More Hospital Tips

From an insider

Last night’s “hospital tips” post brought this from a physician at a fancy hospital who doesn’t want me to use his name. (See the final, sad, sentence.) I’m doing this as a new post, and not just an update to the old one, so that Substack will push it out to everyone. Lots of good stuff here:

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This was an excellent posting. I wish it were in a larger venue.

I have been an ICU doc for over 30 years. When it is clear to me that a patient is going to be in the ICU for more than a few days, I have talk with the family member who has been around the most (this person is often NOT the power of attorney).

1. Take care of yourself - unless things are really bad, you should go home and sleep in your own bed. If things are really bad, you should create a schedule of shifts with family/friends.

2. Get a pen/pencil and a pad of paper (I used to hand these out before the electronic medical record). Write down 1. your questions whenever they occur to you. Most people think of their most important questions

about five minutes after I have left. They should write down their questions whenever they occur to them. When you ask a team member (Nurse, MD, physical therapist, etc) a question, first ask: are you the person to answer this question ? If they are not, ask them who is. Take notes on the answers to the questions. Use this pad to note major events of every day, including any interventions and the results of any major diagnostic procedures (X-ray, scan, endoscopy etc).

3. Make a list of the teams, their members, and everyone that plays a substantial role in the care of the patient. It is hard to remember the names of all of these people.

4. Different people see and say things differently. This means that if you ask the same question to 3 different team members, you will get four different answers.

5. If you have a large family that wants to know everything about a patient’s care, the time required to answer can prevent the team from getting their other work done. In these instances, it is best to appoint a single

point person for the family. When in doubt, the power of attorney for the patient should be the point person for both the care team and the family.

6. Your advice about kind words and social graces are spot on. Everyone on the care team is human, and will interact more with people that they have good interactions with, and will avoid those that are hostile.

7. While you are with the patient, the environment in the room should be how they would like it. Their TV shows (or TV off for many of us), their music, etc.

8. Always act as if the patient can see, hear, and feel everything that happens.

9. If a patient has not created a will, a power of attorney for health care, and a power of attorney for finances, now is the time to do so. (while the will is difficult to bring up, I cannot count the number of families and patients that have been grateful that I raised this issue).

10. For any patient who is in the hospital (especially the ICU) for more than a few days, the road home is likely to be a long one, often passing through a Long Term Acute Care Hospital and a stay in a rehabilitation facility. You will need your own strength, and the support of family and friends for that time when the patient finally comes home. The burden of caring for them falls almost entirely on that family after that.

If you decide to publish this, please feel free to do so without public attribution. I swim in a sea of leftists.