If you’re admitted to a hospital, you may lose your sense of control over your own healthcare.
You’re expected to wear a gown instead of your own clothes. Many people pop into your room unannounced, and they write notes in a chart that you can’t see. You may be given medications but not know what they are for, and sometimes, you may not know who is making decisions for you.
Yet autonomy is a cornerstone of medical ethics. Capable patients must be sufficiently informed in order to make the best decisions for their own care.
When you visit a physician, nothing is done without your consent. After listening to your concerns, asking more questions and performing an examination, the physician will offer a working diagnosis and suggest some options for investigation or treatment.
In order to make informed decisions, you need four key pieces of information: (1) the purpose or reason for the treatment or investigation, (2) the common side effects or risks, (3) the serious, including life-threatening, side effects or risks, and (4) alternatives to the proposed treatment or investigation.
Here are three keys to improving your hospital experience.
- Stay in control. If you are capable of understanding your situation and treatment options, you should continue to make important decisions about your care in the hospital. Ask the four key questions for any proposed treatment or investigation.
Ideally, you should express your wishes before you find yourself in the hospital. Consider writing an advanced medical directive. If you become ill or incapacitated, what types of treatment would you want? If you were no longer capable of making your own decisions, whom would you entrust to make decisions on your behalf? Discussing these issues ahead of time will make things easier for your family and will make it more likely that your wishes will be respected.
- Know the team. There are so many people working in the hospital that many patients don’t know who is who. It doesn’t help that many health care workers wear surgical scrubs (or “greens”) and white lab coats.
What could be easier than getting up and changing from comfy pink sleeping pajamas to comfy green pajamas? If we all did this, no one would buy pajama jeans.
You could try to read the nametags, but if you’re not sure, don’t be shy. Ask for each person’s name and their role (i.e. nurse, respiratory technician, pharmacist, dietician or doctor). If it’s a doctor, what is their specialty (i.e. internal medicine, hospitalist or surgeon)?
Most importantly, you need to know who is the “attending physician” or “most responsible physician.” This is the physician who is directing your care throughout your hospital stay. It is possible that this might change from day to day which of course is less than ideal.
- Set up a channel of communication with your attending physician. Some hospitals have white boards in every patient’s room indicating the plan or schedule of tests or procedures, the results of tests and the expected length of the hospital stay.
If this isn’t the case, you should have a large pad of paper at your bedside so that this information could be written down for you. You should prepare your own list of questions for your doctor. Try to find out when that doctor is expected.
Like the traveller forcing himself to stay awake on the plane so he won’t miss his meal, patients dread falling asleep and missing the doctor during daily rounds.
I’m hoping you won’t find yourself or your loved ones in the hospital any time soon, but if you do, follow these three steps to maintain control of your care.