Category Archives: Your Hospital Guide

What Football and Infectious Disease Control Have in Common

Communication. Such a simple concept. And yet so many ways in which it can fail.

Two examples of communication failures hit the news this past week, both of which have potentially severe medical repercussions, albeit on very different scales.

The first occurred this past Saturday at a Big Ten football game. The quarterback took a hard hit, and his head slammed backwards onto the ground. When he got up, he was so shaken and off-balance that he stumbled and collapsed into his teammate. So obviously, he would be pulled from the game and given medical attention, right? Nope. The coach put him back in for another play, as the crowd booed its displeasure and indignation. No one could believe the coach would show such blatant disregard for his player’s well-being, and there are strict regulations in place regarding head injuries in sports and protecting the athletes when there is any suspicion they have suffered a concussion.

But the coach didn’t pull the player out for a neurological check because he (the coach) hadn’t seen the player’s hit, his head-slam, or his resultant signs of head injury. The coach knew the quarterback was playing on an injured ankle (which had been medically cleared for play), and when he saw him limp back to the sideline, he assumed it was an ankle issue, stuck him in for another play, then had medical personnel check his ankle, and put him in again. Thousands of people in the stadium saw what happened. Millions of people saw on TV. Everyone assumed the coaches saw. But they didn’t – they were monitoring so many different things, planning, talking to people, and assuming important information would get to them. But the information didn’t get to the right people.

The university where this occurred is taking steps to ensure such an event doesn’t happen again. For example, they’re placing medical personnel in the press box for future games and giving them direct communication lines to the coaches. Systems approaches are good. They help. I’m glad they’re putting in extra safety layers to protect their student athletes, and I hope other schools and teams follow this lead. But systems measures can only go so far. We also need individual safety layers, and I cannot overstate the importance of personal advocacy (both self-advocacy and advocacy of others).

If the quarterback had said, “Hey, Coach, I hit my head and don’t feel right,” or, if he was too dazed to speak for himself, if his teammates had told the coach about the injury and their concern, or if anyone who had seen the incident had spoken up and relayed the information to the coach, then the athlete would have been given prompt medical attention and not sent back out on the field to be head slammed again. People need to speak up. And they need to speak up to the people in authority – the decision makers – and not just grumble quietly or complain amongst themselves.

Earlier this week, the news hit that the first person in the U.S. had been diagnosed with the Ebola virus. Ebola requires close contact with someone who is symptomatic with the disease in order to spread. We have good infection control measures in U.S. hospitals. We have quick dissemination of news. We have the CDC (Centers for Disease Control and Prevention). We have state and local health departments. We have a lot of good systems in place. The patient had recently come from Liberia, where there is a current outbreak of Ebola. He developed symptoms, he went to the hospital, and he told some of the medical personnel that he had just recently returned from Liberia. And he was sent home with a prescription for antibiotics. And he continued to be symptomatic, exposing other people for days, until he returned to the hospital and received the correct diagnosis, appropriate medical care, and concomitant infection control measures.

In this case, the patient actually had communicated the important information, but it didn’t get to the correct people. A systems issue, to be sure. But more individual advocacy and strong communication would go a long way here, too.

I was not on the sidelines with the football team, and I was not in the emergency room where the patient first presented, but I have some pretty good ideas as to some of what may have been going on.

Both the sidelines of a football game and an emergency department can be bustling with action. Things are going on in different areas. Different teams (offence, defense, trauma, radiology….) and their respective coordinators (offensive and defensive coaches, head coaches, triage nurses, nurse practitioners, attending doctors, etc.) are functioning within a larger whole, trying to attain their overarching goal (winning a game, getting all the patients taken care of) while trying to maintain the well-being of each individual (the athletes, the patients). With so much going on, communication frequently suffers. And when people are nervous about speaking up, communication suffers.

Players may have been afraid to “argue” with a coach. They may have assumed the coach knew all the facts. The patient or his family or the nurse he originally spoke to may have assumed the ER doctor or Physician’s Assistant or Nurse Practitioner who discharged the patient had read the travel history and considered the possibility of an Ebola infection. Both situations just needed someone, anyone, to say to the decision maker, “Hey, wait a minute. Do you know that (I hit my head and can’t walk straight/the quarterback looks like he has a concussion/this patient was just in a country with an Ebola outbreak/I just flew in on a plane from Liberia)?”

