How to Survive a Medical Hospital Stay

 If you should end up in the hospital for a medical problem, here is some information that will help keep you safe. 

Meet and speak with every doctor on your case. Ask them questions about your illness. You can ask questions like, how many cases like mine have you had in a year? If the answer is less than 25 ask why. 

It is always a good idea to have a health care advocate. This can be done legally by assigning a Power of Attorney or a less formal friend or family member that will speak for you if you can not. If you have a living will (I highly recommend having one) your health care advocate is responsible to make sure the doctor carries out your wishes. 

Be sure to pack for your hospitalization with a plan. You need to bring your insurance card, your driving license or another picture ID, your medication list, a summary of your medical history, bring comfy clothes to sleep in, slippers, and hygiene items. LEAVE ALL JEWELRY AND OTHER VALUEABLES AT HOME. Theft is a big problem in most hospitals. If you want to know the stats of thefts in a particular hospital, call the security department and they will assist you.

If you did bring something of value to the hospital the security department can lock it up in the hospital safe. At that point the object of value becomes the hospital’s responsibility if it becomes lost. Also, I want to mention how nurses and techs are instructed to compile your list of personal belongings. The most common item people bring with them is wedding bands and diamond rings. We are instructed to log a diamond ring as ‘a gold colored band with a white/clear stone.’ As you can see from this description; this is how the hospital gets out of paying for a lost diamond ring. This places the burden of proof on you! You then have to prove it was stolen and that it was a diamond. Hospital policies can be tricky to navigate through. My best advice here is to only bring what is absolutely necessary for your hospital stay.  

You need to end up on the correct hospital unit. If your medical problem is of the respiratory sort, then you need to be on the pulmonary floor. Being placed on the correct floor will decrease medical mistakes, because the nurses and doctors on this floor are specialized and know the ins and outs of your problem. 

Take an active role in your own health care. If someone enters your room, they must identify themselves and tell you why they are there. Be sure they explain EVERYTHING they are doing and why BEFORE THEY PREFORM THE PROCEDURE. Make sure your doctor explains what is next for your ongoing treatment. Be informed!  If the staff member has not washed their hands; stop them before they touch your body. Tell them to wash their hands and then report their behavior to their supervisor. There is NO excuse for not washing hands before giving care. You can also ask the health care member to put on NEW gloves before they touch you. This is your right as a consumer of medical care. This action will reduce the potential spread of infections. Insist your bathroom be cleaned everyday. Your linens need to be changed everyday as well.  

Reduce medication errors by: Know all your medications. Know why you are taking the medication. Know what your medication looks like. Know the doses of your medications. Ask the doctor what changes in medications he or she will be making to your medication regime while you are in the hospital. If a nurse brings a medication in your room to give to you and you don’t recognize it, refuse the medication until the nurse double checks it.

This is one of American hospital’s downfalls. Tons and tons of medication errors are made everyday at any given hospital. The reasons for this are copious.

All nurses are educated to give medications CORRECTLY. Nurses spend a lot of time on this issue in nursing school. We are taught to give medication in this fashion:

The right person

The right medication

The right dose

The right time

The right route

If nurses stick to the ‘5 rights’ of giving medications; no medication errors would occur. But, errors continue to happen. Having an unrealistic patient load contributes to medication errors.

Currently many hospitals are updating the way medication is given to where it is virtually impossible to make a mistake. Most American hospitals are addressing patient safety because they have had terrible scores in this area.

Another reason medication errors happen is related to the shortage of nursing personnel. Some of the shortages are real, for instance, Louisiana is having a terrible time attracting and keeping nurses but, some shortages are self made by the hospital administrators. The goal by most administrators is to keep the costs down and the hospital going; sometimes, at any cost, which includes loss of life. They send those cases to the bean counters.  

