Don't Let a Hospital Make You Sicker
Avoid preventable complications like medication errors and hospital-acquired infections.
When I told one of my hospitalized patients the other day, "We'll be sending you home tomorrow," she wasn’t exactly pleased at the news. Yes, she told me, she was feeling better than when she'd arrived two days earlier. But shouldn't she stay until she felt 100 percent? Isn’t a sick person always safer in the hospital than at home?
My answer—and plenty of studies support it—was an emphatic "no." From hospital-acquired infections to medication errors to surgical mistakes, being a hospital patient carries a risk of its own, known as "preventable complications." Millions of these occur every year.
An Institute of Medicine study estimated that nearly 98,000 Americans die each year due to medical errors. "It is a very serious problem," says Joe McCannon, vice president of the Institute for Healthcare Improvement.
But rest assured: Finding solutions has become a priority for hospitals. In the meantime, there are measures you as a patient can take to counter some of the more common types of preventable complications.
Surgical errors
The risk: About 1,300 times a year, surgeons operate on the wrong person or remove the wrong limb or organ. Also, doctors leave surgical instruments inside the body once in every 5,000 surgeries. This is the stuff of headlines, but such incidents are rare, considering that more than 20 million surgeries occur every year. Far more common preventable problems are stitches coming loose, blood clots forming during or after surgery, and infections. These can lead to very serious outcomes.
What you can do:
- Inquire about taking antibiotics before or immediately after surgery to minimize the risk of infections.
- Make sure your surgeon has a plan to prevent blood-clot formation.
- Ask the surgeon to mark the surgical site with a pen in front of you, while you are still awake.
- Speak up if you sense something is wrong. This may seem a little intimidating, but if your busy doctor or nurse has in fact overlooked something, your concern may be the only warning he or she gets. "It's astonishing how many people see something wrong but don't say anything because they figure the people in charge know," says Dr. Carolyn Clancy. Well, sometimes they don't. You just may prevent a preventable error.
Medication errors
The risk: Giving the wrong drug, administering the wrong dose, mixing drugs that interact badly, or giving a medication to which a patient is allergic—all can be deadly. Unfortunately, such mistakes are not rare. Adverse drug events cause one out of five injuries or deaths to hospital patients in the U.S.
What you can do:
- Always inform your doctors if you have drug allergies.
- Make a list of all the medications you were taking before the hospital stay and their dosages.
- When a staff member gives you a drug, make sure you are getting the right one. Ask what it is and what it's for.
- Before you leave, ask for a list of all the medications you received during your stay and those that you are expected to take. Compare the list with the medications you were taking before coming to the hospital to make sure you are not taking the same drug (with a different name) twice.
Hospital-acquired infections
The risk: The Centers for Disease Control and Prevention report that 99,000 patients a year die from hospital-borne infections. Germs are everywhere: on surfaces, doorknobs—even your doctor's necktie.
What you can do:
- Ask anyone who examines you to wash his or her hands first.
- Ask your doctor or nurse to clean her stethoscope before it comes in contact with your skin.
- If you need a urinary catheter, make sure it is kept in for the shortest possible time.
- If you need a "central line" (an IV tube going into a major blood vessel), ask if it's possible to have tubes that are coated with antibiotics.
- If you have an IV, make sure it doesn't stay in place for more than a week. Let the nurses know if it becomes loose.
- Every time a line or regular IV needs to be inserted, ask whether the hospital staff follows sterile procedures before inserting the tube or needle.
Bedsores
The risk: More than a quarter of a million cases of these pressure ulcers were reported to Medicare in 2006. They result when parts of the body—heels, ankles, tailbone, buttocks, or hips—rub against surfaces such as wheelchairs or bedsheets. They are not only painful but also highly prone to infections that can spread to the bones or blood. The cost of these preventable complications was about $11 billion last year alone.
What you can do:
- Change position every two hours or ask the nursing staff or a family member to help reposition you.
- Check for redness or sores on the skin to help find the ulcers as early as possible.
- Keep the skin as dry as possible.
- Keep your knees and ankles from touching each other. Use small pillows or pads to keep them separated.
- Ask about special mattresses and pressure-reducing devices. Most hospitals should have them.
Courtesy of PARADE
The problems are as bad here in Canada, too. If you get sick, you only hope you don't have to go to the hospital. I had an experience in the hospital that shocked me. The nurses were very busy but besides that some of them really didn't have the"heart" for the job! I hope the next time I have to enter the system I have someone to look after me that will be an advocate for me. That's what the patient needs is an advocate when they are in the hospital!!
For Medical/ Surgical RN which is where you would go a stable non critical patient the pay is on average 32 dollars in hour. Typical shift is twelve hours so eight hours at 32 dollars in hour and time and a half for the last four hours of your shift. So for one shift before taxes the lowest level of hospital nurse makes $448 dollars for that day of work. For critical care and emergency room that pay averages to about 45 dollars an hour, again after 8 hours hourly pay goes to time and a half for the last four hours of the shift. So one shift will come out to about $630 dollars. Also if to many staff has called out sick the hospital will call staff members on their off days and pay them double time the entire twelve hour shift for them to come in and work. So for critical care or emergency room at the end of a double time shift they have made $1,080. As a patient remember hospital staff is paid very well. As far as being staffed correctly that is another issue. They may have to many patients per nurse and need assistants to help them on the floor but that is no reason for your care to be sacrificed. Your life is more valuable then a dirty look form a nurse or an exasperated sigh from a respiratory therapist.
