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Always Have Someone with You in the Hospital

Why You Need a Personal Health Care Advocate

 

Always Have Someone with You in the Hospital

by Dr. Abigail Schildcrout (adapted from her forthcoming book, Your Hospital Guide)

No exceptions. Well, very few exceptions. A hospitalized person will benefit from having a non-hospital-personnel person with him or her at all times.

Your Backup

Redundancy is routinely factored into systems to ensure safety. If one safety measure fails, the backup measure kicks in. Your car has brakes, and it also has seatbelts to keep you from being thrown from the car if your brakes fail to stop you in time to avoid hitting the deer that runs in front of your car. Your alarm clock has battery backup. Your house-wired smoke detectors have battery backup.

Your hospital buddy can remind your doctor that the last time you had a fever and started seeing pink elephants, you had a urinary tract infection.

Your hospital companion is your backup safety mechanism, and a hospital is simply not an ideal place to be without backup. A person in the hospital is either quite ill, or is undergoing something that has potentially serious side effects or complications. A post-surgical patient may be groggy from anesthesia or from pain medications, and may very likely not be able to think appropriately. Similarly, a sick person may very well not be in the clearest state of mind. Chemotherapy can sometimes cause unpleasant reactions — exhaustion and severe nausea and vomiting does not put someone in the best frame of mind to absorb complicated medical information. A woman who has had an uncomplicated pregnancy and has just delivered a healthy child may begin to bleed and may not be in a state to understand a potential need for emergent surgery. Someone needs to be there in the hospital to cover for you when necessary.

If it turns out that there are no acute events requiring your hospital companion to step up as your backup, then you will at least have had some company, and someone to bounce things off of when you had decisions to make. It is never a waste to have had the necessary backup on hand. If you make it home from the grocery store without an accident, you generally don’t say to yourself, “What a waste it was that I had my seatbelt on.” Similarly, when you arrive at work on time, you don’t usually lament the fact that your alarm clock battery wasn’t used last night. Your hospital buddy is your seatbelt, or your battery backup. He or she is your personal advocate in a place where you may very well need an advocate.

Do I Really Need This?

Isn’t that what the doctors and nurses are there for — to advocate for you? Of course, but they have many other patients to care for (your nurse usually has three to seven other patients, unless you are in the intensive care unit, and your hospitalist generally has 12 to 20 or more other patients along with you each shift). It is beneficial to your healthcare providers to have someone knowledgeable about you there.

Or your companion can point out to your nurse that normally you are quite sweet, and the fact that you are cursing at the nursing staff is a severe, sudden personality change, for which you should be medically evaluated.

Your hospital buddy can remind your doctor that the last time you had a fever and started seeing pink elephants, you had a urinary tract infection. Or your companion can point out to your nurse that normally you are quite sweet, and the fact that you are cursing at the nursing staff is a severe, sudden personality change, for which you should be medically evaluated.

Doctors arrive in patients’ rooms at random times. Your companion will be able to take notes for you while you are napping or sedated — just make sure to scribble a permission-to-talk note for the doctor, so that your doctor can speak to your companion and fill him or her in on what’s happening. As you write down your daily list of questions for your doctors, you can decrease the stress of worrying about missing your doctors’ visits when you know that someone you trust has that list and will ask and record the answers for you. You can nap, when necessary, with peace of mind.

Is This Necessary Around The Clock?

What about at night? Again, it is always safest to have someone with you. Your companion is there in case of emergency. Occasionally there may be an instance when someone remains in the hospital simply because they are awaiting a procedure that has been scheduled, or are finishing a course of intravenous antibiotics, but otherwise are rock-stable, and then it may be reasonable not to have someone stay overnight with him (although it is still preferable to have someone there). However, when things are at all rocky, it is still preferable to try to have a companion.

Who Can You Ask?

Who should be your hospital buddy? You should be accompanied by someone who:

  • You trust to take accurate notes for you
  • Will speak up for you and question people when necessary
  • Is able to put up with you when you are in a less-than-perfect-health-induced crabby mood

It should be someone with whom:

  • You are comfortable sharing medical information.
  • You have discussed your general medical goals and wishes, including what you would want done in a life-threatening emergency (if this person is not your legal medical proxy, he must know who your legal medical proxy is and how to reach that person).

This person could be a spouse, partner, family member, friend, or a hired hospital companion (there are private nurses available for hire, as well as trained non-nurse hospital companions who can especially be helpful overnight).

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Dr. SchildcroutDr. Abigail Schildcrout of Practical Medical Insights gives you the time and attention that your doctors can’t give you, and in so doing, gives you the tools to get the most out of your appointments, conversations, and relationships with your doctors.

To discuss how Practical Medical Insights can help you, Call Dr. Schildcrout at 248.439.9123 or e-mail asmd@practicalmedicalinsights.com today.

Practical Medical Insights and Dr. Schildcrout will not serve as or replace your own physicians.