Not until the IV needle slid into my vein did I realize my life was in danger. Less than 30 minutes prior, I had failed a procedure called the cardiopulmonary exercise test (CPET) in a pulmonary testing lab. The woman administering the test said I was in eminent danger of having a heart attack because of a highly suspect EKG. This test, done by attaching small electrode patches to the skin of your chest and arms, checks for signs of heart disease. Soon, she whisked me via wheelchair to the emergency room for my first hospitalization as an adult.
While tests done in the emergency room showed I did not have a heart attack, something was definitely wrong with me. From the emergency room, I was admitted as a “guest” to a cardiac ward of a New York City hospital for the next nine days.
A hospital can be one of the most frightening and intimidating places in society. Your health and your life are in the hands of mostly strangers. Yes, a hospital is full of trained professionals. But for your sanity and comfort, you should know how to communicate with your providers, understand how they are trying to help you, and know what to say when you feel your treatment could be better.
First, a little background is helpful. Going in for my hospital journey, two things were in my favor: I was white, and I was male. In addition, I have been a pharmacist for 25 years, and I am currently going to school at Columbia University for my Master of Public Health (M.P.H.) degree. Also, I have been fortunate to spend time in hospitals doing clinical work and spending time with patients in the United States, Africa, and the Caribbean. Yet nothing prepared me for wearing the gown, being tethered to an IV, being a human pin cushion, and having to depend on others to advocate for me.
Lying on the gurney in the emergency room was quite different from my experience working in emergency rooms. People moved fast, there was little time for introductions, and the staff had to make life-or-death decisions. When a doctor comes with three or four people trailing behind like a mother and her ducklings, the doctor in front is the attending, a person who completed a residency or training in a specialty and practices medicine in the clinic or hospital. Residents are doctors in final stages of their training. Your advantage in this situation is you have many people watching someone take care of you under the eyes of an accredited physician. At the same time, if you feel uncomfortable with the resident, you can ask the attending to take care of you. If they say no, ask for the attending’s name. Asking for someone’s name personalizes a non-personal situation, and you may receive better care.
After I was stabilized with medication, I left the emergency room. When you go from one department to another, also known as transfer, mistakes can be made. Ask to make sure all your personal items are on the gurney. And by all means, be nice to the transport attendant wheeling you around. Their jobs are difficult, and “please” and “thank you” go a long way with them. Ask them to make sure your blanket is tucked under your feet, so people do not see your privates and your IV tube is not tangled.
Now I was wheeled into my room. The first person that you see is the nurse on your shift. If you are able, ask their name. A writing board on the wall shows people taking care of you, and the names change throughout the day. Ask what will happen to you. Ask for a piece of paper and pen (more on this later). Nurses are important. Treat them kindly, but also expect to be treated with courtesy. If you’re not, ask to speak with the charge nurse. This nurse oversees all nurses on the shift. They are busy. Communicate your concerns in as few words as possible.
You now live in a medical ecosystem where you can tell when meals come, when you will be given medications, and when people take your blood pressure, temperature, and blood draws. Let this routine comfort you amid the uncertainty of your outcome.
Family, friends, and classmates visited me. You may not be so lucky. There will be times when you cannot advocate for yourself. You have two options. One, ask for a hospital advocate. These are people who work in the hospital who can help you. Two, ask for your nurse and wait until evening, if possible. When the night shift nurse comes on to work, they may have a little more time to talk.
Regarding your medications, you have the right to know why you are taking each of them. If you notice they are a different color, ask why. If you were taking a liquid medication by oral syringe and suddenly you are taking a pill, ask why. If they are changing your IV, ask the nurse what the name of the drug is the first couple of times. Let them know you are watching but not getting in their way.
Throughput means how a patient passes through a medical process. Think of hitting a home run. You run the bases, and then you come home. Or this is your procedure from beginning to end. In my case, I had a cardiac catherization, a procedure where the doctor snakes a tube to your heart using a dye to detect heart blood-vessel blockages. Before doing this procedure, you need to go NPO, meaning no food or water. If you are given a “leave your room” time, expect delays. They are unavoidable and necessary. In my case, instead of going NPO for eight hours, I was NPO for 15 hours. No one communicated the delay to me. When I saw the doctor later, I said, “I was delayed in my procedure. Would you do that to a member of your own family?” Again, remind them you are a person and entitled to get prompt communication.
Finally, let’s talk about physicians. They have amazing treatment tools at their disposal. Remember, while they are busy, they can come across as intimidating when you ask them questions. Remember the paper and pen? Use them to write down questions as you think of them. When the doctor comes to visit, questions will be ready, for a satisfying interaction. There will be important providers who write prescriptions, nurse practitioners, and physician assistants. Ask them questions as well. However, they may need a physician for a final answer.
Finally, when the nurse pulled out my last IV and said good-bye, I completed my visit as a guest in the “hospital hotel.” I felt that I received good treatment because I empowered myself through courtesy and communication. But it’s important to remember that courtesy and communication should be a two-way street. Knowing your treatment plan and asking questions will reduce your stress level and get you the best care possible.