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HOW TO SURVIVE IN HOSPITAL

©Written By David Elliot - BHBN HOSPITAL RADIO

“GOING IN”
You may have waited months to be let into hospital and then suddenly be told to present yourself the following day. It’s infuriating but it can’t be helped – they’ve no certain way of knowing when a bed will be left free for you, and as soon as it free, they want to take advantage of it. So it’s best to be prepared, as any good boy scout is. Or if you’re whisked away in an ambulance, this is what your nearest and dearest brings as soon as possible:

· Toothbrush and paste
· Flannel
· Soap
· Deodorant
· Pyjamas or nightie
· Slippers (preferably the sort that don’t fall off when you sit on the side of a high bed)
· Dressing gown (if you can raise one)

For the latter, many doctors or nurses are fresh air fiends and the morning window opening feels as though as if its going to give you pneumonia as well.

You will also need to have a plentiful supply of tissues. All right so you were brought up always to have pure linen handkerchiefs. But the hospital won’t wash them for you and it’s straining your visitors’ love to breaking point to present them with a little damp bag full of dirty handkerchiefs to wash. And if you do use an electric razor, check if they have the right plug on the ward.

Bring too your documents such as National health card and any letters from your doctors. They don’t like you taking in valuables either on the wards, bit if you dare not leave father’s half-hunter or the sock containing your life savings – give them to the ward manager, who’ll probably groan but cope.

In a great many hospitals there’s no place for your clothes, so someone had better come with you to take them home again. Although I’ve known old hands who never go into hospital without a spare pair of trousers in a paper bag, just in case they decide to walk out.

But it’s friendlier anyway going into hospital with someone; you’ll seldom feel so bleak trundling off in a solitary taxi to hospital; - especially if you’re about to have a baby!

© David Elliott, for Birmingham’s BHBN, 2003

“ADMISSION”
When you arrive at your designated hospital ward, be prepared to answer a barrage of questions as part of the admissions procedure. It’ll seem as though they’re taking down everything about you, along the lines of “have you or any member of your family ever had T.B., St Vitus’ Dance, a steady job…” and so on. They ought to ask you exactly what pills you’ve been taking in the previous weeks – if they don’t, for heaven’s sake tell them. One of my family, and a nurse at that, couldn’t focus for days after a minor operation because something they’d given disagreed with something else she’d taken before.

I wouldn’t get too upset when they ask you about your religion and next of kin, it does not mean they expect you to spark out; on the contrary. They ask everyone this – think how terrible it would be if they did have to take a look at you and things were bad enough to require a chaplain or your Auntie Maggie. Make sure that the name that goes onto their books can help if decisions have go to be taken about you, or the hospital wants to ring and ask someone to come and bring you home. You don not necessarily want your sole remaining relative in The Outer Hebrides, you want your closest friend, say.

Even it’s the middle of the day, the nurse responsible for your admission may say to you: “Take all your clothes and hop into bed – I’ll be with you in a minute”.

Now don’t get your hopes up when you hear this, it’s just one of those phrases nurses say every working day. However, there are a number of reasons why you’re put into bed on the ward, even though you may not be treated for a while. Firstly, as soon as they are to start testing, scrubbing, assessing or merely peering in wonder at you, it is easier if you are flat out where they can get at you. Secondly, it begins to induce in you a suitably dependent and receptive frame of mind. And finally…there’s nowhere else to put you.

“WHO’S WHO ON THE WARD”
Going into hospital isn’t fun. Like the Battle of Britain, it may save the day and make a good story later, but at the time there’s a good deal of blood sweat and tears about it – and even the gallant pilots didn’t have to use bedpans.

You’re now drawn, willingly or unwillingly, into a whole new world of instability and anxiety. Old lags that have been in hospital a lot can distinguish a fair difference between one visit and another. It isn’t just that one time they might have been having a baby in a scented maternity hospital, the next time losing their gallstones. A few of the things that affect you are the things you can do something about yourself.

