Tuesday, November 11, 2014

Hospital Life, Paramedics and Advocacy - One Viewpoint

What if you or someone you loved ended up in one of these? This is a typical hospital bed.


Creative Commons Image, Public Domain use*


Do Not Assume

Illness or injury could affect you or your loved ones at any time. Being informed is one step in the process of getting quality care. The information in this post is specific to Canadian hospitals, in particular in transition units, but is generally applicable in the US as well, and concerns dealing with staff in hospital care and advocacy for the patient. This does not refer to independently funded, private hospitals, which have different guidelines and rate scales.

Know Your Rights and Advocate for the Patient

Incompetent and autocratic nurses may try to order you out of the room, OR use old practices such as mixing old food with new food for patients on liquid feed solutions. This practice was changed once it was questioned. You have a right to stay in the patient's room if you want to, so state your intention. Some staff do not like being observed in the care they provide, hence they ask the family or loved ones to leave. Your not being there can result in undue roughness, unsuitable comments to or about the patient, or mistreatment of the patient (with no explanations).

Do not be intimidated by doctors or nurses. Shoddy care can result in the spreading of hospital-incubated illnesses. I've seen the result of poor sanitation and not reading a patient's chart. Ask questions. Ask for upgrades in food given to patient - swallowing tests, dietary considerations, OR request more physio, doctors to check ailments, more training for patient, and progress) Keep a journal of patient's progress if stay is prolonged. Record names so you can be specific when making a complaint.

Be Aware

Find out what resources are available when you have a problem with how your patient is being treated. Demand proper treatment by contacting the appropriate personnel. Meet the Nurse practitioner who works with the patients. Social workers are available at hospital locations. They act a liaisons for the patients, family members and the hospital. This is specific to the health industry. Be wary of nurses or care aides trying to teach the patient  (dementia, brain trauma or injury patients) when they aren't qualified. They can cause confusion on the part of patient.

Advocate for the patient, speak up directly to the staff and when that is ignored, go above their level of  responsibility. Some doctors have made inappropriate comments to worried family members, and some senior nurses in particular remember the days when nursing staff ruled the corridors secondly after doctors. They do not like the fact that family can now be in attendance nearly all the time and observe firsthand the care given. 

Finally, if all options are exhausted, there is the formal complaint process. Dealing directly with the specific unit in the care location is preferable.

The Good Guys

Paramedics and emergency personnel save the day, IMO, as do the attentive care aides and nurses who show compassion and will discuss the care of the patient, without just wanting to check off 'done' on their patient charts.  Many times when the vocally 'short-staffed' nurses ignored the patient's call bell, it was the care aides that saved the day and treated the patient with more respect. Having a family member there to translate from the patient to the staff what is needed is most valuable in these situations.

In these days of cuts to hospital funding, the family is drawn more and more into doing the job (or assisting) nursing staff at rehab places and in hospital transit units. Waiting for the nurses for assistance with basic requests usually means inattentive care for the patient's most basic needs. Be prepared to devote a certain amount of time to the person in hospital care. Side issues to consider are parking fees, and your own health during a stressful and demanding time. You may have to deal with administration issues concerning the family member, adding to the stress

I saw the difference in how a patient is cared for when no family members were around, as I was in attendance for 5-8 hours a day, all days of the week. I gathered a complete image of care except for the wee hours of the morning. There seems to be little awareness that the aging population is a coming trend.


The Bare Facts: Examples of the Bad


Nurses not reading reports, but asking family members

Too much sedation given without consulting family or family doctor

Suggestions not appropriate'The patient could have had a stroke' after too much sedation, OR 'some just let them go-regarding feeding processes

Staff Demands for family to leave the room for any procedures during normal care

Care Aides who try to teach patients and confuse them

Restraints too tight which leave 'embossing on skin', which are used for 'safety'

Staff ignoring the call bells of patients, while they chat or update records at nursing station

Lack of attention to patients at risk, resulting in falls, then blaming the family member

Staff speaking inappropriately to family members or arguing re-requests for patient care

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Have you observed behavior that isn't appropriate in a hospital setting for yourself or a loved one? Do you know who to contact? Have you had an incident with a careless health professional? Do you think our health care industry is in trouble yet? Will health care be adequate to handle the aging population we hear so much about?

Please leave a comment to let me know you were here, and I'll reply. Thanks for dropping by. In this post, I'm referring to the treatments of ailments other than the high profile cancer units, or children's hospitals which seem to do a better job and get more funding. 

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References

* Hospital Bed Image: Creative Commons, Public Domain  This file is made available under the Creative Commons CC0 1.0 Universal Public Domain Dedication

The person who associated a work with this deed has dedicated the work to the public domain by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law. You can copy, modify, distribute and perform the work, even for commercial purposes, all without asking permission.

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24 comments:

  1. One of the reasons I pushed for marriage this year is that non blood relatives are not allowed in ICU unless they are married, and I was worried that if something happened to Russell, I would be denied permission to stay with him.

    My brother in law had a terrible stroke in Jan. and they told my SIL to just 'let him go, he'll never recover, we're putting him in a nursing home to die'. She is a tough cookie and threatened them with a lawsuit. He is doing so well now; he came home in March and while he still can't walk or express himself verbally, he can stand, he zooms around in the wheelchair and scooter, he has dignity with toileting (they remodeled a bathroom for him with a great new toilet and shower). He has use of one arm/hand for eating/drinking and knows everyone. Take that Cape Cod Hospital!!!

