How to Escape the Hospital Alive: Some Practical Tips

1) Indulge your germ-phobic tendencies. Quite frankly, hospitals are filthy places, and the people who work in them can easily pass the muck among patients as they go about their daily jobs. This includes nurses, nurse aides, physical and respiratory therapists, laboratory/radiology personnel, dietary workers, custodians, and most certainly physicians. In response to alarming outbreaks of multi-drug resistant bacteria, many facilities have established infection control protocols to combat the problem. Nevertheless, you should insist that all staff wash their hands before touching you, especially if they are assessing IV lines, open wounds, urinary catheters, or any tubing that enters your body. Donning a pair of gloves alone is not sufficient, and you should not be shy about voicing your opinion. Moreover, ask physicians or anyone with a stethoscope to swab the diaphragm (the circle-shaped part that touches the body) with an alcohol prep before they place it on your skin. These practices will reduce your chances of acquiring a potentially life-threatening nosocomial (hospital-acquired) infection.

2) Question all medications before you take them or before they’re administered to you. ALL personnel should ask you to state your name (if able) and should double-check your demographic wrist band before administering any medication. The same goes for drug allergies. If you are given a pill that looks unfamiliar, ask the name, why it was prescribed, and how long you will be taking it. If the nurse comes in to give you an injection or IV medication, definitely question the medication. Drugs administered by injection into the subcutaneous tissue, the muscle, or directly into a vein take effect much more quickly than those given orally, and errors can prove fatal in a matter of seconds. This is especially true for blood products. At least two licensed individuals (usually nurses) should match the blood product information to your identification and “blood” band information. Wrist bands are critical for identification purposes, particularly if you become incapacitated. You may find them unfashionable, but you literally risk your life by refusing to wear them.

3) Demand a healing itinerary and question deviations from the plan. You have the right to participate in your health care plan and to question it at any time. Physicians, nurses, and ancillary personnel should explain every step in the healing process, including your diagnosis, procedures and services to alleviate your problem, as well as the expected healing trajectory. For instance, if someone comes to draw your blood or take you for an x-ray when your physician or nurse has not informed you that these services are needed, do not hesitate to refuse and ask for clarification. With multiple physicians and several nursing shifts involved in a patient’s care, orders can be duplicated, cancelled, or changed within a short period of time, thereby increasing the chance of miscommunication. Your care plan is constantly evolving, and despite how powerless you may feel in the hospital setting, you remain the captain of your healing ship. By speaking up, you could very well avoid an unneeded and potentially harmful test!

4) Have a friend or family member stay with you as much as possible. Hospitals vary in their visitation policies, and specialized units like critical or intensive care areas may be very strict, but having a personal advocate or a second pair of vicarious eyes to watch after you where allowed is in your best interest. He or she can help ease your mind that your care is going as planned, especially in the immediate hours following a surgery or procedure when you are still heavily sedated. Your advocate can also ensure that your needs are met in a timely fashion, such as summoning help when you are in pain or need assistance using the restroom and cannot find the call button. Many a hip has been broken and a hospital stay prolonged when an incoherent, weak patient attempted to get out of bed on her own because she could not get help for any number of reasons. An advocate is often a family member who is aware of your medical history and can act as a decision-maker should you be come incapacitated. However, you should be aware that due to privacy concerns, the healthcare team cannot discuss your care in detail with anyone at your bedside unless you have given express permission.

5) Check out of the “hosp-i-tel” as soon as you’re medically stable. The more time you spend in the hospital, the more likely you are to develop complications, such as pneumonia and urinary tract infections, and to become a victim of a dreaded medication error. Everyone excoriates managed care for encouraging ever-shorter hospital stays, but at least part of their reasoning is sound—people get sicker the longer they stay, which leads to poorer health outcomes and higher costs. In fact, the Centers for Medicare and Medicaid Services (CMS) recently announced it will no longer reimburse hospitals for multiple hospital-acquired complications, and private insurers are following suit. The hospital is no place to stay well, and since many services including long-term IV antibiotics, complex wound care, and physical therapy can be done on an outpatient basis, even within the home setting, it pays financially and physically to leave without delay as soon as the acute phase of your illness/injury has been resolved.

These tips are not meant to imply that hospitals are places to avoid at all costs, nor that you should be exceedingly paranoid when you enter one. Hospitals are great places to be when you are acutely ill or injured, and most healthcare workers strive to provide the highest quality of care. Housing many patients with nasty bugs and compromised immune systems in close quarters presents a significant challenge—how to not only heal the sick, but keep them from getting even sicker. It is no easy task given the unique environment and other factors like the critical nursing shortage. You may think that by asserting yourself you will be labeled a “problem” patient. If you express your concerns politely, most personnel will be happy to explain things in detail and comply with your requests. Some of us will be downright delighted to interact with such a well-informed patient! Keep in mind that in most cases, you are only asking healthcare workers to do their jobs correctly. This is not an unreasonable request. In all honesty, after all your effort you may be labeled a “problem” patient. Still, better to be a “problem” patient than a dead or maimed one, no?