Systems approaches. Individual back-ups. Individual care. Systems back-ups. All necessary to minimize the holes in the information sieve. Don’t skimp on the systems. But also never be afraid to plug the holes in the systems yourself.

 

Decisions and Advocacy in Someone Else’s Realm – In the Store, Studio, Doctor’s Office, or Hospital

Our eldest son had his senior pictures scheduled for this past Friday. It was the last day before school started that we could schedule them, and they have to be done at a specific place and before a specific time so that they’re put in the yearbook. On Thursday, I asked him to try on his suit with whatever shirt and tie he wanted to wear so we’d have everything together and ready to go the next afternoon. And of course the suit didn’t come anywhere near close to fitting him.

So we then had about an hour-and-a-half window to find him a suit. I brought Son #2 along with us since he fit neither into his nor his older brother’s suit and would need one within the next month. Thankfully, Son #3 fits perfectly into Son #1’s old suit.

The problem is, I know very little about mens’ suits and my husband was away on a business trip. I needed to go someplace where there would be someone to guide us. We went to a national chain suit store nearby. They had a decent selection, but their prices weren’t great. The salesman seemed to know the different brands and cuts well, and went right to the styles that would fit the boys. But he was pushy. About the colors. About the tailoring. About shoes. I resisted the shoe push. But overall I felt pressured into an overall expensive purchase (admittedly much of the pressure being my own fault for not having checked suit-fit weeks ago). I did not walk out of that store feeling comfortable and happy.

Eldest son’s suit was ready for pickup Friday morning. It actually looked quite good. We headed to the photography studio for his sitting.

The woman at the front desk took us to a waiting area where the photographer met us and ushered us into the back. The photographer did not seem like she wanted to be there. In front of us, she complained with a colleague about another customer before she had my son go through a number of poses with different backgrounds. She seemed like she just wanted to be finished. With one particular pose, I asked if we could do a “serious” (not smiling) shot, and she said, “No, we did another serious shot and I like the smiling one on this pose.” And then she sent my child to change out of his suit into his other outfit for some casual shots.

I was a bit more forceful (but politely so) with the next set, and rather than asking her to do a shot with a particular expression I stated firmly (and sweetly) that I would like one done. She didn’t argue. But I left the studio feeling that I hadn’t gotten what I wanted with the formal shots. And the formal pictures had been the whole reason for my prior day’s rush on the suits.

I bring up these events of this past week because my mother just finished proofreading my completed manuscript for “Your Hospital Guide.” One thing she mentioned to me is that it can be really difficult to insist on something (like keeping your Hospital Buddy with you at all times) in a medical environment.

I get it. I really do. It was hard enough to say “I’m sorry, we’re not purchasing shoes today” as the salesman put them on my sons’ feet and told them how they needed ones that looked like this. It was hard enough to say to the photographer, “I’d really like a standing-up shot with a serious look.” And these are situations that are relatively unthreatening. The salesman and photographer are the authorities in their environments, but I and my family are the customers and we can risk annoying these people or even walk out if we want to without worrying about physical danger.

In a medical situation, a patient may feel that arguing, advocating, or questioning anyone in the environment might cause their or their loved one’s care to suffer. “This woman has my/my family member’s life/health in her hands. I’m not going to say anything that might make her angry.” But when you’re a patient, your needs are extremely important. Much more so than your need for a blue rather than a gray suit or a specific pose in a photography sitting.

When you are going in for a medical test or procedure, the time you are left alone in dressing areas or waiting areas can be extremely stressful. It may be “policy” for family members to wait back in a different waiting room, but this type of policy is changing in many hospitals as people figure out how to run a medical enterprise with the patient’s point of view in mind. There are certainly some situations where people other than the patient and hospital personnel cannot be there (for example, in an operating room), but many times there is no medical contraindication to the presence of a Buddy.

