When was the last time you snapped at someone you care about? Were you tired? Hungry? Not feeling well? Stressed? All human beings get short-tempered under these conditions. It can be easy for misunderstanding, frustration, and miscommunication to flourish.
So it’s no wonder that hospital stays can be frustrating. Whether you’re sick yourself or trying to comfort and assist a loved one, it’s an extremely emotional time. On top of that, sleep deprivation is common, especially during the first day as labs are drawn and tests are obtained in order to figure out exactly what’s going on. Food may or may not be readily available, especially if you arrive late at night or if there is concern that you may not be able to swallow safely.
On top of that, when you step into a hospital, you are essentially entering another country. There is not much of an exaggeration. The number of new terms the average medical student learns is comparable to learning a new language. Hospitals have distinct customs, rules, and traditions that are entirely foreign to someone unfamiliar to the system. Furthermore, due to the demands of contemporary medical care, the employees with whom you speak are also likely to be somewhat tired, hungry, not feeling well or stressed.
It’s frankly remarkable that most interactions between patients and doctors go as well as they do when the conditions offer so much potential for disaster. Recognizing that people are essentially entering a whole new culture under the worst of circumstances, here’s some pointers on how to minimize the potential for frustration. While I focus on neurology, these tips apply for other types of problems as well.
1) Strive to be graceful under pressure. Common courtesy is invaluable in stressful situations. Little things like “please” and “thank you” can become indispensible in maintaining an atmosphere of mutual respect. The result is that hospital staff will actually want to help you more. Being nasty or demanding may feel like a necessary way to get quick results, but it will also ensure people avoid going into your room by any means possible.
2) Don’t be afraid to be assertive. Medical professionals need to know when you are uncomfortable, need help, have important information or a suggestion. Let them know. Also, don’t hesitate to ask questions. Another helpful technique is to rephrase the doctor’s words and repeat back your understanding of what they’ve said to ensure clear communication.
3) Know the primary team or doctor that makes the decisions about your care. For you, this is the most important group to know. No one, not even other doctors, places orders or says what’s happening during your hospital stay without this team’s permission. It’s also a good idea to only ask this group of doctors what the plan for your care is. Other doctors may give that team advice, or have a partial idea of the plan, but may not be up-to-date unless they have just spoken with the primary team.
4) Recognize that information and plans change constantly in the hospital. As events occur, the information you recently heard becomes outdated. One of the most common sources of frustration for patients is that they feel one person tells them one thing about what’s happening, and then someone tells them another. At some point in time, both people were probably correct, but the situation has changed and one person has not yet been updated. Point out any contradictions that appear, and remember that ultimately, the plan is between you and the primary care team to decide.
5) Recognize that your care provider must balance your immediate needs against others who require attention. For this reason, it may take some degree of time in order to respond to your request. I’ve had people ask me for their breakfast while I’ve been rushing off to give CPR to another patient. There was no way their breakfast could be my priority.
6) Know the jobs of the people who see you. Going back to my example above, the other reason why that patient’s breakfast wasn’t my priority was because I wasn’t their doctor, nor do doctors usually bring patients their breakfast. I can see how people can get confused. It’s not uncommon for dozens of care providers to be involved with each patient: respiratory therapists, physical therapists, social workers, consultants, nutritionists, technicians, nurses, not to mention doctors. It may be helpful to write things down. At the very least make sure that whoever enters your room gives a proper introduction, says what their job is, and what they intend to do while they’re there. It’s something everyone who works in the hospital is supposed to do, but is occasionally overlooked.
7) Have just one person be ultimately responsible for making medical decisions and for relaying information on to other family and friends. Insisting that physicians directly talk to everyone who would like an update could literally take all day for a particularly popular patient. Furthermore, it would likely only lead to more confusion as people discussed their different interpretations of what was said. Involving too many people in medical decision-making can also lead to slow responses during emergencies.
8) Know that a lot of important sounding information in hospitals is actually insignificant. Lots of things make bleeping sounds in hospitals. Numbers continually flash across screens. Alarms go off. Most of the time, all of that doesn’t actually mean anything important is happening. Asking nurses and staff to give you a guideline will help you from worrying unnecessarily, and could help alert medical staff in the event of a true emergency.
9) Take care of yourself. It’s tempting for friends and family members to run themselves ragged when a loved one is in the hospital. They hardly leave the bedside—not to eat, not to take care of their personal lives, and not to get a good night’s rest. While their devotion is admirable, if prolonged the patient in the hospital bed may end up being even more worried about their loved one than vice-versa! And I’ve already mentioned the dangers of fatigue, stress, and hunger on good interactions with medical staff. To take care of others, you have to take good care of yourself as well.
10) Ask for help if you need it. The psychological stress of illness is profound for both patients and those who care for them. Spiritual counselors like chaplains are almost always available in hospitals, as are family counselors and social workers. If you find that despite best efforts, the relationship with your doctor isn’t working, you can talk to a patient care representative to try to reach some resolution, or request a different physician.
Some of what I’ve mentioned may seem like common sense, such as being polite, but common sense in stressful situations isn’t so common. While some frustration is hard to avoid when in the hospital, paying attention to some of the tips above can help make the best of a bad situation. Hospitals actually give medical care providers lists like this to help ensure good communication with patients (whether or not those guidelines are adhered to is another matter), and it’s only fair that you have something to help you as well.
The American Academy of Communication in Healthcare,http://www.aachonline.org, last accessed July 2012
Dawson LE, Communication failures across facilities and at hospital discharge. Continuuum: Neurologic Consultation in the Hospital, 1124-8. October 2011