Friday, January 2, 2009

A hospital stay from the patient's perspective

I have spent the last few years in and out of hospitals (myself and my dad). For 2 of those years I have been the primary care-giver for my dad. I try to maintain a life in the Chicago area and travel back and forth to accompany my dad to multiple hospitalizations. No regrets.

At this very moment, I am hanging out with my dad and helping him fight an infection so that he can undergo additional orthopedic surgery. I give dad antibiotics in the SASH method through a port-a-cath every 8 hours. I take him to PT 3 times a week. I take him to clinic doctors and oncologists. I take vitals, I clean bed pans and help dad stay clean.

Dad is where he is right now because of hospital/hospitalist error. The error was that the hospitalist neglected to communicate with dad's clinic doctors. Unacceptable from my perspective.

My life is on hold because of dad's health. And I am not alone. There are many parents of sick children and adult children of sick parents who quite literally but their lives on hold while they save a life.

That gives us a unique perspective of how hospitals operate.

The common experience is
(1) The patient's PCP advises hospitalization.

(2) The patient knows and trusts the PCP or clinic specialist and agrees.

(3) From the moment the patient enters the hospital, he or she is treated by a doctor who they do not know.

As patients and advocate family members, we are not comforted by this person with a white coat who is a stranger to us, the patients and families. A complete stranger.

For those of you who have not been a hospital patient recently, there are many strangers in the patient's hospital room: hospitalists, nurses, nurses aids, technicians, patient transporters, sitters, social workers, discharge planners, cleaning staff. And if the hospital is a teaching hospital, you can many more people to that.

Imagine you are elderly, in pain, scared, terminal or alone. Imagine the fear. Imagine if you cannot understand the technical language that is being spoken. Imagine the fear.

Imagine if you ask to see your admitting doctor and you are told you will not see the very doctor who wanted you admitted! Imagine the fear.

Imagine if the doctor who you do not know tells you he disagrees with you personal, admitting doctor. And further imagine that the doctor you do not know says you are fine and can leave the hospital. Then imagine you are back in the same hospital (with a different stranger) 3 days later even sicker. Imagine the fear.

Now imagine some doctors saying "you just don't understand the new system." Ahhh-haa. There's the problem. In a culture of nationalized banks and talk of changes in health care, we the patients are very scared about how our interests are going to considered.

I regret to inform the medical community but an M.D. after your name does not mandate that all patients trust you! Trust is earned. And it is darn hard to develop that trust during the course of a hospital admission.

Patients are not just another body in a bed. Patients are not just another case file. They are real, breathing human beings who (up until now and in this country), had the freedom to decide who will be our doctor.

Now, some are suggesting that we should just arrive at the hospital, shut up and be grateful that any doctor is treating us. Um. No. It does not work that way in the United States.

Do I get on a soap box about the delivery of medical care in the United States hospitals? You betcha. Do I blog about problems that I personally see in the hospitalist program model and even non-hospitalists bad doctors who continue to practice? Yup.

And, I have plenty of time to do it. I am not educated as a nurse but I have been one for my dad. I changed my life to be his caregiver and advocate. I changed my life to make sure that he survives with as high a quality of life as possible.

Ad every time that I need to manipulate dad's wheelchair and help a man who is NWB on the left foot, I struggle. My leg buckles and I fall in pain. But I plug along.

I understand that the Duke orthopedic surgeon would not correct my hurt leg because I am a vocal advocate for my dad. No regrets here.

My dad is alive because of me.

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