To save money, the hospital administrators will ‘pull’ a nurse to another floor for staffing needs. This is a HUGE mistake by the administrators. A nurse going to another floor in which he or she is not familiar is a perfect set up for mistakes. I can say, during the time I spent as a floor nurse, I was ‘pulled’ to another floor numerous times. I did not feel comfortable or more importantly I did not feel competent. I typically worked on a psychiatric floor. I was ‘pulled’ to the cardiac floor, several surgical floors, ICU step down floors, many specialized medical floors, like neurology, ortho, pulmonary, infectious disease, and medical-surgical floors.  The attitude by most hospital administrators is “A nurse, is a nurse, is a nurse,” which means we are all the same. Not true! I know psychiatric nursing like the back of my hand. I don’t know the ins and outs of the other above mentioned floors and more importantly, the illnesses and typical medications. Yikes!  

What is the nurse/patient ratio during this shift?

(California nurses enjoy a 1:5 ratio. I see this as baseline. Any number above 5 you can count on being ignored that shift with the exception of the administration of scheduled medications, procedures, and emergencies.)

Do you normally work on this floor?

What floor do you typically work?

What type of nursing do you specialize in?

Have you been ‘pulled’ from another floor to work here today?

Are you here for just a portion of this shift?

Do you feel comfortable and qualified to work on this floor?

How long have you been a nurse? If the answer is less than a year, have your health care advocate watch every move the nurse makes. Keeping a journal of events is a really good idea too.

Are you from a traveling agency?  

Did you just get here or do you have experience in this hospital and on this floor? These nurses are generally very good, however if they just got into town they are at a disadvantage because of the unfamiliarity to their new surroundings.

Do you float? (Which means the nurse’s daily assignment is to work on a grouping of various specialty floors. The benefit is that he or she obtains a lot of knowledge and experience, which usually makes this nurse confident and competent.)

 Are you from a local nursing staffing agency? Nurses who come from a typical staffing agency have to pass a general nursing test, a drug test, and can not have any communicable diseases. The nurse has to be licensed in the state in which he or she works and be certified in CPR. The hospital saves money by hiring ‘agency nurses’ because they typically do not receive benefits from the hospital.  Agency nurses have a reputation of being really bad or really good. The loyalty to the hospital is removed by working for an agency. 

I think the most important and telling question to pose to all of your nurses is: How much experience do you have with the medications and procedures that are typically used and preformed on this floor?  

You have the right to know who is taking care of you and what their qualifications are. Period. 

Each question represents a potential break in the health care system for mistakes to occur.  

Mistakes occur even in the most perfect of situations. It then becomes important to prevent situations which encourage mistakes. (For instance, ‘pulling’ a nurse to an unfamiliar floor.)

To sum up, remember you are a consumer of health care. We are consumers because of the structure of HMO’s. As consumers we can say “NO” to any treatment, test, or medication. We can ask for a second opinion. We can ask to have a more experienced nurse and or doctor. We can call the house administrator for any reason at any time. Also, hospitals employ a patient advocate; this person is also called an ombudsman. If for any reason you think your care has been sub-standard call the ombudsman. The ombudsman’s job is to investigate your issue and to help you solve your problem. Also, you may have your family with you all three shifts. Many people do not know this. The hospital staff can kick a family member out only if they are interfering with your care.  

Infection control is paramount in the hospital. Hospitals house many, many infectious people. For this reason alone it is essential for the health care workers to wash their hands and or place a barrier (like gloves, masks, goggles, and gowns) to protect you from a hospital born infection. The statistic of hospital born infections is staggering. Pneumonia and urinary tract infections are at the top of the list. The super bug MRSA started as a hospital born infection. Protect yourself! Wash your hands too!

If your room mate is coughing insist he or she wear a mask. If the roommate refuses to wear a mask then you wear one! (reverse isolation)

If your roommate has a drippy wound make sure all the dressings are disposed of properly. The bag of dirty dressings should not stay in your room. Also, dirty laundry should not stay in your room either. Trash cans should be emptied every day and more if needed. 

This is a lot of information. Typically, if you are in the hospital you are very sick. It then becomes difficult to keep track of all of this. Because you are sick, I can not stress the importance of having a health care advocate enough. If you are spending more than one day in the hospital, have somebody there with you. Have that person write down everything that happens during your stay. Include the names of the care givers and their specialty. Keep a dated and timed log of given medications and by whom. Same goes for any treatments and any other care. 

I hope this information will enable you to have a successful hospital stay. Good luck! 

Tags: Hospital mistakes, Infection control