And your Hospital Buddy is there specifically for you. Not to make the hospital run efficiently (although he may help with that when helping you document information or answers to your questions, thus facilitating understanding and ability to follow directions). Not to improve the rankings of the hospital (although she may do that by helping you stay calm and comfortable so that when you fill out a survey form after your visit you’re more inclined to rate your patient experience more highly). Not to improve the hospital’s bottom line (although he may do so by asking questions that help you stay safe after you leave the hospital and prevent you from needing to be re-admitted).

When you are feeling afraid of ruffling feathers in a medical environment, your Hospital Buddy (or Doctor’s Office Buddy or Medical Buddy) can step in politely for you. Neither one of you should ever be afraid of asking questions until you understand something or letting people know your needs, your goals, and your fears. Do it politely. Do it with respect. But do it. “I’d like my sister to sit with me until I go back for the biopsy. If you need to ask me anything in private, I’ll ask her to step out for a minute. Otherwise, I need her with me.” “I need a doctor to evaluate my father immediately. Something isn’t right.” “When should I take the first dose of each of these medications?” “What would happen if I didn’t undergo this procedure? What is the risk of the procedure itself?”

It can be hard to speak up. I left the suit store having spent more than I would have liked and having purchased a suit for Son #2 that was not really his top color choice. I don’t think my son wanted to offend the salesman (who was insisting that the gray suit was more versatile than the blue striped one). And I didn’t do a great job of stepping away from the salesman with my son to make sure he could decide without pressure.  And as I said earlier, I don’t really know much about mens’ suits. But this whole escapade was at worst a few hundred dollar less-than-perfect effort. With the photography sitting, at worst I won’t have a choice of all of the specific poses I would have liked. We can get another suit. We can get more pictures done.

The stakes are much higher with a medical issue. And I’ve been there, too. My worst decisions have been when I’ve felt pressured by time and been afraid of offending someone. The pressure and the fear can cause us to walk out of a doctor’s office or a hospital with that icky feeling that we’ve just done the wrong thing. Sometimes the time pressure is real, but don’t let the fear of offending someone prevent you from questioning or from getting another opinion. Do it respectfully but firmly. “This is a very big decision for me. While I’m thankful for and respect your opinion, I need a little extra input from another doctor so that I can feel comfortable that I’m making the right choice for me.”

Then know that whatever you decide, you’ve made the best choice possible with the information at hand.

 

Leaving the Stress of the Hospital for the Stress of Leaving the Hospital

Our recent veterinary ordeal hammered home for me one of the most important hospital issues (for humans, as well as our fuzzy friends): the transition from hospital to home.  I have a section in “Your Hospital Guide” devoted to this subject, since it is a major deal.

The time around a hospital discharge can be a time of mixed emotions. Hospitals are not fun places to be, and there are many risks within them. We’re generally pretty happy when we or someone we love is deemed well enough to leave. But a lot of us are hit at the same time with a huge wallop of fear and panic: what if he’s not really ready yet? What if something happens and I don’t have the resources that I would have in the hospital? What if I don’t notice something that a doctor would notice?

The keys to a safe hospital discharge are communication and preparation.  Listen carefully to everything the doctors and nurses say to you before leaving, and make sure it’s all written down.  When reviewing the discharge instructions, ask questions whenever anything is not completely crystal clear, and write down the answers.  And make certain that you have 24-hour phone numbers to call when you have further questions, because no matter how thorough you are with your pre-leaving-the-hospital questioning, other things will come up.

Within two days of bringing our dog home from the veterinary hospital, even though I had spent a good amount of time speaking with both the veterinary student and the veterinarian before leaving,  I made at least a dozen phone calls back to the vet hospital.  Medication X is supposed to be given once a day – I picked him up at 6 p.m., so do I give that medication tonight, or did he already get it today?  Can the medications be taken with food?  Can the medications be taken together?  His cheeks are sort of puffing in and out with his breathing – do I need to worry?  When exactly is he supposed to wear the cone?  His staples are supposed to come out in a week – that brings us to a Saturday night, so is a day or two before or after that ok?  And which would be better – a little early or a little late?  You said he should eat a low fat diet – for how long?  He’s not eating.  He doesn’t seem to like the food – is it more important for him not to have fat, or more important for him to eat?