You are a nurses worst nightmare! You have no idea how hard our job is. I come to work only to serve the patients I have and give them the best care that is humanly possible. DO you have any idea of the multitude of work nurses have to do? DO you realize that nurses care for more than one patient at time? DO you know that we are trying to get you that blanket but the patient down the hall is having chest pain, and the hospital decided to take all our nursing assistants away? Do you know that nurses are NOT waitresses? Do you know that we are now checking all patients that come into the hospital for infectious disease MRSA upon admission, because maybe the problem started before you ever got to the hospital? Do you realize that is it o'clock in the afternoon and we haven't even had lunch yet-and we've been working since am? You come into the hospital with a mistrusting and suspicious attitude, your Starbucks and try to tell us how to do our job. I invite you to try. We are trying to do a difficult job, and we don't need to be attacked by family. You may be concerned about you family member, we are too, but we can only do what we are allowed too, and are the mercy of the Dr.s, other departments to get procedures and tests done, and our administration who is so far removed from the bedside, they have no idea what impact that one more piece of paper has they are throwing at us has. Our hospital has an admission that is over 10 pages long. How can we as nurses spend the time that we ALL want to at the beside when we are riddled with paperwork? Spend 2 hours in our shoes, you'd go home crying. Oh and as for getting paid well; we're not. Do you know nurses don't even get any type of retirement? When your done your done, if you have money if your 401k that's your retirement nothing else. Stop being so harsh, and grouping the few bad seeds you may have encountered into one.
WOW!! momontheg0 needs a REALITY CHECK!! Puhhlease, momontheg0, what kind of living do you make? What is your job? Visitors are the BIGGEST spreaders of disease, and half of them don't come to visit the patient, they come to visit the NURSE! I, too, am an underpaid and (mostly) underappreciated nurse that LOVES what she does and takes DAMN GOOD CARE of my patients!! Try walking in our shoes, missy, and see how "easy" it is!! Yeah, I'll grant this, there are bad apples in every bunch, be it nurses, doctors, waitresses, gas station attendants, and moms!!! There are SOOO many times that the Family makes it so less pleasurable to take care of their loved ones, because they are RUDE, CONFRONTATIONAL, OBNOXIOUS, CARELESS, AND IGNORANT! So, DeeAnn, please, go get the real education, and walk in a nurses' shoes.
P.S. I never begrudge family coming in to visit any time in my ICU, but I always ask for the respect of allowing me to do my job. To add, do you have any clue as to how many times nurses' lives are threatened by their patient's "loved ones"? And, for the education we are expected to have, and the responsibility on our shoulders, yeah, honey, we should be paid better.
While I am not a registered nurse I am registered and certified in four separate imaging modalities, have worked with patients throughout the country in small and large cities since 1975, and can vouch for much of what ktsme (also) reacts to. Healthcare laws and hospital policies limit the amount of general information we can provide patients or their loved ones. That is strictly in the Dr.'s domain, and not even an option for any kind-hearted nurse or technologist.
IMHO the primary reason for healthcare personnel burn-out is overregulation, too much work and the inordinate pressures put upon us by otherwise caring, supportive families who don't work with the sick, dying, or incapacitated daily. Nursing homes, hospitals and NICU's, and severe burn units have been known to become "dumping" grounds where often times there are no visitors or loved ones who inquire about recovery.
momontheg0's suggestion re. ktsme quitting if the 'kitchen is too hot' only opens the door to the inexperienced, undermotivated individual who can be enticed by a paycheck, but actually care little about their patient care. Trust me, there is a real dedication and no large financial reward in an RN title where there is a 2025 estimated shortage of 500,000 and where one-in-five (20%) quits within the first year after graduation.
When it finally becomes my turn to occupy a hospital bed my hope is that a competent, experienced (not always inclusive) and caring healthcare worker administer to my needs during my convalescence. You should only wish the same.
To ktsme,
I agree with what you are saying - you want to be there to comfort patients as a nurse and the system is very, very disjointed. What is most unfortunate is when family members ask questions and you cannot answer them for fear of saying something that will get you into trouble. You may know the answer or have a very honest opinion from your experience that the family needs to hear and are unable to share because of politics. As a family member of someone who is very sick right now I can tell you the whole system is messed up - none of the doctors are talking to each other. The families are left to fend for themselves to get important information to help the patient and my biggest fear right now is seeing the inadequacy of the system pull together to ensure the best healthcare decisions are being made by the doctors. The nurses are the ones stuck with trying to answer these tough questions we are asking because the doctors are not available during the hours the family can be there (during visiting hours) because they've made their "rounds" at 6 or 7 AM already. If we want to talk to the doctors, we have to be there before we are supposed to because we cannot get vital information we need any other way. We are supposed to "talk to the doctor" but can't get access to them. It's no wonder there is no trust in the medical system. And I agree the nurses are carrying way too many patients in their caseload. The patient should not have to "wait" for a nurse to help the patient go to the bathroom when they can't hold it and the patient should not have to "wait" for a glass of water when that water is what the patient needs to help them mend. If the patient is freezing as a side effect of a drug they are taking - they should not have to "wait" for a blanket. Nurses should be able to be at this kind of service but are stuck behind a computer logging their last five footsteps. I can honestly say we (the family) are scared to leave our loved one at the hospital alone because he can't fend for himself and we aren't confident his needs are being met. Only the "squeaky wheels" are getting what they need. Those that don't complain are being left on their own for too long or ignored completely. That is the reality. What's worse is when you ask the doctors questions - they get defensive. Why not give an honest answer and when someone asks you if you read the chart (because they know you didn't) what is wrong with someone wanting to make sure you, as the doctor, have all the important information you need so you don't harm the patient. Very, very sad. You would think all of these things are happening on their own - but they absolutely are not. First hand experience has shown it is not. My Dad died as a result of it.
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