Once in hospital, the chief in a department – orthopaedics, maternity and so on, is called a Consultant. He/She will be in overall charge of your case; a surgeon if it’s an operation you’re in for (or might be), a physician if you’re in for treatment that needs no knife. Surgeons are addressed as “Mister”, Physicians as “Doctor”. If the Consultant doesn’t seem to be around your ward, it doesn’t mean they are always on the golf course, but that a lot of Consultants deal with more than one hospital, or even a different branch of the same one.

Next in line is the Registrar – junior or senior; they may be quite high-powered, in line for a Consultant’s job one day.

The one doctor you will see every day is the House Doctor – that’s the doctor who is closest to the patients. Get on good terms with them and you will feel better at once.

Nursing has been reorganised, but the grades that matter to you most are Charge Nurse or Sister or even Ward Manager, who is the one who holds your destiny in their hands more than anybody. Then there are various grades of nursing staff, depending upon their training. Many hospitals also have Matrons too.

Once you’ve sorted out who’s who, the great thing to remember is that behind the uniform is a person. A person who like’s to be noticed as such – it’s very daunting to some nurse to be ticked off for something that you actually said to another nurse of about the same appearance. A simple “thank you” is all that most hospital staff require for the countless small favours that they perform for you during your hospital stay – it’s so easy to say, but so often forgotten. Nurses will affect your happiness in hospital more than anything else. Affect your health, too; studies done a few years ago proved that in hospitals where the nurses were happy, and talked to each other and the patients, people got out of hospital quicker.

A survey some time ago in the Nursing Times gave nurses’ views on how patients could help the nurses to help them. Although some of the answers were a little disturbing, like: “do not ask for a bedpan after the normal round” or “do not be sick over the bedclothes”. The vast majority said: “ask”. Do not get out of bed to shut the window if you’ve got a weak heart – ask a nurse to do it. Do not lie there worrying yourself because you do not like to bother the nurses – ask them what’s wrong. They can’t do a decent job on you unless they know what state you are in; whatever else nurses are trained in, it isn’t telepathy; and they are much too busy to hang about watching for slight changes in your expression. So speak up.

The trouble with hospitals, of course, is that the people who are the most approachable are the ones who know least. It’s well known that most patients get all their information, including the new formula for diabetic treatment or the reading on the cardiac patient’s monitor, from that splendid woman with three teeth who sweeps under the bed in the mornings. It comes as a shock to realise that she isn’t actually a Fellow of the Royal College of Surgeons. She’s fine for finding out when the meal times on the ward are and which of the hurrying figures in uniform is which; but once you have identified the nurse in charge of the ward, make sure you get your medical information from them or the nurse assigned to your care - no one else. Especially not the patient in the next bed who knows all the symptoms and has had all the illnesses.

Above all, don’t be afraid to ask what is the plan of treatment for you and have your say if someone turns up with a huge implement ready to do something quite different. Then you need to make a fuss, and a big one, and go on making it until someone sorts out what is what.

 “THE PATIENT’S DAY”
Your life as a patient in hospital will largely be affected about some of the things you can do for yourself.
For example, there’s the question of your attitude to treatment. Unfortunately, the people who seem to mind hospital treatment least are the people who find it easy to sink into infantile dependence – but a too total acceptance of everything you’re offered may even be dangerous. The people who get on best know when to complain and when not to. Certainly if they won’t tell you why they have suddenly changed your treatment altogether; if they tell you you are to have onr thing done and someone turns up with a huge implement prepared to do something different, then you need to make a fuss, and a big one and go on making it till someone sorts out what is what.

Relatives often ring the ward to find out how you are getting on; but they should not get upset if the nurses are curt. It’s partly a question of keeping your confidence: you do not, after all, want your boss to be gaily told that your exotic disease is much better this morning, thank you. Tell your family that only one person should ring your ward and Auntie Milly, Grandma and the office can then call that person – if you do the nurses will sink to their bony knees to thank you.

If you are a smoker, you will find that most hospitals have a strict no smoking policy. The trolley that comes around your ward selling sweets and tissues is probably not going to have your favourite weed which encourages a good deal of smuggling. Naturally you do not go puffing great gusts of cigarette smoke down someone else’s bronchitis; otherwise it’s a question of what the hospital allows and where. Do not try to smoke anywhere near oxygen apparatus – you’ll only blow yourself up.

