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Blog: Paper Doll, Tackling The Stacks And Piles
 Vital Signs: Gathering Information During/After A Medical Emergency--Part 2
Last
week, we talked about how essential it is to get all your
ducks in a row long before you experience a medical
emergency. Having the information you'll need (who you can call, where
to go, etc.) to get you quick assistance and that first responders will need
(pre-existing medical conditions, allergies, current prescriptions) to
begin treatment, builds the foundation for medical experts to give you the care you require. That's
life-saving organization.
Once you arrive at the
hospital, information will fly around quickly, and aside from the
insurance paperwork you'll fill out for the hospital's benefit, little
data will be in paper form for your benefit. Today, we'll look
at some of some of the best ways to gather the information to
ensure that you can be your own patient
advocate.
Paper Doll is an
impatient patient, so I've learned not to sit idly while awaiting tests or meds scheduled for a particular time.
But in order to advocate on your own behalf (or that of a loved one),
you have to track all the information you can. The best tools
to allow you to do this? A legal pad and a pen. 
Why so old school?
That fabulous notebook computer or netbook or smartphone on which you
take notes for everything else in your life faces two troubling
constraints. First, you may run out of juice before you run out of ER
wait-time; second, if you're dependent on the web, you may be
disappointed to find neither cellphone signal nor wi-fi (free or
otherwise) in your emergency room or even your hospital room.
Legal pads, on the other hand, allow you to take
real-time notes
linearly, require no
batteries, can be flipped over to the reverse in the
unlikely event that you fill all the page fronts before being assigned
a room, and replacement pens are easier to come by than
computer-compatible chargers and a free electrical
outlook. (You definitely do not want to
unplug any of the machinery in an ER or hospital room without
permission.*)
Right now, you're thinking "But
Paper Doll, if I'm
in the ER, I'm probably in pain. I
could be panicking. How can I possibly know, let alone remember, what
to write down? If my child or some other loved one is in
anguish, how can I stop to write about what's going
on?"
Excellent question.
Obviously, if your
ER visit involves agonizing or painful experiences, you're not
going to have the desire, dexterity or diligence to write down what's
happening. That's why it's so important to have someone with you in the
Emergency Room and when you're first admitted. That's also why it's so important, as noted last
week, to think carefully about who will take you to the
hospital.
As for what you can do for a loved one, know that collecting information is probably one of the most
beneficial things you can to do help the patient. In some
cases, it's not even safe for you to offer ice chips to lovingly touch
the loved one, but acting as their patient advocate, their eyes and
ears and medical secretary when they can't do so themselves, is an
invaluable service you can provide.
So, what should
you note?
- Write down the name (and position) of every person who comes
in to "do" something to you.
In most hospitals, each staffer wears an official
badge saying something like "Dr. Carter- Emergency Physician" or
"Kiki-Patient Transport Specialist".
If
badges are flipped backward, ask them to identify themselves.
Case in point: A young woman came into my ER "curtain area"
and started asking me questions about my insurance and trying to verify
my Social Security number. She was wearing jeans and a fleece
jacket and no discernible identification. I asked her,
politely, who she was and could she show me her identification
badge. To her credit, she apologized for having it covered
up. (Paper
Doll figures that if you're wearing a hospital gown that
leaves little to the imagination, the hospital staffers should at least
have to show their ID!)
- Write down what they tell you they
think has
happened.
If you have a
broken arm, your diagnosis will be fairly obvious to you.
However, if you've come in with symptoms that could indicate any of a
number of conditions, especially ones which will require more testing
to verify, ask them to explain
the possible diagnoses. This will help
you ask better
questions and better understand why certain tests are
performed.
It will also help if/when you talk to your medical circle. (See far below.)
- Write
down what they tell you is GOING to happen.
If a
resident or attending tells you that you'll be undergoing tests, being
hospitalized, having an IV inserted, or anything else, ask them if these orders have been/will
be written, and when they believe the action will take
place. This doesn't guarantee anything will
happen according to plan, but it will help guide your actions regarding
whether you send your loved one to the cafeteria or if you will
have time to place some phone
calls.
- Write down the names of the medications, the conditions, the
tests...
Get the details of any
orders, including specific test/med names. This information is useful when
trying to understand your treatment (again, when talking with your
medical circle),
but will also be helpful down the road when you are reviewing your
itemized hospital bill. If you know what orders/treatments
are planned, and which actually take place, you'll be able to note any
discrepancies later on.
Medical professionals are
generally excellent, but they are also human. Being alert and aware
(as much as one can be when emotions are heightened in such
situations), and organizing/recording information, can help you make
sure that everyone is on the same page.
During my ER
visit, after I felt a significant time had passed, I asked the
nurse to find out what was the delay in having my ultrasound.
