The purpose of this article is to provide info about the hospital to help a patient or even the family of a patient with medical problems who finds that they are stuck in the hospital and things don't seem to be moving very quickly.  The hospital is a very complicated place.  There are multiple roles at the hospital and each has a different job to do.  Everyone knows about the doctors, the nurses, the respiratory therapists, the social workers, the pharmacists, and the case managers just to name a few.

Most people believe that the doctor runs the hospital.  This just isn't true.  Actually the doctor doesn't even usually work for the hospital.  They are like independent contractors with special privileges to practice medicine there.  There are exceptions to this rule, but this is usually the case.  The doctor does decide the direction that the patient's care is going by writing for tests, ordering medications, ordering room transfers, making medical diagnosis etc. . . .  But despite being the decision makers for your care, the average doctor spends little more than five minutes per patient as they follow you through the hospital.  This is due to many valid reasons such as the sheer volume of patients each doc has to see in one day.  Now if you can remember what you wanted to ask the doctor in that five minutes you get to see him/her your questions will be answered and it may change the direction that your care is going.  This is the most direct way to drive the care forward and get answers.

Unfortunately, most people don't remember to ask every question of the doctor when he is there.  In this case, the next person in line and the people you will deal with the most are the nurses.  Nurses are the true care drivers in the hospital.  A good nursing staff will dramatically change your hospital visit in a positive way.  Without good reporting from nurses, the doctors in the five minutes they get with the patient wouldn't know how to progress forward with the care.  

In fact, the nurse is the gateway to all the different parts of the hospital.  They coordinate with respiratory therapists to get you your treatments, call doctors when you need things or to report problems, correct prescribing errors with medications, coordinate with the diagnostic testing areas such as MRI and CT scan to get your test done in a timely manner, and deal with pharmacy to correct problems with your medicines.  The nurses are usually the coordinators with all the other parts of the hospital.  This is the main reason they are so vital to your care.

A good nurse can speed your stay up light years. A good nurse can prevent the hospital from slowing down on the weekend. This is why it is so important to keep a strong positive relationship with the nursing staff. It is oftentimes a good relationship with the nurse that motivates the nurse to call a doctor about something for you that they know they are going to get yelled at about. It is that strong relationship with the nurse that makes the nurse fight for you when the doctor is trying to give up on you. Having a good relationship with the nurse will motivate the nurse to help you make very important decisions like when a doctor has approached you to sign a DNR (Do Not Resusitate) form.

Having a strong positive relationship with the nurse is very important, but so is empowering your nurse to action. Some nurses are stronger than others at this. Some nurses will spring into action on your behalf and some will need to be gently built up and called to action. But what happens if you have a weak nurse taking care of you? What happens if you have tried to build him/her up, and ask them to take action for you and he/she still doesn't help you? There are multiple ways of dealing with this and I will cover them in order.

1. Be okay with things the way they are. One of the most important things to remember in the hospital is knowing when to push things and when to back off. Relations with the hospital staff are very important. You must decide when it is worth it and when it isn't to possibly jeopardize that. The following steps are for when you decide it is important that things change. Take caution since it is very easy to make the nursing staff think that your motivation is personal. It helps to use a very strong family member to do this who has a medical background or a health advocate to do this for you as they have experience dealing with medical personel. They will more easily be able to do this without hurting anyone's feelings.
2. Ask to Speak to the Charge Nurse and get your Nurse Assignment Changed. Try to put all personal issues aside and make sure that both the nurse and the charge nurse know that it is nothing personal. Tell them that you just aren't meshing with the current nurse. The assignments arent set in stone and can be easily changed.
3. Ask to speak to the House Supervisor. The house supervisor is the brain of the whole hospital. They coordinate all the bed flow throughout the hospital and thus have access to all areas of the hospital and all departments. They usually have a very holistic view of the hospital and access to many resources others don't have to meet your needs.
4. Ask to speak to Administration. This is the last resort. Sometimes you are left with no other course when something is bothering you so badly. In some cases, it is the system itself that is broken. In those cases, hospital administration is the only group of people that can fix it.

Always remember that your hospital nursing staff determines if you have a good stay or a bad one, a quick stay or a long one, if you understand what is happening or if you are confused and just following along.  Nurses really drive the care forward.  Make sure you keep a strong healthy relationship with your nursing staff.