Need a Medical Procedure in June or July?

This is a blog from last year, but it is important enough to review it annually (like we review our Advance Directives) as it is one constant in the health care system.

If we talk with our friends and tell them of an impending elective surgery or medical procedure,often we are met with, "Don't go in July. The new "doctors" are there, and they don't know anything." And June isn't much better, as the fellows typically have one foot out the door, and some people often complain that the care is lacking. Is it true? Are we more vulnerable at the end of June and in July, when many of our doctors went from Mr., Ms. Mrs. to "Dr. Smith" overnight? It may be, but it reminds us of the need to continue to do our due diligence and not assume that things will "flow" perfectly" and there will be no glitches in our care. So, how do we do that?

1-If you have an elective procedure, try not to do it at the end of June/July; the new doctors (as well as the new nurses, physical therapists, and respiratory therapists) have a lot to learn, one being how the hospital runs. While your care will probably be fine, it may be slower with a few bumps.

2-Be on top of things. Do not ASSUME that everyone knows who you are and why you are there. While we hope, assume, and feel it is their place to know that everyone who enters our room knows everything about us, that is not the case. Often, they don't have time to read all ofour records or review all of our medications, and we need to be the ones guiding them. This is so important! After my first child and a complicated Caesarean section (which put me into isolation away from my child), I was awoken by someone prodding my stomach at 5 am. Without waking me or introducing himself, he walked in and started poking. I asked who they were, and the response was "Dr. Smith." I replied, "are you the fellow?" He answered with a mumble, and it occurred to me that this was a student. My reply was, "Are you STUDENT doctor Smith?" I sent him packing, but before I did, I explained that before he ever walked in and did what he did to me, he needed to introduce himself and know who I was. Waking a new mother (away from her newborn) was probably avoidable and could have been better handled. I never saw him again, and he probably never forgot me.

3-If you need an IV and know you are a difficult stick, tell the nurse (or whoever is putting in your line). I let them miss twice and then insist on a supervisor or the "best sticker around."

4-Bring a list of all your current medications to the hospital. Be sure to include the prescribing practitioner, where it was filled, and the time of day that you take your medications (empty stomach, after meals). Sometimes the nurses have too many patients and may not be able to give you your medicines at the exact time you take them at home, and if it is crucial, you will need to work out the times with your hospital practitioner.

5-The needed hospital may not have the exact medication you are on and may substitute a different drug. Again, if you feel strongly that you want to take your blood pressure pill as opposed to a similar one, bring all of your bottles of medications and ask if you can use your supply. Typically, the nurse will hold your meds for you, give them as directed, and return them to you.

6-Before you take any pill or have an IV (intravenous bag) hung, ask what it is. Ask, ask why, and who ordered it if you don't know. Also, if any blood tests are ordered, ask what are they for? Who ordered them? When will you get the results? Don't be afraid to ask questions! When I was in the hospital (early August after a heart attack), they would come in at 3 am to draw the daily labs. I asked if they could come a little later (the phlebotomists are given a schedule every morning), and they were able to switch and give me a little extra sleep. It isn't always possible, but it doesn't hurt to ask.

7-if you are on a narcotic for pain and take it every 4 hours, understand that when it comes to pain meds, hospitals will typically not give them regularly, i.e., at 8. 12, 4, you have to ask for your pain meds. You may not need it, and they don't want to take the risk of you having more than you need (becoming "snowed"). However, if you feel you will need it, write down the time you are due for the next dose, and call for it at least 15-20 minutes before you are due (or need it.). Your nurses are busy, have other patients to take care of, and may not get to it the minute you want. It is your job to do this; you don't want to chase pain but stay ahead of it.

8-Bring your hospital go-bag. This includes phone chargers, glasses, ear plugs, toiletries, slippers, and anything that will make you comfortable. Remember, this is not a hotel. Also, bring a pad of paper and a writing utensil. Ask anyone who comes into your room, who they are, who sent them, and get a card and their information and title. And if they don't wash their hands, remind them.

The key is to try not to be alone. Bring a loved one if you can; hire an advocate. It may seem costly, but it doesn't have to be, and an advocate can make life better for everyone. As one of my former clients said, (we worked on her illness, and taught her how to advocate for herself), “Everybody needs a Myra.”

Finally, be friendly and appreciative—nurses, doctors, mid-levels, transport, cleaning crew, and dietary work hard. A thank you and a smile will make their day. And last but not least, call them by name. When in doubt, use the last name. But acknowledge everyone. They are doing a difficult job and want you to get better and have the best care possible.