The Hospital is No Place for a Sick Person, Part 1
Over Thanksgiving this year, I had the unfortunate experience of having emergency surgery and spending two nights in the hospital. On Tuesday night, I called my doctor about some complications I was having from a surgery I had had two months prior, and when I went to see him Wednesday afternoon he asked, “when’s the last time you had something to eat or drink.” My heart sank, as I knew this was the “surgery question.” In one fell swoop, I had gone from thinking he’d give me a some medicine or tell me I was fine to having unexpected surgery the day before Thanksgiving. I wasn’t a happy camper.
So, I headed over to the hospital with my mom and saw some familiar faces. Not only had I been there for surgery related to this two months prior, but exactly one week earlier I had been there to have my tonsils out. I was so frustrated to be there that I had tears in my eyes, but the nurses were so reassuring and joked along with me about knowing exactly where to start my IV and things like that. It was really calming to be around smiling nurses who knew I was scared and did their best to put my fears to rest.
They took me to the pre-op holding area, gave me some Versed, and I got to speak to my doctor. The surgery was simple, he said, they just needed to drain an abscess that had formed at the surgical site and I’d be home for a late dinner. He patted my leg and said, “you’re going to feel so much better when you wake up.”
But I didn’t. No, not only did I not feel better, I felt much worse. I’ve been through surgeries before, and I know what is normal post-op pain. Hell, less than 24 hours after the original surgery two months before, I was off pain meds, upright, and I was at my first nursing school clinical. So yes, I know what it feels like to have pain from surgery, and I knew that something wasn’t right. The nurse in the PACU (post anesthetic care unit) was one of the kindest nurses I have ever met. When she asked me to rate my pain, she took me seriously and would say “okay, let me get some more medicine.” When I started itching all over from the medicine, she didn’t brush it off; she checked me all over for any signs of a rash or hives, and called the doctor to get an order for Benadryl.
Because I had had surgery so late in the afternoon, they transferred me to the general medical floor to finish recovering once the PACU closed. I was left in the care of the floor nurses, and everyone still seemed confident I’d be going home that night. It gets a little hazy from here on, because the Benadryl made me really sleepy. All I know is that I woke up at midnight still in the hospital, because my pain was uncontrollable.
Now, I’m not telling you this story just to update you on the goings-on of my life, this post actually has a purpose (I swear). During the time I spent in the hospital, I had some eye-opening experiences that I hope will help me during my time in nursing school and once I head out to work in the field myself. So, without further ado, here is my list of reasons that (in the words of a very wise friend) “the hospital is no place for a sick person.”
[Note: This started out as a small list of "things I learned from being a patient" but quickly developed into a several-thousand-word diatribe. For this reason, I've decided to break this into several posts over a few days so as not to write a totally overwhelming post!]
1) Sleeplessness.
What’s that thing you always say to sick people? “Get some rest,” or something, right? Yeah, that’s what they all said to me, too, and I would have been happy to get some rest had that been at all possible. To start, narcotic pain meds don’t make me sleep. They make me irritable, nauseated, and totally restless. So when I woke up at midnight, I literally only got five more hours of sleep over the next 36 hours, even though I spent each of them in bed.
The next morning, I asked the nurses if when the on-call doctor came we could see about getting me a sleeping pill due to the fact that the meds were messing up my sleep. They said sure, but that never happened, even when I asked the doctor myself. I was prescribed Zofran for my nausea, and I went so far as to ask the doc if I could have Phenergan since it tends to help me sleep. Inexplicably, she said no and I was continued on Zofran. That was problem #1, as far as my sleepless nights were concerned: no one was worried about my insomnia other than me.
Problem #2 was far more frustrating. On my second night in the hospital, I was up until 0500 but finally felt like I might be able to fall asleep. I closed my eyes, and drifted off until there was a knock at the door. I checked the clock and saw that it was only 0600. Rather than narrate the rest of the morning, let me list the times and reasons people entered my room:
0600: Time for my antibiotic
0630: Time for vital signs
0700: Shift change, RN and CNA introduced themselves
0730: Nutrition came to drop off my breakfast
0745: CNA wanted to let me know my breakfast was there, and asked if I needed help eating it.
0800: Time for pain medicine
0815: CNA wanted to help bathe me/do bed change. (By this time, I had stopped trying to sleep)
0830: Doctor came to do rounds
0900: Nutrition came to take my tray away
0930: Vital signs
1000: Pain medicine
1030: CNA wanted to know if I needed anything
1100: Discharge instructions
That’s thirteen times that someone entered my room in five hours. I was so frustrated; I wanted to say to them “listen, can you please, please, PLEASE just leave me alone to get some sleep!? I promise I’ll push the call button if I need you.” I understand that some things have to be done on a schedule. Vital signs, medicines, rounding etc. are all things that they don’t have much control over, and I get that. But things like the bath, bed change, welfare check, etc. could have waited, especially since I expressed to both the RN and CNA that I was exhausted due to not sleeping normally during my admission.
I honestly believe that had I been able to get some real sleep I would have been able to leave the hospital much sooner.