It was easy to ask all these questions, because the veterinary hospital is open 24 hours a day, and there are always students and vets on site that can answer follow-up questions.  Hospitals for animals are small – the staff knows all of the patients.  It’s frequently more complicated with hospitals for humans, which are much larger and which often have multiple specialists caring for patients.

Before you leave a hospital, know whom you should call for what types of questions or situations.  If the nurse tells you to call your primary care doctor with any questions, make sure you speak with your primary care doctor before you leave, and that she has been fully updated on your situation and feels comfortable with immediate post-hospital questions.  If you’ve had surgery during your stay, make sure you have a phone number to reach the on-call surgeon.

It can take a little while to relax back into a normal routine after a hospital stay.  Be patient with yourself, and never be afraid to call your medical team with questions.

Response to Critique of Chapter 1 of “Your Hospital Guide”

I have to admit, I love receiving positive feedback.  It makes me feel like I’m on the right track, doing the right thing, being helpful, etc..  But the concerns and suggestions I receive help me to improve at a much quicker pace, propelling me to better communicate my thoughts.  A non-perfect critique prompts me to re-evaluate and re-think things in a more intense way than just re-reading my own words and listening to any kudos that have been tossed my way.

I received a phone call yesterday afternoon from a close family friend who is a retired Ob/Gyn physician.  This man is a remarkable doctor, beloved by his patients, and he managed single-handedly from halfway across the country to keep me sane through a significant scare during my pregnancy with my third child.  I have the utmost respect for him both personally and clinically.  When he started the phone conversation with “I’ve been reading your blog, and I want to talk to you about something you’ve written in your book’s first chapter,” I listened very closely.

His concern was specifically, “Don’t allow perfection to be the enemy of the good.”  He agreed that having someone with you in the hospital is extremely important, but is afraid that people will read my advice to have someone there at all times and if they are not able to do so, may give up on the idea of a Hospital Buddy completely, or not understand the most important anticipated times to have someone there.  Some of those most important times include when a person is medically unstable, when someone is having surgery or is post-surgery, when procedures are being done, and when medical teams are rounding.  And I am extrapolating from his concern to think that after taking to heart my advice, perhaps someone might avoid going to a hospital when needed because they do not have someone to go with them.

So as I do my final edits of my book, I will work in the above thoughts.  However, I am going to have to take my seatbelt analogy a bit further here as I work in those thoughts.   I don’t want to water down the force behind my original exhortation to try whenever possible to have round-the-clock Hospital Buddy presence.

You are most likely to be involved in a motor vehicle collision when you are in an intersection.  Certain intersections have statistically higher rates of collisions.  Collisions happen more frequently in icy conditions.  If you had a finite number of seatbelt hours, you would make sure to buckle up on an icy day while driving on a two-lane country road without shoulders.  You would buckle up when going through the intersections in which accidents were most frequently featured on the evening news, and try to click your belt through most intersections in general.

This may end up providing you with enough protection.  It is certainly better than never wearing your belt.  Problem is, depending on your speed, road conditions, and general traffic patterns, you may hit intersections at times that differ from what you had anticipated, and you’ve got your belt on too early or too late to cover the actual crossing.  It doesn’t account for the metal trash can that blows into the road in front of you, the car door that opens into traffic, the oil slick on a clear day, or the wasp that flies into the car.

So the best thing to do is to have your seatbelt on at all times, and you should do whatever you can to do so.  When you have only limited seatbelt time, you should try to have it coincide with your statistically most hazardous driving time.  And when you have to drive somewhere because you are fleeing from immediate danger, and the car does not have seatbelts, you should drive anyway, keep as alert as possible, and accept the potential risk.

If you are on a business trip in a city where you don’t know anyone, and you develop appendicitis or have a heart attack, don’t avoid or delay going to the hospital because your wife isn’t with you.  But your wife or brother-in-law or friend should drive into town as soon as possible to join you.  If you break a hip and have hip replacement surgery planned for tomorrow and your sister is only available to be with you for 24 hours, have her come in for the surgery and the time immediately following.  But if you can think of a friend who might be able to be with you until then, and someone to be with you after your sister leaves and at the time you’re discharged home, call them.  And when you have an elective, non-urgent surgery, test, or procedure coming up, plan it during a time when people will be able to be there with you.

