know who your primary nurse is. Establish a warm relationship with him or her. Kindergarten rules apply, smile, be polite, gracious and respectful and you will likely be responded to in kind. This can result in more attention, and fewer mistakes.
5. Doctor’s rounds — your chance to speak with your doctor, ask questions about your condition, treatment, expected prognosis and expected discharge date and plan. This is your face-to-face time with your doctor, surgeon or specialist. Maximize this time by having your advocate there. Have your questions ready beforehand so you won’t forget them. Write them in your notebook and record the answers there too.
6. Make yourself memorable in a positive way. Doctors and nurses are people too. They have individual interests, children, pets or favorite vacation spots. Tell them something about yourself and ask something about them to help foster more of a personal connection so you aren’t just the broken hip in room 318. Be the nice patient who is appreciative and has been to Italy 15 times.
7. Preventing hospital-acquired infections -the most common is MRSA. Ask anyone coming into your room to wash their hands with soap and put on a new pair of gloves. Watch them do it. This includes the nurses and doctors. Have an anti-bacterial dispenser by your bed and ask everyone visiting your bedside to use it. If possible, arrange for a private room.
8. Mark your body part to be operated on. As silly as this may sound, it has become acceptable practice. It is your body and you will suffer the repercussions of a mistake. Meet with the surgeon before surgery. Have your advocate or a family member or friend there. Review your name, birth date and what body part is being operated on. “Better safe than sorry” is a primary concern. If you can’t speak to the surgeon, review this information with the anesthesiologist or nurse involved in your surgery.
9. Beware of weekends, holidays and the nighttime shift. Staff is decreased at this time. The regular staffs, who know you best, may not be there. These are the most common times for medical mistakes to occur. Have family visit at these times and stay longer. If possible, hire a companion or private duty aide to stay with you. Boca Home Care Services routinely helps families so their loved ones are not alone during these vulnerable shifts.
10. Ask questions until you are satisfied with the answer. The person you may help save is yourself! If something seems wrong, like a medication or an x-ray order, ask the nurse to “please” double check it. Hospital personnel are aware of the thousand of hospital errors which occur in the U.S. so you are being reasonable to make sure. How you ask makes the difference. Condescension and rudeness will not help your cause. Asking in a polite and friendly way should be met with acceptance. If not, ask to speak to someone else. This is your body, health and well being…. it is your right to ask and be responded to. If your requests are being unfulfilled, ask to speak to the hospital advocate, quality assurance person or the social worker.
These suggestions are being made with a reasonable assumption that the patient can self advocate. If they can, a friend or family member is still needed to assist with helping the patient and getting information streamlined. If the patient is unable to self advocate, then the need for someone to do so, on their behalf is critical.
When family is far away, either a friend can act as an advocate or you may need to hire one in the form of a Geriatric care manager or home health company.
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