At some point in their lives, most people have to stay in the hospital. These stays might occur unexpectedly, so you will not always have time to plan for them. But other times you will have the opportunity to make preparations. If you have arthritis, for example, you might wind up in the hospital for a hip or knee replacement. Although a trip to the hospital isn’t anybody’s idea of fun, there are a number of things you can do to make your stay, and your homecoming, a lot more pleasant.
Understanding the procedure
If you’re going to be in the hospital for a surgical procedure, it pays to learn as much as you can about what to expect before, during, and after the surgery. Discuss the details with your surgeon. First, you’ll want to know what the procedure entails and how long it will take. In particular, find out what type of anesthesia you’ll need. The three basic types of anesthesia are local anesthesia, general anesthesia, and regional anesthesia. Local anesthesia, the kind your dentist uses when filling a cavity, involves numbing only a small area of the body for a short time. General anesthesia, usually given by injection or inhalation, works on the entire body and puts you into a deep sleep. During general anesthesia, your heart rate, blood pressure, breathing, and body temperature must be monitored to watch for possible complications.
Regional anesthesia involves numbing an entire region of the body — for example, the lower body. Common types of regional anesthesia are spinal blocks and epidural blocks. In these, an anesthetic is either injected or delivered through a small tube called a catheter into the spinal fluid (spinal block) or the space just outside the spinal canal (epidural block). This numbs the nerves connected to the lower body. You may be awake during regional anesthesia, or you may be sedated. Your blood pressure and other vital signs will be monitored.
Talk with your surgeon about which type of anesthesia is right for you. Let the surgeon know if you have ever had a reaction to anesthesia in the past. Other factors that can influence the choice of anesthesia include your overall health, whether you smoke, whether you’re overweight, the type and location of the surgery you’re having, how long it’s expected to last, and what medical conditions you have.
Other questions to ask are how your pain will be managed following the procedure, how long you’ll need to stay in the hospital, what you’ll need in terms of rehabilitative care, and how long it should take you to fully recover. If you take any medicines on a regular basis, ask the surgeon whether you should stop them on the day of surgery or the day before. (Some medicines can interact with anesthetics.)
Preparing for your surgery
There are a number of things you’ll need to do to prepare for your surgery. For example, you must undergo preadmission testing, which is usually done a few days before you’re admitted to the hospital. This generally includes a review of your medical history, a complete physical examination, various blood and urine tests, x-rays, and meetings with the hospital health-care team.
Blood transfusions are sometimes needed during surgery, and the safest ones are autologous blood transfusions, which use your own blood. You might therefore have to give some of your own blood before your surgery. Blood donations are usually scheduled once a week for several weeks before surgery, depending on how much blood is needed.
You’ll also want to appoint a trusted friend or family member to be there with you as much as possible when you’re at the hospital. Let this person serve as your “advocate,” helping you ask questions and remember important information. Also, make sure you have someone who can take you home from the hospital, as you’ll be in no condition to drive. Make sure you have someone to feed and walk your pets and bring in the mail during your absence. You might also want to contact your newspaper about suspending delivery while you’re gone.
Don’t forget to plan for your homecoming. Arrange for someone to stay with you for the first several days after you get home. Before your surgery, consider making double batches of foods like chili, spaghetti sauce, and casseroles so you won’t have to cook any meals from scratch when you get home. It’s also a good idea to set up a “nest” in your home where you can spend most of your time. For example, you could set up shop on your living room couch, keeping key items such as a phone, a TV remote, reading materials, medicines, water, and facial tissues on a nearby coffee table. That way, you won’t have to move around too much during the day.
If you’re going to have hip or knee surgery, don’t forget to apply for a temporary handicap sticker through your local Department of Motor Vehicles several weeks before your surgery. And since mobility will be a big issue, you might want to make your home more “handicap accessible.” That means, for example, moving everything to arm level in the kitchen; modifying your bathroom with a shower chair, grip bar, and raised toilet; borrowing a walker or crutches if needed; and removing throw rugs and taping down electrical cords so that you won’t trip on them.
Get it down on paper
In the weeks before the surgery, you might have many different people asking you questions about your insurance, your medical history, and any legal arrangements you have made. It’s a good idea to put all this information down in writing so you can answer these questions easily and minimize frustration. The following are some things you might want to write down:
- The name and phone number of the designated friend or family member who will talk with the doctors and keep other family members abreast of your status during and after the surgery.
- A list of all of your current doctors and their phone numbers.
- A list of all of your medical conditions, as well as any previous surgeries you’ve had.
