On Being Hospitalized

Evelyn Philipps

— Following a recent fall at the home of my daughter, I was hospitalized for the first time since I was in a maternity ward more than five decades ago. Since I had spent twenty plus years working in a medical setting, I considered myself reasonably sophisticated about medical matters and still, the experience taught me several new and important lessons.

The first lesson was about getting to the hospital. My daughter, who lives barely two miles from the nearest hospital, knew enough not to drive me there herself; instead, she called 911.  They dispatched the Volunteer Rescue Service. The ambulance arrived within minutes and the emergency medical technicians (EMTs) immediately started to treat me. They checked my vitals, assessed my general condition and mental status, and checked the list of my medications. The EMTs relayed the information to the hospital and informed the emergency room (ER) of our estimated time of arrival (ETA). When we got to the ER I was immediately put into a bed. This avoided sitting in the waiting room, triage, and filling out endless-seeming paperwork, all of which I would have had to endure if my daughter had driven me to the hospital. 

We are fortunate to live in a county with a first-class rescue squad whose services are free. (Policies regarding ambulance services vary from one locale to another, and I suggest that you check out the policy in your area.  Use of a private ambulance can be costly and often is not reimbursed by Medicare or other insurance.) 

Lesson Number Two concerns medications. The doctor in the ER informed me that one of my medications was not in the hospital’s formulary, presumably because it is too expensive. What I didn’t know — and what no one told me until much later—is that I could have provided the hospital with the medication in its original bottle and the hospital pharmacist or ER doctor could have approved my taking it. Thus, the nurses on my unit could have dispensed it along with my other pills. As it was, I endured a long stretch of excruciating pain in the middle of the night, which was finally alleviated by a shot of morphine.which might not have been necessary had I had the medication which was not on the formulary. (Here again, medication policies vary from hospital to hospital.)

Another thing I learned is that so-called “frequent fliers” to hospitals keep handy a bag with all their medications in their original bottles in case they require hospitalization. To be sure, hospitals don’t encourage patients to bring their own medications lest they take pills without the nurses’ knowledge. Hospitals need to have control over the medications patients take to ensure that nothing is contraindicated, potentially harmful, or which can cause an allergic reaction.  However it never hurts to ask if you can provide your own medication.  I have always carried with me an up-to-date list of my medications, other pertinent medical information, and the names of persons to contact in the event of an emergency. I realized how important it is to keep this list current.

Lesson Number Three is not to go it alone, if possible. Nowadays many hospitals are over-crowded and under-staffed, so it never hurts to have an extra set of eyes and hands when you are hospitalized. Having a list of relatives or friends on hand is a good idea.  Among other injuries, I hit my head on a slate patio when I fell, which caused a small brain bleed. That meant I needed close monitoring of my mental status. My husband was able to stay with me through the night in a comfortable recliner provided by the hospital for just this purpose. This is why I strongly suggest that patients have someone stay with them, at least initially, to serve as an advocate who can go to the nurses’ station, make phone calls, and do whatever else may be necessary for the patient’s care and comfort. Luckily the brain bleed turned out to be negligible and I required no surgery.

On the whole, my stay in the hospital was satisfactory with ample room for improvements. Nurses were sometimes not there when I needed them, especially after the first two days.  Clearly, they have a heavy caseload and need to prioritize. So I learned a few additional lessons: speak up, ask for what you need or want, and ask questions. Most important of all, don’t go home until you know that everything you will need at home is in place and which services, such as physical and occupational training, will be provided. You have the right to refuse discharge if you feel the plan is not safe. I made the mistake of going home prior to the delivery of a hospital bed. Scheduled to arrive at 5:30 p.m., it wasn’t delivered and set up until 10:30 p.m., by which time my husband and I were  thoroughly exhausted. To make matters worse, the bed came without guard rails. It was not a good homecoming.

A final note: let the hospital know about your experience, both the positive and negative aspects. That way nurses and other staff members who went the extra mile, get the positive feedback the well deserve, and those who could have done better are held accountable and can work on improving their skills.

I am now on the mend and extremely grateful, knowing that this could have been a catastrophic, life-changing event. I hope others can benefit from my experience.