A patient checklist can be a simple and efficient tool to help you better understand and manage the realities of complex, often confusing care in a busy hospital setting. An informed and involved patient is a safer patient because care today is often fragmented and rushed. Ask questions. Speak up. Trust your instincts — you know yourself best. Bring a friend or family member with you if you can to advocate for you. However, whether you have an advocate or are on your own these practical suggestions can help you partner more effectively with your doctors and nurses for better, safer care during a hospital stay.
1. Get to know your nurses and aides.
- Nurses are the human face of technology-driven care. Your nurse is your day-to day point person and coordinates your daily care plan. She or he can be a powerful ally and helpful guide in navigating the foreign terrain of a hospital and its system and ways.
- Aides handle many of the daily personal-care issues that are crucial to your comfort but they generally do not dispense medications or perform other nursing duties.
- Eash hospital has a different nurse/patient ratio, but nurses can always use more help. Understand that your nurse is caring for many sick patients but don't hesitate to ask for help when you need it.
- Make sure you have the phone number for the nurses' station in case your call bell is not answered in a timely fashion and you really need assistance, especially at night, when there is less staff on hand.
2. Make names a must in all hospital interactions.
- Names are the first thing to go in the hospital setting: "Oh, that's Bed 19, the bypass." Using names is the best defense you have against feeling anonymous and dehumanized. Names are a reminder to everyone that you are a person first and a patient second.
- Using names encourages the essential human connection — the key to collaborating with your care team. Get to know your doctors' names — don't let them remain strangers to you at this most crucial time.
3. Consider your hospital room your temporary home.
- Find out how to work the TV, the phone, the bed and the call button. Make sure that everything actually functions properly.
- Climate control is essential to your comfort. Being cold slows healing and increases vulnerability to infections by suppressing the immune system. Make sure you have enough blankets to stay warm.
- Real estate is everything in a hospital. Just a modicum of sunlight, a quieter room or a sliver of privacy can make a world of difference to a patient. If you're going to be in the hospital for more than a day, and you're very uncomfortable with your room or bed assignment, ask for a change.
- You might want to bring a portable entertainment device such as an iPod containing music or audio books. However, keep in mind that hospitals are not responsible for personal effects so keep track of items like this.
- Place multiple sets of earplugs and a sleep mask on the bedside table within easy reach.
- Put pens and a notebook in an easily accessible place so you can make notes and write down observations.
- Place a bottle of hand sanitizer on your bedside table within easy reach for your own use. You may be bedbound and not able to wash your hands very often. Facial wipes and mouthwash or mints are also good items to have on hand.
4. Make cleanliness in your room a priority.
- Hospital rooms are really dirty, period. Three-quarters of patients' rooms are contaminated with bacteria that can cause staph infections. Use disinfectant wipes on "high-contact surfaces" that you might touch — the rolling table surface, chair armrests, bed railings, the phone, the call button and the TV remote. These are the things that are often overlooked by the janitorial staff. Disinfectant wipes are available on every hospital floor and your aide can probably help you with small tasks like this.
- If your room is really dirty, ask for someone from the hospital's "environmental services" to come clean it.
5. Consider whether a visit from your pastor, priest, minister, imam, rabbi, shaman, guru, monk or any other type of spiritual counselor will offer you solace, support and guidance.
6. Create a master medication list — use the notebook you have brought.
- Keep a numbered list that includes drug name, prescribing physician, schedule with dosages, what day you started and stopped and why you are taking every drug, for example, "blood pressure." This list will be the record of ALL medications you are prescribed during your stay and can be used to check against hospital and insurance bills.
- Your nurse can help "translate" instructions and abbreviations into plain language so that you understand exactly what is going into your body and why.
7. Know your daily medication schedule: medication mix-ups can be deadly. Your hospital bracelet should be checked each time you are given any medication.
- Nurses learn the "5 Rights" checklist for safe medication. You can use it, too, every single time you are given any medication by reviewing these "5 Rights": the right time/schedule, right drug, right dosage, right route (i.e. injection, IV, oral, topical) and the right patient — you! Speak up if something seems wrong to you.
8. Create a daily journal with the notebook you have brought.
- Record how you are actually feeling day to day. How you feel matters! You know yourself best, what feels normal to you. A daily journal is a good place to make notes of any questions for your doctors and nurses as a reminder to yourself since you may have only minutes with them at a time.
- Make a note to ask every day if catheters, IVs or other invasive devices are ready to be removed — that can help prevent infections.
9. Wash your hands frequently if you can or use a hand sanitizer whenever or wherever one is available. Hand washing saves lives.
- A small homemade sign that reads "All Visitors — Please Wash Your Hands" reminds everyone that you want to be diligent about this yet takes the onus off you always having to ask. Always remember that the most common way a hospital-acquired infection is contracted is person to person via hands or touch.
10. Keep hydrated. Water is essential to life. Patients can easily forget to drink water.
- Hydration is key to recovery. Dehydration can have dire consequences. Make sure you always have your water pitcher filled and try to sip water throughout the day.
- Sucking on ice chips can be a good alternative if you are unable to drink water.
11. Express thanks to your doctors, nurses and aides for their help in caring for you. An "attitude of gratitude" goes a long way towards fostering meaningful human connections with your care team.
12. Find out who in the hospital — patient representative, case manager or social worker — can help you with questions and concerns like getting medical records, discharge planning and executing health-care proxies or advance directives.
13. Speak softly. Be considerate of your roommate.
- The decibel level on a hospital floor can reach that of a busy street. Don't add to the noise pollution.
- Music via headphones or simple, foam earplugs can help you cancel out the constant hospital din.
14. Start a CaringBridge.org entry.
- This is a great free site (http://www.caringbridge.org) where you can update family and friends and stay connected without making a million calls or having too many visitors in the hospital. It is also a terrific outreach tool if you are on your own and need some specific outside help or guidance.
15. Try to laugh every day! Easier said than done in the hospital but laughing actually releases the body's natural painkiller — endorphins — and so helps speed the healing process. Bring a funny book or audio download, watch a comedy on TV, talk to a friend who makes you laugh — it's good medicine.
Adapted from The Patient's Checklist: 10 Simple Hospital Checklists to Keep You Safe, Sane & Organized Copyright © 2011 by Elizabeth Bailey. Excerpted with permission from Sterling Publishing Co Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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