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    1. I reported general doctor for something similar, JoJo. As a neurologist and an ICU doctor told us, the medical field doesn't know much about recovery from strokes or traumatic brain injury. Every individual is different, and variables are diverse. Bravo for your SIL!

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  2. We had a bad experience when my father was in the hospital some years ago - too much sedation, medication errrors - in short, a real mess. You definitely do have to be very vigilant, especially when the patient is too ill to advocate for themselves.

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    1. I've heard from others who have had difficulty in the States, Julie, and a doctor and several nurses here said you HAVE to advocate for the patient. One doctor, exasperated, even used his influence to get us out of one unit with arrogant nurses. I've had care aides tell me of more incidents, as they got to know me.

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  3. I hope none of the bad parts apply to our local hospitals. Matt and I have both been residents in them but not for longer than 3 or 4 days.

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    1. Like I said, Jo, do not assume. Like any profession, there are good nurses and hospital units and there are very poor ones where the nurses think they rule the show. I had more trouble with nursing staff than anyone else. I saw mistreatment of dementia patients as well, and some of them used to think I worked there and ask me to help them. Of course I couldn't, but it doesn't make me want to ever have to be a patient, either.

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  4. Over the last few years (and seven abdominal surgeries) I have seen a lot of the good - and the bad.
    And both are amazing examples of their type. And yes, I have logged complaints - and compliments.
    The paramendics who took us to hospital when this all started where amazing. And came back the next day to see how he was. I know they were probably in the hospital anyway, but to take time out to find out where he was and visit touched my heart. First thank you letter generated...
    Our system (Australia) has some differences - but a lot of similarities too.
    Hugs.

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    1. Compassion should be a prerequisite for working in the medical field. I haven't yet met a paramedic team I didn't like. Kudos to you for sending praise. I've verbally done that for the good nurses. One actually apologized after being rude the day before and became friendly after that.

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  5. I've had a number of terrible experiences with doctors and nurses. I worked in a nursing home and observed abuse. When I broke my back, the nurses in the hospital treated me horribly. But I've also worked with excellent nurses who never left the floor for a break and always put the patients first.

    Love,
    Janie

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    1. Then you know the inside story, Janie! My aunt was a nurse, but she was caring, and efficient.

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  6. What a sad situation to find oneself in. As if having someone in the hospital isn't stressful enough. Lucky is the person with a strong advocate by their side.

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    1. I remember my mom saying she could have a 'rest' in the hospital, but that doesn't apply anymore. It's still the squeaky wheel syndrome. . .

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  7. Nurses not reading reports, but asking family members..... something that I have observed in many hospitals.

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    1. That way, they will absolve themselves by saying it was the family's request. Saves them time too. Not appropriate and it is part of their job to know what is shown in the patient's record. Thanks for visiting.

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  8. I'll be bookmarking this post. I don't plan to spend any time in a hospital, but of course I have no say in the matter. Life happens.

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    1. That is the general feeling, Milo, shock at the occurrence and adjustment by the patient and the family. It's the harsh side of the medical part of our world.

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  9. This is a scary thought, something that I, as a healthy person with a healthy family who's been lucky to have avoided any accidents, have never really thought of. I can't remember the last time I've even set foot in a hospital.

    But should I or a loved one need hospital care, I'll definitely remember this. You never think the people that are there to save your life are capable of this, but it's a sad, harsh reality. All you can do is make yourself aware and do everything to ensure it doesn't affect you or your loved ones.

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    1. Yes, it is a scary thought, but it is reality in some instances. Being informed is quite important in many fields today. You have to ask the right questions, too.

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  10. This is really good information. A lot of people think doctors and nurses always know what's right and will always be fully invested. While many are fully invested, not all are. Some are just collecting a paycheck. That's true in any job. Always be an advocate for your loved one, and they will typically get better aide because of it.

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    1. It is shocking to see this firsthand. We do expect caregivers to care. I found out many don't. They dislike family advocates even more as we force them via the right channels to do their job better - at least while we are there.

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  11. DG--I am so sorry this was your experience. I can just comment on what I just went through which was a partial knee operation three weeks ago. I could not have had better care at this Catholic Hospital/Kaiser here in Denver. The surgeon was outstanding and one I had before. I asked for and had the same anesthesiologist I had before (5 years ago). I am very sensitive to meds and they did everything they could to control the throwing up I always do for at least two days afterwards, checking all the time. etc. etc. Opportunity to comment about care with survey afterwards. I don't know how it is with Cancer patients. Everyone needs to have an advocate, asking questions making sure everything is OK, IV's etc. Being informed before and after is very important.

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    1. Good luck with your knee recovery! You're lucky and I'm glad to hear you received good care. As it should be.

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  12. A great piece and definitely a subject that the word needs to get out there to people! Not only is the situation often sudden and unexpected, but as a patient's family, you are sent through an emotional wringer! It is extremely hard to keep your wits about you, maintaining a studious eye and being able to relate specific observations. People need to be encouraged to persevere and do these things despite the pain and turmoil they are enduring simultaneously. Poor behavior as medical professionals' parts needs to be corrected. Excellent care and truly seeing to patients' and their families' needs needs to be uplifted and encouraged.

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    1. Times have changed with hospitals and we must be aware of shortcomings and advocacy when someone we care about is in the facilities.

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