As an outpatient PCP, I make a point of avoiding the hospital if I can. I long ago ceded that territory to the fine folks called hospitalists. I’m happier for it and by extension, so are my patients. I still follow many of my patients in the hospital as a courtesy, but I’m no longer primarily responsible for their care.
There are tons of great people who work in hospitals. Many of them are doing their best to make your stay a successful one. Like navigating any big institution though, a little insider knowledge goes a long way. Let’s pull back the curtain on 5 “dirty secrets” I wish all my patients knew about being hospitalized.
5 Hospital Secrets You Must Know
- The hospital is a dangerous place. I know – counterintuitive. But you want to minimize the amount of time spent in a hospital or ER as much as possible. Many, many AVOIDABLE complications occur because of contact with the healthcare system. C. difficile, hospital-associated infections, pressure ulcers, and delirium are no joke. The longer you’re in a hospital, the higher your risk becomes.
- The computerized medical record isn’t perfect. Especially when it comes to the list of your home meds. I’m not just saying this; the research shows that it’s true. Even if your doctor is affiliated with the hospital or you’re in the same system, there’s probably still something wrong. Bring a list of your medicines. Better yet, bring a bag of your medicines. Assume most people don’t know anything about your medical history, even if you’ve been to the hospital before. DO NOT rely on the hospital’s list of meds or the computer – mistakes will be made.
- Times for tests, labs, surgeries, and discharges are estimates, at best. Surgeries get canceled, labs take longer to result than expected, and discharges fall through because of issues with insurance, orders, and other things. Almost nobody can guarantee when something will happen in a hospital, including and especially the doctor. Try to be patient, and don’t hold it against anyone who gives you an estimate.
- Hospitals are constantly under pressure to discharge patients. See point number 1. The longer you’re in the hospital, the higher the chance something goes wrong. Daily discharge meetings determine whether or not a person is “ready” to go home. Best-case scenario, the meetings push along items that need completed before discharge. Worst-case scenario, people can feel like they’re being pushed out the door before they’re ready. Since the patient or caregiver is not always in these meetings, you need to speak up for yourself if you feel you’re being pushed out without key items being taken care of. Keep a list and let your doctor or nurse know if there are things you don’t understand or need prior to leaving.
- After you leave the hospital, certain things become much harder. Once you are discharged, your care transitions to your PCP, who may not be aware of everything that happened to you. Specialist appointments that aren’t arranged ahead of time are harder to get. Medical equipment or IV medicines can be difficult or impossible to order, depending on insurance. If you find you can’t manage at home after refusing to go to rehab after discharge, you’re usually left with no recourse but to go BACK to the hospital to get admitted to rehab. Whenever possible, arrange these things before you leave the hospital, rather than waiting until your follow-up appointment.
Better ownership, better outcomes
All these tips boil down to one thing: take ownership of your health. Understand what things are keeping you in the hospital, what needs to happen before you go home, and why. If you don’t understand, ask questions until you do. Nobody will advocate for your care more strongly than you. Knowing these 5 secrets will help your next hospital stay go that much smoother.