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


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. 



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

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