Illness is apart of life and at some point you and/or a loved one will probably get sick and have to be hospitalized. When that happens, there are some things you will want to know to help you understand the healthcare system and how hospitals work. I have compiled a list of 7 things that I feel are the most important things for you to know if you or a loved one is ever hospitalized. This list is based on my ten years of experience working as a Medical Social Worker in the hospital, hospice and primary care settings.
#1. Get An Advanced Directive
Advance directives are legal documents that express your healthcare wishes in writing. A living will or a durable power of attorney are the types of advance directives that you will see in the healthcare setting. A living will allows you to document your wishes regarding end of life medical treatment. In this document you are able to state what type of treatments you would or would not want if you are ever in a situation where you cannot speak for yourself. A living will only go into effect if you have an incurable or irreversible condition. A Durable Power of Attorney (POA) is a document that assigns a Healthcare Proxy to make healthcare decisions for you in the event you are unable to do so. The POA only goes into effect if you are unable to make healthcare decisions for yourself. At that time, your healthcare proxy would make all of your healthcare decisions on your behalf. Be sure that your POA knows and understands what your wishes are and is someone you know and trust will carry out your wishes.
It is important to complete an advance directive before you get sick and while you have the mental capacity to do so. If you become unable to make healthcare decisions for yourself and you do not have an advance directive already in place, then all of your healthcare decisions will have to be made by your legal next of kin. Sometimes, this is an estranged spouse (yikes) or multiple adult children who have to come together and collectively make decisions. I have seen cases where the children could not agree on a course of action. I have also seen cases where the legal next of kin cannot be located and it seriously delays the patients’ treatment. This can lead to a lot of drama, confusion, undo pain and suffering for the patient, as well as decisions being made by someone who may not have the patient’s best interests in mind. So do yourself a favor and speak with an attorney, your physician, or social worker and complete an advance directive before you get sick! You can also go to websites such as Legal Zoom for these documents. Be sure to make changes to your advance directive(s) as needed. Also, don’t forget to provide a copy of your advance directives to your Primary Care Provider and your assigned health care proxy.
#2. Be Prepared To Speak Up!
You’ve heard the term “the squeaky wheel gets the oil”, well its true! Doctors and nurses are often times super busy and they have multiple patients to care for. In addition to this, sadly racism, biases, and prejudices exist in the healthcare field just as they do in all other areas in America. So you have to be prepared to speak up for yourself if you feel that your needs are not being met. Be polite but firm, and ask questions. This is your health we are talking about. You must be prepared to assert yourself if need be.
Healthcare professionals use a lot of big medical terms and they sometimes communicate to patients in this manner. Often times, however, patients don’t understand everything that they are being told. So if you don’t understand something, ask for clarity! If you don’t agree with the treatment plan or if you need more time to do some research before making a decision, then by all means let your provider know. If for some reason you are not satisfied with the care you are receiving, ask to speak with the charge nurse or someone in the hospital’s Administration Office so that your concerns may be addressed on a higher level.
If you have a loved one who is too sick to make decisions for themselves, be sure to have someone there at the hospital with them at all times or at least much of the time. Try to take shifts with family members or close friends. Utilize your FMLA benefits from your place of employment if possible, so that you can be there with your loved one. This is very important and every effort should be made to have someone there at the bedside to advocate for patients who are unable to speak for themselves.
#3. Start Talking About Your Discharge Plan ASAP
If you or your loved one is hospitalized due to a traumatic injury or illness that leaves you dependent on others, be sure to speak with the hospital Social Worker or Case Manager as soon as possible regarding your discharge plan. In situations like this, rehabilitation, home health services, hospice services, or nursing home placement may be needed. These things can take some time to arrange so it’s always good to start the conversation early. There may also be the need for medical equipment like a shower chair, wheelchair or hospital bed that will also need to be arranged. Communicate with your doctor and social worker to ensure you have everything you need before you leave the hospital.
#4. Go To A Hospital Where Your Primary Care Doctor Has Privileges
If at all possible, go to the hospital where your primary care doctor has privileges. This will ensure that your doctor will be the doctor caring for you for the majority of your hospital stay. This means continuity of care, which is extremely important. If you could choose between a doctor who has cared for you for years and knows a lot about you vs a hospital doctor that knows nothing about you, which doctor would you choose to care for you?
We are all different and unique, unfortunately healthcare providers sometimes treat patients like they are all the same, which can lead to misdiagnosis and oversights. So, when possible, it is good to receive treatment from a doctor that knows you well and is familiar with you and your medical history.
#5. Speak Up If You Think You Are Being Discharged Too Soon
It’s no secret that our healthcare system needs a lot of work. Insurance companies essentially run the show here in the United States. They set the rules as to when doctors can admit patients and when to discharge a patient. I can’t tell you how many doctors I’ve talked to who are extremely frustrated because they feel like insurance companies are essentially telling them how to treat their patients. They are under extreme pressure to discharge patients quickly and keep the hospital length of stay numbers low. So if you genuinely feel that you are not well enough to go home, let your doctor know. However, you should also be open to hearing from your doctor as to why they may feel it is time for you to be discharged and what options you have for continued care at home. Being in the hospital increases your risk of being exposed to many dangerous germs and illnesses as well, so please keep that in mind.
If you have Medicare insurance, you also have the option to appeal you discharge if you feel you are being discharged too soon. Speak with your Social Worker or Case Manager for assistance in initiating your appeal.
#6. Keep A Pen And Pad Nearby To Write Things Down
While in the hospital, there will be much communication regarding your care and there will be multiple nurses and doctors that you will speak to. It’s a good idea to have a pen and pad handy to jot down the names of the people you speak to, what medications you are being given, and what you are being told. It is also helpful to write down any questions that you may have for your doctor so that when your doctor comes in you will be able to easily recall these questions. Often times when the doctor sees the patient, they are the ones doing much of the talking, so having your questions written down will help you recall what you would like to talk about as well.
#7. Don’t Expect To Get Much Privacy Or Sleep
It’s the hospital, not the Ritz Carlton. There will be nurses, nurses aides, housekeepers, doctors and other staff in and out of your room. Yes, I know it sucks but all of these people have an essential job to do. So please try to be understanding and patient with them. When I’m sick all I really want to do is sleep, so I understand the frustration. If it really bothers you, I would suggest having a sign placed on your door asking the staff to be as quiet as possible when entering your room and to keep the light dimmed if possible. Unfortunately, the traffic in and out of your room can’t be avoided so please try to be understanding.
Being in the hospital can be a scary experience. It’s usually something very new and confusing to some people. I hope this list offers you some sense of relief and much needed knowledge to help you make the best decisions possible regarding you or your loved ones healthcare. Be well!