- The names and doses of all of the medicines and dietary supplements you take.
- Any dietary restrictions you have.
- Your insurance plans, including the name of your insurance company, the plan or policy number, and contact information.
- Any pertinent legal arrangements you have made, such as a living will or durable power of attorney for health care. Both of these are known generally as advance medical directives. A living will states what kind of care you want to receive should you become unable to consent to treatment. A durable power of attorney for health care authorizes another person, such as a trusted friend or family member, to be your “health-care proxy” and make decisions on your behalf when you are unable to do so — for example, when you’re under anesthesia.
Be sure to abstain from alcohol for at least 48 hours before surgery. Take a shower the night before surgery to reduce the risk of infection. Follow your doctor’s instructions about when to stop eating and drinking. (This is important because if there is anything in your stomach when you are anesthetized, it could end up in your lungs. It doesn’t happen often, but it can cause serious complications.) Don’t wear make-up, lipstick, or nail polish to the hospital.
Also, pack a “hospital bag,” which should include the following:
- Comfortable bedroom slippers
- A lightweight cotton shirt to wear under your hospital gown
- A robe or gown that reaches down to your knees
- Reading material
- Address book
- Cell phone
- Copies of insurance cards, advance medical directives (living will, durable power of attorney for health care), and medical history
- Any medicines you routinely take
- Personal items such as glasses, toothbrush, tooth paste, brush, comb, and razor
- A loose-fitting sweat suit and shoes and socks to wear home
Leave jewelry, large amounts of cash, credit cards, and checkbooks at home. If you feel you must bring these items, find out whether the hospital has safe deposit boxes to store them. You may want to bring a small amount of cash to cover incidental costs such as newspapers, magazines, and gifts from the gift shop.
Staying safe and comfortable
There are a number of ways you can make your hospital stay safer and more comfortable. First of all, get to know your health-care team (see the sidebar “Who Are All These People?”). Whenever people come into your room, politely ask them who they are and what they’re doing. Establishing a good rapport with the health-care staff can help you get your needs and concerns addressed.
Also make sure your health-care team knows who you are, and always be sure to wear the I.D. bracelet the hospital gives you. Be certain someone checks your I.D. bracelet before giving you any medicine or other treatment, as there have been cases of mistaken identity in hospitals.
Being assertive (or having an assertive advocate by your side) can help make your stay a more pleasant one. Be sure to speak up, asking questions and voicing your concerns. If you’re experiencing a lot of pain, for example, ask whether anything can be done to make you more comfortable.
Because you’re likely to be tired and weak, especially after surgery, the National Institute on Aging offers the following safety tips to help you minimize falling and other accidents:
- Use the call button when you need help.
- Use the controls that lower your bed before getting in or out of it.
- Be especially careful not to trip over all the wires and tubes that may be around your bed.
- Try to keep the things you need (such as a water bottle, a phone, and reading material) within easy reach.
- Take only prescribed medicines. If you bring your own medicines with you, be sure to tell your nurse or doctor. Don’t take any drugs without the permission of your attending physician.
- Hold onto grab bars for support when getting in and out of the bathtub or shower.
- Use handrails on stairways and in hallways.
Before you go home, be sure you understand your discharge instructions. Be sure you know what medicines you’re supposed to take, in what doses, and how often. Ask when you can resume your normal activities. Be sure you know how to use any medical equipment at home. Get these instructions in writing, and be certain you have the name and phone number of someone you can call if you have questions when you get home.
Know your rights
Before you’re even admitted into the hospital, it’s important to know your rights as a patient. The American Hospital Association has established a patient’s “bill of rights,” and most hospitals use some version of this. The following list sets out a few of your most important rights:
- The right to considerate, respectful, and high-quality care
- The right to understandable information concerning your diagnosis, prognosis, and treatment, including an explanation of the benefits and risk of that treatment
- The right to make decisions about your treatment before and during treatment and to refuse a recommended treatment to the extent permitted by law and hospital policy
- The right to have an advance medical directive (such as a living will or durable power of attorney for health care)
- The right to privacy and the right to expect that your medical records will be treated as confidential by the hospital (except in cases where opening records is permitted or required by law, for example, in cases of suspected abuse)
- The right to review your medical records and to have the information explained to you, except when restricted by law
If possible, get a copy of the patient bill of rights your hospital uses before you go to the hospital.
Even under the best of circumstances, a hospital stay is no day at the beach. However, having everything in order before you go in can help ensure that you come through it as healthy and comfortable as possible.