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CHAPTER 6: GOING INTO THE HOSPITAL


Hospitalization may be necessary for a specialized medical procedure, for an elective surgical procedure, or because your illness has become so severe that it cannot be managed elsewhere. Ideally, there should be time to schedule a hospitalization without the pressure of an emergency. Very often, however, this is not the case, and when you need immediate medical attention, you go to a hospital emergency room. The physicians who are on call will evaluate your condition and decide or recommend whether you need to be admitted. State and federal laws prohibit hospitals and emergency rooms from refusing care to anyone who needs it. When you are seen in the emergency room, your personal physician will be notified. Your doctor, if available, may come into the emergency room if he or she has privileges to practice in that hospital.

    Before you agree to be admitted into a hospital there are several important questions you should ask: Is being admitted the best of any alternatives? What procedures or treatments are likely to be done during the hospitalization? How long will the stay be? What would happen if you were not admitted?

    When you are hospitalized for elective surgery, a number of additional health care personnel become involved: the surgeon, the anesthesiologist, the radiologist, as well as others. You will experience a number of different hospital environments that may well be unfamiliar and confusing: the operating room, the recovery room, and, possibly, the critical care unit. (Surgery is discussed in more detail in the next chapter.)

    Before you go to the hospital, try to do some planning.

  • Make a list of questions or concerns to discuss with your doctor prior to your hospitalization
  • Ask your doctor how to reach him/her while you are in the hospital
  • Carry with you a list of your medical conditions and current medications, any drug or food allergies you have, your insurance information, names and phone numbers of family and friends
  • Label personal items (hearing aids, dentures, eyeglasses) with your name and address to avoid loss
  • Leave jewelry and other valuables at home
  • Take to the hospital a personal belonging (not a valuable one) such as a photograph of a loved one, to provide comfort and reassurance

    There are other aspects of hospitalization that may dismay or bewilder you aside from the discomfort of being ill or undergoing uncomfortable medical or surgical procedures. Knowing about them ahead of time may help dispel these frustrations. Hospital admission usually requires filling out a number of forms and making a number of complicated decisions. There will be significant changes in your daily routine and you will likely be put through a number of tests in unfamiliar settings. Your normal familiar clothing will generally be replaced with unflattering and rather revealing hospital gowns. The food is not always appetizing and may be served at unusual times of day. And you will probably experience some lack of privacy. Medical staff and hospital personnel will be going in and out of your room continually to ask you important, but fairly demanding questions or to take your temperature, give you medication, change your linens, adjust your bandages, and so on. Most people will knock on your door and then barge on in before you can respond. Although you may feel intimidated or dependent in the face of all of this authority, remember that your health is your first concern in such circumstances and, ultimately, your responsibility. In the end, you--not the hospital staff--are the person in control of your well-being.

    It is important that throughout your hospitalization you look out for yourself regarding your care. After all, mistakes and accidents can happen in the hospital, and the best way to avoid these is to ask plenty of questions. Ask about medications, ask about procedures, ask about when or how things are supposed to occur, and so on. Some of the anxiety of a hospital stay can be relieved if a family member, a friend, or other interested person can be there to help look after you and be your advocate.

    When you're admitted, you need to consider what type of room to get, how much it will cost, whether a telephone or television is or can be provided in the room, and whether special dietary concerns can be handled. Generally, you will have to sign a form agreeing to the type of care that is being provided: This is not a consent form for specific kinds of treatment. Other forms involving the method of payment give the hospital permission to share information concerning your circumstances with various organizations, such as insurance companies that may be involved in paying for your hospitalization and any procedures. Once you have completed filling out forms, which may be time-consuming, you are generally taken either to your room or to other sites within the hospital where you will receive various tests (blood tests, X rays, electrocardiogram, etc.) that may be required as part of your hospitalization.

    While you are in the hospital, you should expect your doctor to visit you daily and sometimes more than once a day, depending on your situation. Besides talking with you during these visits, your doctor will evaluate your condition and write various orders and progress notes in your chart so that nurses and other staff members are kept up-to-date on your care. You should feel free to talk with your doctor about these orders so that you will understand what is being asked of other staff members while you are a patient. Also, you should know how to reach your doctor while you are in the hospital.

    While in the hospital, you have a number of rights:

  • The right to be free of restraints and abuse
  • The right to leave the hospital, even against the advice or wishes of your doctor
  • The right to refuse medical care, even if life prolonging
  • The right to know the truth about your condition
  • The right to keep your condition a secret from your family or anyone, unless you have a contagious disease

    You also have the right to know the truth about your condition, including an honest description or statement. You also have the right to keep your condition a secret from family members or anyone else. The exception to this is when you have a contagious disease.

    As soon as possible after being admitted to the hospital, you, a family member, or a close friend should speak to a hospital discharge planner. Preparing for your discharge can take anywhere from a few hours to several days, depending on the nature of your condition and your personal situation. It's best when family members and others who will care for you after hospitalization are involved in the planning. The main issues are the ease or difficulty you will have in performing daily activities after discharge from the hospital and who will assist you on a day-to-day basis. Once this has been settled, it is important to determine the date of discharge. You should receive written notice of the discharge date, after which you have until noon of the following day to decide whether this date seems appropriate. If you decide that the discharge date is inappropriate, you should discuss this as soon as possible with both your doctor and the discharge planner. If you have good reasons for objecting to the date of discharge, it can often be changed without any lengthy process. The main objective is to remain in the hospital only as long as you need the care that can be obtained only in the hospital.

    We have acknowledged that a hospitalization can be a trying process that is made even more challenging because it happens when you are not always feeling your best. Although you may feel a loss of control and a sense of intimidation, the key to overcoming these feelings is to look out for yourself and ask plenty of questions. Having another person with you is also very reassuring.




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