Please keep your comments, feedback and questions coming!  I appreciate all of them immensely.  And Dr. Ronnie, how do you feel about my sending you my full manuscript this week for a second opinion?

“Your Hospital Guide” Part 5 (of 5) of Chapter 1 (Always Have Someone with You in the Hospital)

Choosing your Hospital Buddy/Buddies:

Who should be your Hospital Buddy?  You should be accompanied by someone you trust to take accurate notes for you, someone who will speak up for you and question people when necessary, and who is able to put up with you when you are in a less-than-perfect-health-induced crabby mood.  It should be someone with whom you are comfortable sharing medical information.  It also should be someone with whom you have discussed your general medical goals and wishes, including what you would want done in a life-threatening emergency (if this person is not your legal medical proxy (someone to whom you have given the legal authority to speak for you in a medical situation if you are incapacitated), he must know who your legal medical proxy is and how to reach that person).  This person could be a spouse, partner, family member, friend, or a hired Hospital Buddy (there are private nurses available for hire, as well as trained non-nurse hospital companions who can especially be helpful overnight).

It is tiring, both physically and emotionally, for someone to be your Hospital Buddy.  Therefore, you might want to line up a few people, if possible.  This will enable people to take turns, so that everyone has a chance to get home (or to a local hotel) to shower (guests are not allowed to use patient showers), sleep, and attend to any other urgent matters.  If the hospital stay is only for a couple of days, then one person should generally be adequate.  If the hospital stay stretches beyond two or three days, it helps to call in the reinforcements, even if only for a few hours each day or a few overnight shifts.

When people to whom you are not close enough to ask them to be your Hospital Buddy ask what they can do to help, request that they help hold things together at home.  If your Hospital Buddy is your spouse or someone else you live with, ask a neighbor to take in your mail and take care of your pets.  If you have young children, have a friend, family member, or trusted adult babysitter stay with them so that your spouse can be with you.  Other help-offerers can be asked to bring dinner the first few nights you’re back in your house.  The more people you allow to help you, the less pressure you’ll feel like you’re putting on any one person.

“Your Hospital Guide” Part 4 (of 5) of Chapter 1 (Always Have Someone with You in the Hospital)

My hospital has specific visiting hours.  Won’t the nurses kick my Hospital Buddy out?

What about visiting hours?  In general, most nurses are lenient about allowing people to stay beyond designated visiting hours, provided visitors are quiet and considerate of roommates.  With resistant hospital personnel, your best bet is generally a calm, well described explanation of how your/your Hospital Buddy’s presence is actually assisting the nursing staff (help with keeping the person comfortable, assistance with getting to the bathroom, bringing a person water, general psychological support, help remembering details when communicating with doctors, etc.).  Getting permission from your doctor is also extremely helpful, as it can help avoid objections from a later shift of hospital staff who might not be familiar with your Hospital Buddy system.

It is much simpler to have a companion stay overnight when there are private patient rooms.  In a private room, there is generally more space for a convertible chair or a cot.  When there is a roommate in the picture, there can occasionally be resistance from a roommate’s family or from nursing staff to overnight Hospital Buddies, and this is best dealt with ahead of time, with permission from your attending physician.  Make sure you address the hospital staff’s concerns (e.g. you will keep noise levels low, you will respect a roommate’s privacy, you will keep the cot/sleeping chair as out-of-the-way as possible), be as polite as possible to the hospital staff, and remember to thank them for accommodating your request.

Why is it even an issue to have someone stay overnight?  And why are there ever limits on visiting hours?

When you understand the objections to overnight visitors, and the reasoning behind visiting restrictions in general, you can easily address any concerns, and are much more likely to obtain the permission that you require.

The short answer to why you need to argue for overnight stay permission is that the hospital is trying to ensure a restful environment for all its patients, and visiting hours tend to be noisier than other times.  However, it is more complicated than that.  The information in the later chapters of this guide (in the section describing “The Places,” which is currently slated to be Section 4, but that could change) will help you to understand many of the factors that play into how a hospital functions, and you will be able to use this knowledge to advocate effectively.

 

“Your Hospital Guide” Part 3 (of 5) of Chapter 1 (Always Have Someone with You in the Hospital)

If the person being hospitalized has memory difficulties, even when they are medically rock-stable, there should be a Hospital Buddy with them 24/7.

