IN THE HOSPITAL

Excellent, detailed explanations for a stay in the hospital
from Kaiser Permanente

Click HERE for a pop-up description of Kaiser Permanente scroll up or down if necessary to see full window
Kaiser Permanente is an insurance company and it has great learning resources. They seem to have done an excellent job of making navigation of their website pretty easy and intuitive. One reason that you can trust an insurance company is that it wants to reduce costs. If it is making suggestions to the patient, we can be sure that they want these suggestions to work. That's why I like it.

DISCLAIMER
Sorry, spending any time in a hospital is not a vacation and not a stay in an expensive hotel - It's work

10 Ways to Stay Safe at the Hospital

for more detail from Kaiser-Permanente click : Staying Safe In the Hospital

1. Prevent infections - wash your hands and ask for moisturizer to keep them from drying out
2. Know your medications - in the hospital, medications and doses can change frequently. See if you can get an after-visit summary - or whatever your hospital calls daily summaries - each day. Go over the medication list - maybe circle any changes. Ask the nurse administering your meds to speak them out as she or he gives them to you, even if they get in the med cup too quickly. Be nice, say please, but say it like you mean it. It's for everyone's good.
3. Hospital ID bracelet check - when you get medications or any treatment, make sure that your hospital ID bracelet is checked against your name and birthdate. In many hospitals, the nurse cannot give you medication without scanning the barcode on the bracelet.
4. Be cautious so that you do not fall - wear non-slip socks or slippers BEFORE you stand up. Stand up and STOP. Do not move away from the bed or chair until you check that you are not dizzy. You can call for a nursing assistant with your call light. -> Falls can set you back in many ways and can give you a whole new reason to be in the hospital.
5. Prevent blood clots - MOVE. Do in-bed exercises (ask to be taught); WALK; ask for compression stockings; ask for physical therapy to teach you how to exercise in bed and in the room. EXERCISE IS ONE OF THE BEST THINGS THAT YOU CAN DO.
6. Prevent bedsores - MOVE! Shift position in bed. Get up and WALK. Lie on your side, roll over. Ask for any uncomfortable areas to be seen by the nurse.
7. Pain, nausea, diarrhea - let the nurse know right away and let your doctors know when you see them on rounds. Stay ahead of the pain or nausea or diarrhea - meaning, don't let it get bad, nip it in the bud. If necessary, remind the nurse that you are due to medication or need that medication that you discussed with her.
8. Don't smoke - but you already know this.
9. Stay involved - see if you can have a friendly talk with the nurse about your condition, the hospital, anything. Same with the docs. Not necessarily a complaint. Could be a thank you. Ask some questions but know that the nurse has other patients. Sometimes people have a bad day.
10. It's you health - begin a friendly conversation about a concern. If the person with whom you are talking does not seem helpful, ask the next nurse or doctor. If necessary, ask for the social worker or anyone who was identified as a point person for concerns.

What is involved with a stay in the hospital

• Who are you going to see?
• Everybody but probably not your PCP (depends on how big a hospital and metropolitan area)
• See below to understand the differences between doctors at the hospital: med students, interns, residents, fellows, attendings (med students least experience, attendings most experience)
• Labs, diagnostic tests, lots of questions by lots of different people that are often the same (damn) questions, boredom, getting woken up, anxiety
• Blood serum labs are often drawn (either a new stick or through a central line) at 4AM
• Why? So that the lab can run the samples and have the data ready for the care team
• Depends why you are in the hospital and for how long the stay is expected
• Is it a known condition with a known diagnosis (Dx)?
• Is it an elective surgery? Or, is it an exacerbation of a known condition?
• Is it an unknown, un-diagnosed condition?
• Sometimes it is not easy to get a correct Dx or a Dx at all
• You have to get a 2nd opinion
• Is it a serious condition: like a cancer, a brain trauma, a difficult infection?

For a lot more great information:
Navigating Your Hospital Stay - Kaiser Permanente

Who are your doctors?

for a detailed explanation of who is who go to Different Doctors in the Hospital from VeryWellHealth
VeryWellHealth is HONcode certified

DISCHARGE AND DISCHARGE PLANNING

Discharge Checklist for Patients and Caregivers from Medicare.gov

• Discharge is the process by which a patient is discharged from the hospital
• It depends on the physician writing an order that you can be discharged and when
• the order will be to EITHER discharge you home OR to a transitional care unit (TCU) at a skilled nursing facility (SNF), usually known as a nursing home but not necessarily.
• you need 3 days of INPATIENT status at the hospital to get Medicare to cover your stay at a TCU
• OBSERVATION status does NOT count
• check with the SNF, NOT the hospital, as to coverage (I'm sorry, but we cannot always trust the hospital when it comes to the details of after care/post-discharge care.)
• If your stay at the hospital was observation and/or less than 3 days, but you need skilled care - such as nursing and/or physical/occupational therapy - consider home healthcare.
• Even if you have to pay out of pocket
• Do the math: call a skilled home health agency and ask about the rates for nursing and PT/OT visits.
• Then, consider how many visits you might need. Err on the side of more, maybe 4-8 weeks
• Then, call the TCU and find out how much they charge WITHOUT Medicare coverage.
• Realistically, consider what you need: Do you need 24 hour care OR just therapy and a 1x per week nurse visit.
• Of course, it you can comfortably be transported regularly to outpatient PT/OT and a clinic (for nursing/physician services), this is the least expensive.
• A nurse will go over some papers with you at discharge. Some take more time and some are very quick.
• Go over the medication list in those papers. Try to make sure the medications listed, such as pain medications, are the ones you were getting in the hospital and that work for you.
• Opioids/narcotics for pain - There is a lot of fear by the medical practitioners: either they are overly concerned with addiction OR they fear a lawsuit by the regulators and discipline by the hospital administrators. You need to be concerned about addiction but a three day supply to get you through the first few days at home is likely not a problem, unless you have had a previous addiction.

This is a very important checklist to download for yourself BEFORE you are admitted or EARLY on in your hospital stay:

Discharge Checklist for Patients and Caregivers from Medicare.gov

SEE THE ELDER CARE PAGE FOR LINKS TO MORE RESOURCES