A hospital is no place for the sick. Ways to make it better.
We all have underlying insecurities about losing control.
Posted Oct 03, 2010
A quick trip to the ER is nerve-racking enough. But a protracted hospital stay? No one likes the sound of that.
Illness aside, we fear a lengthy stay because hospitals (and nursing homes) are not, we hope, of our regular world. There are the illnesses to be caught there--as Maryn McKenna describes in her new book Superbug: The Fatal Menace of MRSA. And there are the medication errors, like the much-publicized heparin overdose given to Dennis and Kimberly Quaids' newborn twins.
But there are other realities that tap into our underlying insecurities about losing control. As someone who has worked in hospitals and who has had both parents hospitalized for lengthy stays, I speak from experience when I say that the hospital is another dimension (might there be "The Twilight Zone" on Medicare?). The flip side is that many lives are saved thanks to a hospital stay. When a person is healed—or cured—we are grateful there was a place to go, and specialists to intervene, and we call it a miracle.
This is the paradox.
Here's another. If you don't open your mouth the staff won't know your needs. But if you open your mouth too much you fear the risk of alienating the staff that is there to save your life. We feel at once royally annoyed yet oddly impotent. (Remember what happened in the Seinfeld episode when Elaine gets on the wrong side of one doctor, and the office "makes a chart" on her. Subsequently, her "difficult reputation" follows her around New York from doctor to doctor as she tries to get help for an itchy rash.)
Seinfeld episodes aside, the reality is clear. "The only person that connects the entire care team is the patient, but often the patient is the one who feels most out of control," Dr. Alpesh Amin, professor and executive director of the Hospitalist Program and Chairman, Department of Medicine, at University of California, Irvine, says. As such, whenever you can look for a doctor who understands who is most important (you). Go ahead, ask how they view the doctor-patient relationship. There is no place for ego in medicine.
In fact, Dr. Amin makes very clear that the single most important thing is that a doctor must understand that the patient should drive the practice. "I'm one person who knows science," Dr. Amin explains, about a physician's knowledge of the medical aspects of the case. "I need to know more about the other points of view of the care team and the patient and family," he says. By this he is referring to any number of issues that may include: what the patient wants, spiritual, religious, ethical values, medical history, family history...the list goes on. "Only then can we come together to help the patient make the best decision."
It's a good reminder, and it helps that it comes from the top doc at UCI. Still, the hospital can be a scary place. So, how can we feel more in control while we're in an environment that makes us feel out of control? Here's a few thoughts to keep in mind:
• If you are not satisfied with the care of your physician or other healthcare professional, try to speak to that person. If that does not work...
•. Ask to speak to a social worker. Clinical social workers are specialists in providing counseling and in facilitating better communication between physician and patient and the patient's family.
– Often, patients do not request a social worker because they believe that social workers only provide meal vouchers and bus passes (some hospital personnel, I'm sorry to say, are under this misconception as well). This is not the case.
• Do not hesitate to request a visit with a member of the hospital's spiritual care team.
– Times of crisis can throw us into a mode of questioning ourselves and our lives, which is but one of the reasons hospitals have chaplains on staff.
• If there is a problem that doesn't improve, find the Ombudsman.
– An ombudsman is a person who investigates and mediates patients' problems and complaints in relation to a hospital's services. This short article from The Washington Post provides a great snapshot of recommendations from the Joint Commission on Accreditation of Healthcare Organizations, a nonprofit organization that evaluates hospital care about how to address concerns in the hospital.