She stated that no ultrasound had been ordered. I was able to
flip through my notes and find that at 2:45 p.m. Dr.
Looks-Too-Young-To-Be-A-Resident stated the orders had been placed for
an ultrasound, and ask the nurse could she either check the orders
again or ask said resident to pop back in for a second.
(Note: Paper
Doll asked realy nicely.) Magically, a
patient transport person arrived within three minutes to whisk me off
for that very same ultrasound.
Hospitals are busy places; sometimes
instructions are given verbally and take time to be transferred to
written or digital status. I'm not advising you to bug the
doctors. But if you or your spouse-turned-patient-advocate
can keep abreast of what's allegedly supposed to happen, it's more likely things
will go according to
plan.
- Write down the time anyone tells you
anything, and when they tell you things may/should happen.
There's a clock
in every ER curtain area, for reasons too dismal to discuss.
If you watch ER or
Grey's Anatomy,
you know why. Watch it. At one point, I was told that a particular medicine
would be given at a particular time, and that I'd receive a blood
test at another specific time, and the times between them were somewhat
important. The nurses were incredibly efficient during my stay, but once I noticed that more than a half an hour had passed since
I should have experienced the oh-so-lovely blood test, I did
ask specifically about the explanations the doctor had given regarding
timing.
Paper Doll has a ridiculously, annoyingly good
memory. However, an emergency room experience (let alone the
tests and medicines) can have a dizzying effect on both the patient and
his/her loved ones. When you or the person you're
attending is undergoing the emergency, keeping a log of every person
with whom you have an important interaction is a good way to keep your idle hands (and brain) busy doing something useful. You'll experience less anxiety if you have a linear sense of what is happening/has happened, and you won't have to worry about whether you've forgotten or misunderstood something.
Of
course, you can skip noting the comings and goings of cleaning staff
(unless they unplug your IV) or the nutrition department (even though
you'll be expected to eat breakfast before 7 a.m., lunch at 11 a.m. and
dinner at, I kid you not, 3:55 p.m.), but that legal pad can otherwise be a
rich source of information and a way to get a handle on everything you're hearing. It also lets the hospital know that you and
your loved ones are really alert to patient care, and assuming you are
kind and polite in every interaction, they'll be happy to help keep you informed. So ask:
- Ask about your
test
results--what do they mean?
- Ask about your diagnosis.
- Ask about your
prognosis. How might this effect your life short-term and long-term?
- Ask about what
you should/shouldn't do while in the hospital
and upon release.
- Ask when your
symptoms (if any)
should subside and what you can (and cannot) do to ameliorate the
situation.
- Ask about
anything that is not clear. Write it down. Read it
back.
Seriously. This
is not the time to be embarrassed about not understanding a medical
term or the reason why something is done. The more you
understand, the better you can adhere to instructions...you're not a
robot, and you will be far more inclined and able to follow instructions that you
comprehend fully.
Your Medical Circle
All
of the forgoing helps you organize information during the emergency portion of your ER/hospital visit. Later,
you'll be surfing the web and getting anecdotes from friends
who have had (or know someone who's had) similar
experiences.
Paper Doll trusts you that you will only take medical advice from your own physician!
That said, it's helpful to have your own medical circle.
Last
week, after I proposed that you collect information regarding who you'd
call in an emergency, it occurred to me that you'll also want a list of people you can call after a medical emergency. Brainstorm names of people you know with medical experience
-- who not only may have more time to chat with you, but who know you well
enough to explain things in a way that works.
For
example, I remembered that my acupuncturist was also a nurse, but
didn't recall that a dear client's wife (residing just around the
corner), currently a pharmaceutical salesperson, was formerly an
intensive care nurse. Two college friends are physicians (a pediatrician and a child
psychiatrist--certainly helpful for when I act like a cranky toddler), and Paper Mommy has collected a lifetime of friends who happen to be in the medical profession.
I encourage you to
make a list of everyone you know--relatives, friends, siblings and
spouses of friends, pals on Twitter and Facebook--anyone who is or has been a:
- doctor
- nurse
- physician's assistant
- pharmacist
- physical therapist
The point of this is not to get medical advice, but comfort and guidance from someone who has the time and patience to sympathize with your booboos.
Store this list with your other organized medical records...a topic which we'll be discussing over the next few weeks.
Stay healthy!
*The film Sparks
was directed by a friend with whom Paper Doll went to graduate school.
I'm pleasantly amazed that my paper-related blog has finally given me
an opportunity to reference the short film...even if it did require a
stint in the hospital to yield the inspiration.
posted on: 3/10/2009 10:30:00 AM by Julie Bestry
category: Paper
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Paper Doll, Tackling The Stacks And Piles
by Julie Bestry
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