What about an elderly patient or a patient with memory issues?  If the person who is hospitalized has dementia, it is always best to have a companion stay in the hospital overnight.  It is very disorienting to wake up in a hospital, and many patients end up being sedated or restrained due to overnight confusion (Note: overnight confusion is sometimes refered to as “sundowning”).  The best way to prevent or minimize this is by having someone in the patient’s room at all times so that a companion may gently remind the patient where he or she is, help keep the person from getting tangled in any cords or IV lines, and help keep the person calm.  At night, the person’s Hospital Buddy can remind the person that it is nighttime, and that it is time to sleep.

Many times in a hospital, the nurses deal with “problem patients” (those who are awake and confused overnight, and who might fall from bed, pull out i.v. lines, or otherwise pose a danger to themselves), by rolling their beds down near the nurses’ station overnight.  While this allows hospital personnel to keep a closer watch on these people, it also means that the patient is kept in a light environment through the night, with people talking and walking around, which keeps the patient fully awake.  This contributes to a vicious cycle of a person’s having a disturbed sleep/wake schedule, worsening confusion and contributing to delirium.  It is much preferable for these people to have a Hospital Buddy available to stay with them in their room.

In certain circumstances, a hospital may have a “sitter” – an official person hired by the hospital – sit at a person’s bedside to verbally orient the patient when necessary, and remind the patient not to get out of bed.  However, there are not always enough sitters available for every patient who might benefit from having one, the sitter is generally not someone who is familiar to the patient (and thus may not be as easily able to calm the person, who is feeling confused and disoriented in an unfamiliar environment), and many rehabilitation and nursing facilities will not accept a patient who has required an official hospital sitter within the past 24 hours.

What’s wrong with using restraints and/or sedation? 

While these may, at times, be necessary to ensure a person’s safety, there are risks involved with their use.  A person may respond unpredictably to a sedating medication – older patients, in particular, may be more likely to become over-sedated, even with lower doses.  Physical restraints are generally unpleasant for the person to whom they are applied, and restraints may cause a person physical injury.  And again, there are many nursing homes and physical rehabilitation facilities that will not accept a patient who has required restraints in the past 24 hours, which can complicate a patient’s discharge from the hospital.  While a physician may determine in certain situations that the risks of sedation or physical restraints may be outweighed by the risks of not sedating or restraining a person, it is best to try to set up an environment in which those measures are less likely to be necessary.

 

“Your Hospital Guide” Part 2 (of 5) of Chapter 1 (Always Have Someone with You in the Hospital)

Aren’t my doctors and nurses there to advocate for me or my loved one?  Of course, but they have many other patients to care for (your nurse usually has three to seven other patients, unless you are in the intensive care unit, and your hospitalist generally has 12 to 20 or more other patients along with you each day).  It is beneficial to your healthcare providers to have someone knowledgeable about you there.

So my nurses and doctors are busy.  What could my Hospital Buddy really do for me?  Do they really need to be there at all times?

Your Hospital Buddy can remind your doctor that the last time you had a fever and started seeing pink elephants, you had a urinary tract infection.  Or your buddy can point out to your nurse that normally you are quite sweet, and the fact that you are cursing at the nursing staff is a severe, sudden personality change, for which you should be medically evaluated.

Doctors arrive in patients’ rooms at random times.  Your Hospital Buddy will be able to take notes for you while you are napping or sedated – just make sure to scribble a permission-to-talk note for the doctor, so that your doc can speak to your buddy and fill him or her in on what’s happening.  As you write down your daily list of questions for your doctors, you can decrease the stress of worrying about missing your doctors’ visits when you know that someone you trust has that list and will ask and record the answers for you.  You can nap, when necessary, with peace of mind.

What about at night?  Again, it is always safest to have someone with you.  Your companion is there in case of emergency.  Occasionally there may be an instance when someone remains in the hospital simply because they are awaiting a procedure that has been scheduled, or are finishing a course of intravenous antibiotics, but otherwise are rock-stable, and then it may be reasonable not to have someone stay overnight with him.  However, when things are rocky, it is still preferable to try to have a companion.

