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A Guide to Self-Care for the Hospitalized Patient

Susan LaScala, RN-C

Family Nurse Practitioner

      The hospital is a big world and being admitted to the hospital as a patient or accompanying a loved one can be like entering a foreign country. You may have the ticket to get you there – your illness – but that doesn’t mean you know how to speak the language. The scenery is unfamiliar and you don’t know anyone. When you find yourself or someone you care about inside this world, it may be surprising to discover it is a place where you have to advocate for yourself. You go in with the assumption that the medical people are there to take care of you, and they are. But once you get tucked into a bed it is easy to get swept along on a tide that makes assumptions about what you want, and it is up to you to understand and clarify the plans and intentions of the people who are taking care of you. You are not wrong to think this is a difficult position for a non-medical person to be in. Still, you should be able to talk to these caregivers, and they should listen to your questions and answer every one.

      So, what is the most important thing you can do to help yourself, or a family member, when you or they end up in the hospital?

Communicate.

1.  Ask for regular meetings with the doctor who has knowledge of your health issues and the authority to make decisions. Doctors usually make rounds in the morning before they start seeing patients in the office. This can be quite early and they may wake you out of a much-need sleep when they come to your room.

2. Be ready with your questions when the doctors come in. Keep a small pad or 3 X 5 cards by your bedside and write questions as you think of them so if you are sleepy at 7 a.m. you are armed and ready to go with your questions.

3.  Be brief and to the point when you talk with your doctor. After you have exchanged pleasantries, stay on the most important subject with your questions – this hospitalization and your present affliction. Save the questions about your ingrown toenail for a future appointment. Remember that clear questions are most likely to get you clear answers.

4.  If you are in the hospital for hours or days and you haven’t seen a doctor, ask the nurses: who is responsible for me during this hospitalization? Who is the go-to person in charge of my case? When is that person coming to examine and talk to me?

5.  What do you want the outcome of this hospitalization to be? Do your expectations and the doctor’s match? If you are in because you have belly pain and the doctor is ordering scans and blood work, find out why and what he is looking for.

6.  If you are the patient, do you have a healthcare proxy, and have you discussed the choices you have made with your family? Does your family know what your intentions are re: using extraordinary lifesaving measures? This is one of the most important conversations a family can have, and clarifying these choices with the key members of a family can make a great difference in unexpected, tragic situations as well as at the end of life.

      Unfortunately, when you come into the hospital in crisis, which is often the case, the situation may not be conducive to asking these kinds of questions. But once the dust has settled – the surgery is over, your loved one is in the ICU, or you recognize that you may be in the hospital for a prolonged period of time, take the opportunity to identify someone you trust in the system and ask what the long-term plan is.

         Remember, this is your body. This is, therefore, your information. Ask about the options for care; ask about the statistics related to the choices you have; ask the doctor how much experience s/he has with your diagnosis or clinical situation. If you are in a teaching institution, remember that you will have doctors-in-training taking care of you. Ask for a second opinion if you are uncomfortable with the information or care you are getting. In the end you are the person responsible for getting your needs met.

         One last piece of advice: don’t sit and grouse about your worries with your roommate or other patients. They are sick, too, and have their own illness to deal with. If you have an issue or a complaint, find the professional who can help you get answers and solve the problem.