The responsibility of working in a hospital is immense. Imagine every working day having patients and their families depend on you during some of the biggest challenges of their lives. When I had the recent shattering of fortune to spend most of a month with a family member in the hospital, I was disappointed and scared to run across the issues I discuss here. This hospital was top rated in the country and benefited from being inside a world-class city. If these problems happen here, they could happen anywhere. To counter my frustrations over the people and parts of the system that were faulty, I did much praising and thanking the workers who were thoughtful, who were professional, who worked from their heart. In the end, a lot of humans, with both imperfections and superpowers, helped bring my family member to wellness. I am grateful beyond words. I share my top complaints and solutions in hopes of ever-building a better system. I hope you'll share your experiences, too. (And make sure to read Surgeon's wisdom: 7 ways to prevent medical errors)
1. The fall risk. Hard drugs, such as morphine and Dilaudid, are often administered to weakened people, who are not told that they should only walk with assistance once they have taken these drugs. If the patient is not elderly (and sometimes even if they are), they are often overlooked when it comes to these instructions. My family member was not old but she had no business walking while blitzed on morphine. Luckily, she was with a friend who caught her when she did in fact fall. In the waiting room, I spoke to a woman whose great aunt, a patient at the hospital, had broken her wrist this way.
Suggestion: Let the nurses know that the patient will need their help walking anywhere, and ask the patient to consider a bedpan instead of walking to the bathroom while they are on heavy medication. Tape up your own signs on the door to remind the staff that this person should not walk while on pain medication.
2. Nurse scrabble. Being assigned 40 different nurses in 20 days exhausts patients and families because they constantly have to explain health histories and preferences. It also discourages good working relationships from forming between the patient and the nurse, and most importantly, it stretches the window for error. Nurses debrief each other before a new shift begins, but we all know what happens in a game of Telephone.
Suggestion: Find the charge nurse and tell that person you need more continuity of care. They should know what that means.
3. Meal plan. My family member was served corn chowder, a cream-based soup, while she was recovering from an illness that required her to avoid milk until she was well. This represents a real systemic problem in hospitals. There are only a few types of meals -- Clear Liquid, Full Liquid, Low-Fat, etc. -- while there are trillions of health problems being dealt with, and the nurses don't edit the meals for individual cases. This leaves patients vulnerable to a lot of complications.
Suggestion: Ask that a hospital dietician visit the patient. Then call down to the kitchen to make modifications to menus based on the dietician's recommendations. If necessary, call the kitchen prior to every meal.
4. Communication confusion. Getting updates from all the doctors in an orderly way without living at the hospital feels next to impossible. One doctor wouldn't return phone calls from family and insisted I be in the hospital room if I wanted to hear his updates first hand. He was rarely on time and the patient had way too much on her plate to ask all the questions that needed to be answered. This meant that to get our questions answered I had to wait for hours for this doctor to appear. When he did appear, I'm happy to say he gave us a lot of time and was very easy to talk to. Of course, there are also the doctors who won't give you any time at all -- unless you demand it.
Suggestion: For the no-phone call doc, I never found a solution. I just waited it out at the hospital for him. For the fly-by doctors, I would remind myself that contrary to their beliefs we were acting under no hierarchy. These doctors and I were equals and they were being paid to answer our questions. I made sure to have the questions written out beforehand and planted my two feet square on those hospital tiles. Speaking to them never felt comfortable but I got answers that we needed day to day.
5. Bedside mismanners. During some of our hardest times in the hospital we carefully created a healing environment in the room. We'd put on soft music and spoke quietly and lovingly. Seemed like that's when a doctor would walk in and speak at a volume suitable for a lumber yard. This was just one of the colorful bedside manners we witnessed.
Suggestion: Interrupt the doctor to nicely let him or her know what you need to change. "Sorry to interrupt," I said at one point. "We're trying to create a calm space in here. Would you be able to talk more softly?" The doctor took the note and lowered his volume -- a tad.
6. The jaded stone. My family member was having pain from a new IV. Concerned, I went looking for the nurse who was on lunch. The only person present was the receptionist. She didn't want to help me but I begged her, my family member was in pain NOW. Finally, she sauntered into the lunch room. I watched her chat casually with some nurses about something else and pop a berry in her mouth before coming out to tell me that lunch would be over in awhile and someone would help me then.
Suggestion: I didn't do a very good job on this one. I kind of flipped out and marched into the staff-only lunchroom and got a willing nurse on my own. I'd recommend staying calm, if possible.