Stay tuned (I know you’re absolutely riveted!); tomorrow I’ll continue the list! And as always, I’d be thrilled to hear your input as a provider, patient, or third party on any of the points!
Stay safe out there,
Sam
December 9, 2010 at 8:17 pm
As someone who’s been a patient more than once, and who has worked as a floor tech, I find it horrible the way the floor staff acted. As a tech (especially night tech), if my patients asked me to leave them alone, I would ask one more time just to make sure they were ok, then leave em alone other than looking in from time to time. Although the Phenergan issue I’m noticing is pretty widespread. Hospitals seems to be afraid of it due to vascular irritation and the synergistic effect it has with narcotics. It sucks, but I’ve seen it everywhere. The only time I’ve ever gotten a narc + promethazine was because I was a patient in my own ED and the doctor and I were well aquainted and he bent the rules for me on that one.
December 9, 2010 at 8:30 pm
I was very frustrated by the floor staff, but I was too acutely aware of their schedules and need to get things done that I wouldn’t stand up for myself enough, I guess. I should have asked them to let me sleep, but I didn’t want to upset their routines and schedules.
Interestingly, I’ve gotten promethazine almost every other time I’ve gotten narcs in a clinical setting (ER or on the floor). It seemed to be the go-to drug because they weren’t super worried about CNS depression as long as I was being monitored, and it’s much cheaper than Zofran. But, regardless, I was just frustrated that she wouldn’t even give me a lunesta or some benadryl to help me get some rest. I’m sure she had reasons, but she was awful about communicating them, haha.
December 9, 2010 at 10:01 pm
At my recent ER experience, it was tremendously reassuring to know all the nurses and most of the other folks there, but it made me think about how the experience must be for people who DON’T know anyone. I lost count of the number of people in and out of my room, and that was with being able to tell who was who and why they were there.
I’ve thought a lot since then about how one of the major parts of any emergency experience for people is the combination of being scared, and of having a lot of people asking questions and coming and going. My partner and I were reminded to minimize that feeling of hustle and bustle, and to be sure to communicate clearly who we are, what we are able to do, and what will happen next.
As far as being a patient, I learned long ago, back when I had my kids, that it’s really best to have another person to stand up for the patient. Patients are not generally in a good position to stand up for themselves, nor should they need to be.
December 9, 2010 at 11:51 pm
Your in-patient experiences remind me of ones I had a little over 18 months ago. While the surgery I had was successful, the hospital experience was definitely nothing to write home about. What was supposed to be an overnight stay ended up being five days due to an infection. And I was unable to walk or stand, which made things more complicated.
It really made me understand what our patients often have to go through. And it changed the way I deal with anyone who I have in my care; maybe it was what I needed because I find I advocate much more now than I did before my injuries.
Hang in there, Sam.
December 10, 2010 at 12:59 pm
Wow, this post brought back memories! When I was in the hospital for hyperemesis and some other complications, I was put on IV and stuffed in a room on the maternal/child ward. I was there for two weeks, and every single night at 0100 the night nurse came in, woke me up, and expected me to stand on a portable scale to get my weight. However, if I stood up at the time I got really nauseated and usually ended up vomiting. I asked them repeatedly to please, please wait until morning and I didn’t even get a reaction. Someone came in to do vitals every four hours, as well. For the entire two weeks. Now, I understand they have a routine to follow, but really? When I finally had my daughter months later I was put on the same ward for a few nights and then the experience was completely different. Maybe because I hadn’t just had a baby at the time of my first admission they didn’t know what to do with me?
December 11, 2010 at 10:17 am
@medic61
Your comment about the hospital staff not communicating reminded me of an annoying experience I had with a (new to me) PCP. I’ll skip the long winded details, but the net result for me, other than being poorer, was the realization that somewhere along the line the practice of medicine changed from treating the patient to treating the tests, and since they are treating the tests they don’t bother to communicate with the patient.
It sounds like you’ve already learned the importance of communicating with the patient, and I would just add that you should communicate using language they understand. If what you say is full of medical jargon, the patient will tune you out and think about kittens until the noise stops.
December 11, 2010 at 4:56 pm
[...] On The Clock Just another WordPress.com weblog « The Hospital is No Place for a Sick Person, Part 1 [...]
December 16, 2010 at 3:58 pm
Ah yes. I know it isn’t optimal, but waking you up for vitals and then ten minutes later the lab comes in for blood draws (Every three effing hours! OMG.) and then the nurse for pain meds then minutes after that? Come on people, at least the vitals and pain meds can come at the same time. Consolidated your efforts and let the patient (me) sleep. Criminey.
I guess what I’m saying, is I hear you. Big time.
December 16, 2010 at 6:14 pm
[...] observation from my recent hospitalization after surgery. If you missed them, you can read part 1 here and part 2 here. So, let’s get back to [...]
October 12, 2011 at 2:56 am
Hey Sam,
You hit it, that sleeplessness is always a problem of any patient in every hospital. Too many schedule to be done, too many people and even there are times that there is noises all over. Hospital indeed is for those who are sick yet there are a lot of times that it makes us sicker and worst.
Thanks for sharing,
Peny |
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