Monday, August 21, 2017

Who's In Charge

Have you ever wondered exactly who is in charge when you are admitted to the hospital? Really, I have not thought too much about it until it happened in our family. Then, it brought back memories. 

Let's just forget about times when I was hospitalized for childbirth and after that, another illness that just popped up out of nowhere. These all happened long, long ago. Let's talk about in the here and now. Many things have changed since the 1980's. Mostly for the better, depending on many factors.

When you go into an emergency room under the orders from your doctor that state abnormalities on your EKG, basically, they will take you back to a room ASAP. The nurses will get you hooked up to machines in order to tell exactly how stable your vitals are. This is how it happened with my husband.

Once you are there, you are in their hands if you want to find out what exactly is wrong with you. There are some things that you may want to keep in mind on how to manage this kind of unexpected situation. It will help things run more smoothly.

It is true, you are in their hands, however, you have rights. Not rights to be rude, overbearing, and obnoxious. I am talking about rights to question what medications are being administered to you and why. Also, what tests are being conducted and why. Asking them to be specific and continue questioning until you understand what is being said. It helps if you have a significant other with you, simply due to the fact that you may be feeling so poorly that it is hard to grasp what is being done to you. At this point, you just want to be well. I was the one there questioning whenever Steve did not. He may have understood it all, I needed to be in the know, also.

If the ER staff determine that you need to be admitted to the hospital for further testing, your stress level can escalate. As you take the ride on the gurney up to your room, it seems like the ride to hell. Putting on that stylish hospital gown and having a name/birthday bracelet placed on your wrist can be intimidating. Steve's sense of humor was still in tact, in that he said he was starting to feel like the hospital was the Hotel California where you can check in but you can never leave.

The best advice that can be taken at this stage is to be open to your new environment. Hopefully you have someone who can be your spokesperson for when you are not able to. Maybe to even be your sounding board to bounce questions and ideas off of, such as if you need a second opinion. Someone must remain 'the constant.' Even though I stayed from early morning until after dinner was served, I knew that I must get rest so that I would be on my toes for the next day. I was his 'constant.'

One thing that is different from when I had been admitted to the hospital years ago is that now there is a doctor assigned as "the case worker." He/she oversees all of the specialists and pulls all of the information together. They are in the advisory role.

Just in case you may not have a significant other or family member who can be your advocate, be aware that most hospitals have staff members who can advocate on your behalf. Take advantage of this if necessary. They can help you know your rights. 

Did you know that you have the right to decline any treatment, including tests, if this is what you want? Even if you don't understand why they need a particular test or to administer a certain kind of medication, until they can explain it in a way that you are able to comprehend. At that stage you have the right to tell them to go with their plan of action or not. Remember, there are no dumb questions. Never be afraid to ask.

One more important piece of advice based on this true experience. Every doctor does not always have a pleasant bedside manner. Even so, he/she does not have the right to come in and upset patients to the point of worry and anxiety, whereas a nurse needs to help in calming the patient after the visit.

First, let's remember that doctors are human. Steve's case manager doctor came in to his room at 10:30 P.M. (Obviously, he had been working a very long day). He questioned him for 30 minutes. At one point argued with him about the dates of a surgery that Steve remembered vividly. My very calm, polite husband shared with me that this doctor made him feel as if he were in The Spanish Inquisition. That was all I needed to hear!

The nurse actually came in toward the end of this doctor's visit because the monitor showed how fast Steve's heart started beating during this 'interrogation.' He shared this with me when I arrived the next morning. I can only tell you that I was ready to go hunt this man down and tell him how the cow will chew the cud! Actually, I was thinking much worse.

Instead, I did some mindful breathing to calm myself down. But wait! Moments later, in walked that doctor! He said a hello to us and went straight into what was going to take place next and in a calm, quiet way. Really, nothing like how Steve witnessed him the night before, even though his social skills were marginal. For example, he did not use our names, shake hands as other doctors did, come in closer to us, or ask if we had any questions. (He needs to retake Bedside Manners 101).

As he was leaving, I called his name and asked if I could have a word with him? He seemed a bit taken back, however, he of course, agreed. He did not move in closer, much less come to my side of the room. What he did do was listen to me. I used a calm, cool and collected voice. Always start with a compliment, so I told him that I had heard good things about him. Our family doctor only has referred us to the best of the best for doctors outside of his expertise. Then, I went in for the disappointment in him due to how distraught my husband felt after his late night health survey visit. That was really not an appropriate time to question a man in a hospital bed with atrial fibrillation. I let him know that the nurse came in after he left to find out why his heart rate had gone so high out of whack. To end the conversation with him, I simply said that he was to treat my husband from now on with kid gloves. 

What could he do? What could he say? He nodded his head and mumbled something that I took as an apology as he left. I asked Steve if I embarrassed him or if he thought I handled it professionally. He told me that he thought I did well.

It seems that I must have, because every visit from then on was calm and informative. He was on the best bedside manner behavior that he was able to give, which was good.

There are times that one must have uncomfortable conversations and luckily my former job prepared me for this. I am my husband's strong advocate. I will always be there for him, just as he is for me. 

So...I ask again..."Who Is In Charge?" 

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