 

“Your Hospital Guide” Part 1 of Chapter 1 (Always Have Someone with You in the Hospital)

Chapter 1 – Always Have Someone with You in the Hospital

This is possibly the most important piece of safety advice for a person who needs to be hospitalized.  This chapter explains why it is so important, what this person can do for you, and who this person should be.

No exceptions.  Well, very few exceptions.  A hospitalized person will benefit from having a non-hospital-personnel person with him or her at all times.  We’ll call this person your “Hospital Buddy.”  Like your swimming buddy at summer camp, this is a person you choose and who chooses you, who accepts the responsibility of looking out for you, who enjoys your company, and whose company you enjoy.  As a camp counselor would never let a person out into the lake without a buddy (they would have a person “triple up” with someone rather than let someone in the water alone), you should not allow yourself or your loved one to be in a hospital without a buddy.

Redundancy is routinely factored into systems to ensure safety.  If one safety measure fails, the backup measure kicks in.  Your car has brakes, and it also has seatbelts to keep you from being thrown from the car if your brakes fail to stop you in time to avoid hitting the deer that runs in front of your car.  Your alarm clock has battery backup.  Your house-wired smoke detectors have battery backup.  Your Hospital Buddy is your backup safety mechanism, and a hospital is simply not a place to be without backup.

I’m a perfectly intelligent, capable person.  Why do I need a backup?

As was mentioned earlier, a person in the hospital is either quite ill, or is undergoing something that has potentially serious side effects or complications.  A post-surgical patient may be groggy from anesthesia or from pain medications, and may very likely not be able to think appropriately.  Similarly, a sick person may very well not be in the clearest state of mind.  Chemotherapy can sometimes cause unpleasant reactions – exhaustion and severe nausea and vomiting does not put someone in the best frame of mind to absorb complicated medical information.  A woman who has had an uncomplicated pregnancy and has just delivered a healthy child may begin to bleed and may not be in a state to understand a potential need for emergent surgery.  Someone needs to be there in the hospital to cover for you when necessary.

If it turns out that there are no acute events requiring your Hospital Buddy to step up as your backup, then you will at least have had some company, and someone to bounce things off of when you had decisions to make.  It is never a waste to have had the necessary backup on hand.  If you make it home from the grocery store without an accident, you generally don’t say to yourself, “What a waste it was that I had my seatbelt on.”  Similarly, when you arrive at work on time, you don’t usually lament the fact that your alarm clock battery wasn’t used last night.  Your Hospital Buddy is your seatbelt, or your battery backup.  He or she is your personal advocate in a place where you may very well need an advocate.

 

Getting into “Your Hospital Guide”

Few things are more stressful then being in the hospital.  The very fact that a person is there means that something frightening, serious, or potentially dangerous is going on – otherwise that person wouldn’t be in a hospital.  Scary statistics about medical errors are frequently spotlighted on the news, friends have probably regaled you with tales of their own medical horror stories, and you may have some horror stories of your own.  To top it off, when you need to be hospitalized you are likely imagining every possible thing that could go wrong.

Read this guide early, preferably before there is even a thought of hospitalization for you or a loved one in the forseeable future.  Use Your Hospital Guide as a general educational tool to familiarize yourself with the environment, culture and personnel of these medical institutions.  If you or someone close to you is going to be hospitalized, take a deep breath.  You can maintain a fair amount of control in a hospitalized situation.  Your Hospital Guide will help you work with doctors, nurses, therapists, and other hospital personnel to get the best care possible for yourself or your loved one.

Your Hospital Guide is divided into sections.  Section One: First Things First, includes the introduction, which provides a brief overview or “tour” of the book, as well as a chapter elaborating on my most adamant piece of advice to you: always have someone with you in a hospital.  It also has a chapter that briefly discusses the subjects of advance directives (who you want to make medical decisions for you if you for some reason become unable to do so yourself, and how you would like those decisions to be made) and code status (a written order that specifies whether a person is to be resuscitated in a medical emergency if they stop breathing or if their heart stops), since hospital personnel will ask you about these when you are hospitalized, and you should understand them.

My next book posts will convey content from this first book section.  I hope you find the content helpful and informative.  Please leave comments to let me know what you think, and please ask questions!