Maneuvering through a hospital stay can be difficult as well as scary. Recently my roommate was hospitalized. Please understand this is not the first time. There are a lot of health issues involved so we see the hospital at least once a year and sometimes more – we are not novices. Each trip brings it’s own revelations and issues.

The hospital in our little town has “grown up” along with the town and is now considered one of the top hospitals in the area. We are of course, thrilled at the influx of knowledge, skills and professionalism but for every action there is a re-action right? In this case there is a downside that is very apparent. With more doctors and programs in the area, obviously there is more support personnel. Support staff, have a different mind set – they are not accountable to you the patient, they are accountable to the mega system they have become part of. (Remember this little tidbit – it is the crux of so much that is unfortunate in our society.) To paraphrase one TV character some of them are so busy trying to keep their job that they forget to DO their job.

1. The patient absolutely must have an “advocate” – someone who will be there to help the patient make important decisions, someone who can listen to what the doctors are saying and ask appropriate questions to fill in the blanks. When support staff realize someone else is involved, the better the care. Pick the advocate carefully, people who are too emotional are not good candidates. Advocates who are not related should never sign paperwork for the patient, more than one agency has slipped in financial papers and later come back to the signer for payment.
2. The patient and the advocate need to be committed to your needs and concerns but also helpful to the staff.
3. The patient and the advocate must be as upbeat as possible when interacting with the staff – don’t give a false impression of how the patient feels but don’t whine – the staff will run from the patient at every chance. If you are a joy to be around, they are much more likely to check on you.
4. Please remember the support staff are not personal gophers or hoteliers. Be cognizant of what they have to get accomplished and all of the other patients. If you are lonely, ask for a chaplain, their job is to visit with you and they can find others to drop by. They are good at talking about all types of subjects so don’t feel like it has to just revolve around religion.
5. Absolutely do not leave the hospital without a full understanding of the medicines that you have been given in the hospital versus the ones you are being sent home with and why there may be differences.

1. Hospital staff are people too, please respect them.
2. Sometimes pushing you to do for yourself is part of getting well and part of the assessments.
3. Never take your shoes off, hospital floors have the most germs.

• Something off the wall always happens on each visit. During this last stay, for the first time ever, my roommate was not given any food choices. The third night, fish was served which she detests. We knew we could request the dietary department to change out the dish so we called. When we called I also asked what happened to the permanent record they had of her food choices. Surprisingly, I was told that nothing was on record and if there were certain foods she wouldn’t eat, then she would need to list them in her medical records as food allergies. I almost gasped. This was big news and created a lot of concerns in my mind. How cognizant was the Dietary Dept in what the “allergy” list was used for and in the overall care of the patient? Was the hospital on board with this change in policy? Would the fact that certain foods were on the list raise any red flags to the doctors or pharmacies and restrict any medications or treatments that might help her in the long run? Or was the technician just misinformed?

• Another AHHA lesson from this visit – A patient who is in the hospital to undergo exploratory tests who throws up all over herself and has very limited mobility skills is not a cause for immediate help from the nursing staff. Again this raised concerns for me but the biggest questions were” is this real or is there a staffing problem" Am I just being overprotective? What should be the proper response to such disregard? I finally decided to write a letter after she left the hospital - this might help to ensure there would not be reprecussions against her in the care she recieved. And yes, any support staffer who might read this, there are definately reprecussions, we've experienced it first hand.
• And the 3^rd big AhHa lesson – this AhHa lesson was actually a validation of things we had learned earlier. Weekend nursing staff is rarely the same caliber as the weekday staff. Because most of them are PRN (which means called in as needed), there is a wide variation in skill sets and they don’t necessarily meld into one cohesive team however, the good ones shine far above any of the weekend or weekday staff, their commitment is evident in everything they do. On the opposite side of the coin, the weekend specialty staff (respiratory, lab techs, testing crews, etc) almost always outshine the weekday staff – who knows why, it just seems to hold true.

Please note that these AhHa’s are from our small hospital and may or may not be true in your community. Any concerns you have should be raised with the nursing management. The medical profession is a tough field and only one or two bad apples should not be the measurement for the rest of the staff and their overall care. Be vigilant not to judge everyone by a few. Be viligant, be nice but be firm if the situation warrants. It can mean a world of difference to your health care over the long haul.