How To Survive a Hospital Stay

Tax audits. Shark attacks. Things that go bump in the night. Worries pitter-pattering in that empty space beyond the controllable, from where all scary inklings spring. For some people, a hospital admission conjures the same kind of fear. It can be that intimidating. Whether for a planned procedure or as the result of an emergency, the prospect of a hospital stay can rattle even the most poised. The crisp, sterile environment bustling with doctors, nurses and allied health professionals is foreign and disconcerting. It implies a loss of control. Admission to the hospital drives home the unwanted fact that something is indeed wrong; that your body, or that of a loved one, harbors illness or injury. Fear of the unknown merges with worries about prognosis. Despite a strong desire to recover, patients can find the experience emotionally taxing. Fortunately, knowing what to expect and how to prepare can minimize anxiety.

Both Sandy Gunn, patient advocate at Doctors Hospital of Augusta, and Marcia Smith, administrative director of inpatient services at Trinity Hospital of Augusta, agree that patients may feel unsettled about a hospital admission. Though hospital stays can range from a single night to more than a week, the average lasts about 3.5 days. Whatever the duration, the patient needs to relax and focus on wellness. “We want patients to know they’ll be taken care of,” says Gunn.

Passivity, however, is not the prescription. Never enter the hospital with the idea that you must surrender your body to medical science, looking forward to reclaiming it only upon discharge. Patients are encouraged to take an active role in their treatment and recovery. “The patient is part of the healthcare team,” says Gunn.

As a patient, you have rights and responsibilities. Patients can consent to treatments and refuse treatments. Respect combined with confidentiality and protection of dignity is required of those providing care. A patient is on the front lines of pain management, expressing level of pain plus which course of action is working and which is not. Self-reporting of change in condition contributes to the healthcare team’s assessment of the overall effectiveness of the treatment plan. Clear communication and interaction with caregivers is essential.

A hospital admission occurs through three pathways: a primary care physician may directly admit a patient; a patient may be admitted for a pre-planned surgical procedure; or a visit to the emergency room may result in admission to the hospital. In all cases, you will be assigned to a room, private or semi-private, on the appropriate unit. Each patient wears an “identiband” on the wrist, which should be matched to the labeling of any medication dispensed to the patient and any doctor’s orders for procedures.

Shortly after you get situated, a nurse will perform an initial physical assessment. He or she will also orient you to the room, explaining how to use the nurse call button and operate the bed controls. Other relevant information, including papers with pertinent hospital information, is given to you as well. This is an excellent opportunity for the patient or a family member to ask questions.

Any number of a variety of medical professionals may serve you while in the hospital, depending on your diagnosis and treatment plan. “There’s a wide variety of information [patients] get from each person and it can be overwhelming,” says Gunn. Registered nurses (RNs) and licensed practical nurses (LPNs) remain in direct contact with patients during their stay, implementing doctors’ orders, administering medications and managing IVs. Certified nurse assistants (CNAs) take vital signs, aid patients with personal hygiene activities and assist patients who need help with eating, along with additional duties. Representatives from dietary services deliver meals and representatives from environmental services clean patients’ rooms.

Other medical professionals may provide care on a less frequent basis as needed during a hospital stay. Your treatment plan as prescribed by the surgeon or treating physician will determine whether you see an anesthesiologist, radiologist, physical or occupational therapist, social services representative, respiratory therapist, nutritionist, clinical nurse specialist or clinical pharmacist. Some hospitals, such as Trinity, also have pastoral care staff who minister to the patient’s emotional and spiritual needs. If unsure about the treatment plan or the types of services to be received, you or a designated family member or friend should ask for clarification.

Having a family member or friend stay over during a hospital stay gives some patients peace of mind. Hospitals favor the support of family and friends during recovery and most allow visitation 24 hours a day as long as it does not interfere with patient health. While it is not necessary for someone to sit bedside throughout a hospital stay, according to   Gunn and Smith, and such a choice is left to the discretion of the patient, there are circumstances in which it may be advantageous. Patients groggy from anesthesia or pain medications, patients who may not feel confident posing questions to the doctor and those who are disoriented for whatever reason may need a family member or friend to listen to the doctor’s instructions and gather information.

Furthermore, most patients at some point in a hospital stay are not ambulatory and may choose to ask someone to stay who can hand them items out of reach, interact to pass the time and notify hospital staff of any change in condition or need they might have. Smith suggests several ways that family members or friends can be helpful: “Read to them, keep them comfortable, remind them to comply with treatments such as not getting out of bed without assistance, asking questions they may forget to ask, assisting with eating or hygiene, or orienting them to day, time and place.”

Nonetheless, consideration for the other patient in a semi-private room is important. Gunn suggests having only one person stay bedside and only two visitors at a time. She also reminds people that when staying over in a semi-private room, a friend or family member must be the same gender as the patient. In addition, anyone with a compromised immune system or who has an active communicable infection or who has been recently exposed to a communicable illness should not stay with or visit a hospital patient.

In the case of the unthinkable—making end of life decisions—advance directives, in the form of a living will and a durable power of attorney for healthcare, give you, the patient, a voice. Gunn says that all adult patients admitted to the hospital should bring advance directives with them and have a copy placed on the medical chart. (Forms for Georgia may be obtained in pdf format from http://www.re-quest.net/g2g/legal-forms/medical-directives/#GA.) A living will describes a person’s desires exactly, specifically stating what life-saving measures should be taken, and which ones should not, and can be executed when no family members are present. With a durable power of attorney for healthcare, a person appoints a legal representative to make his wishes known in the case that he is unable to do so.

Happily, the majority of hospital stays end in discharge to home for completion of recovery. You will receive a written copy of the doctor’s discharge orders, which will inform you about dietary restrictions, medications to quit or to continue taking, physical limitations and so forth. In preparation for going home or to another facility, Smith says, “While hospitalized write down all the questions you might have about what you may need at home. Can I take a shower? Can I get this wet?  How do I clean this?  What should I watch out for?” Being released to one’s own devices can be just as scary as arriving at the hospital. Ask questions and understand indicators for when a physician should be seen.

“The hospital is a place where the patient’s health is restored,” says Gunn. Enter assured that everyone there shares the same goal of healing you. Ask questions. Actively participate in decision-making. Comply with the agreed upon treatment plan. Get on the road to recovery.