Life as a patient on a ward can often be one where day merges into night and nights seem to go on forever. Time has no relevance and it is quite astonishing how you can lose track of the date and the overall timescale. If you are really ill, meals lose their importance at the same time as their taste. This is no reflection on the hospital’s catering staff, who labour valiantly to excite your appetite. Of course long periods stuck in bed mean frequent naps and consequent difficulty in getting off to sleep at night, with a very light and disturbed sleep pattern, especially in a busy ward.

Ward lavatories nearly always come top in studies of patients’ dissatisfaction. One complaint, as a nurse once put it to me, “they always use the NHS toilet paper – it always puts me off the NHS”; she recommends getting a box of soft tissues of your own. Another major gripe is that too often the toilet doors either don’t lock properly or have long lost the locks they once had. It has been suggested that you make a card on a piece of string marked ‘OCCUPIED’ to hang outside the door. Those with throat trouble or abdominal pains are particularly unable to sing or keep a foot on the door.

Religion is very hard to avoid in hospital, especially the pastoral visits. If you want to be visited, it’s not difficult; all hospitals are in touch with a rich assortment of clerics and people of faiths who come at call – and sometimes of course not at call. One woman I know was all stripped behind her bed curtains ready for the consultant gynaecologist, and it turned out to be the rabbi.

After much research here’s what qualities you’ll need to have to be ‘The Perfect Patient’…

“VISITORS”
Visitors are supposed to be a blessing, and you would feel pretty lonely without any during a stay in hospital. Just occasionally their tender concern makes you wish you had had the sense to get ill in an unpeopled pothole in the middle of the Himalayas.

There’s the one who croons and moans over you till you feel you’d better have a relapse, just to satisfy their sense of drama. There are the ones who treat you as a confessional – these must have read What Katy Did at an impressionable age, and remember cousin Helen explaining that a sick person can become the centre of a household just because she’s always there when anyone has anything they want to say. You, they realise, are pegged down and defenceless, and it all pours. Mercifully, a nurse will chuck them out and the end of visiting time.

But actually most visitors do want to help and it’s my impression that nothing would be lost by being a little more frank than we mostly dare to be – especially when they say “is there anything we can do?” Certainly there is – they can tackle the nurse in charge of the ward about something that is making you an uneasy, they can get you a copy of your favourite magazine or newspaper. Silly little things like washing clothes can often be a lot more valuable than a frozen bedside smile.

Speaking of reading material, you’ll need more than you expect when you’re waiting for something to happen. Don’t consider your stay in hospital as a chance to catch up on that heavy reading you have been putting off. The latest Booker Prize winner is definitely out and it will take you all your time to stagger through the ward’s copy of ‘Hello!’

It’s exhausting when everyone visits at once, so try to get one friend or relative to run a schedule – it’s easier for someone else to ring and say, “not tomorrow, make it Tuesday”. And you can get it across that if you’re staying in a ward with unrestricted visiting, it does not mean that there has to be somebody wearing you out all day long. You do need a bit of time to get cured in as well. Little and often is the best.

In other wards, visiting times may be restricted from four to eight, for example, doesn’t necessarily mean they never let visitors come at any other time. If that’s when your partners working or a relative has come all the way from the Orkney Islands and didn’t know the hours, it’s always worth asking first.

If you’re expecting visitors, Ask your visitors to come at the beginning of visiting time, if at all possible. It’s heartbreaking when everyone else’s troops in and there’s no one for you. Cards, flowers, fruit, bottles of squash are, of course, all welcome but there’s never enough accessible space on the bedside locker to put them all on. Because of this lack of space, I’m reliably informed that a pretty paper carrier to put all of into which is chic enough to impress the nurses, is acceptable, whereas an oily old bag with your butcher’s name on it is not. The ladies and gentleman of the lamp are not too keen on their wards looking like a camp for migrant fruit pickers.

The visit of your spouse plus or minus other sundry relatives can become so important to you in hospital that at times unreasonable pettiness on your behalf can erupt. Comments such as “why are you late?” when your spouse has moved heaven and earth to get the family fed and clothed, friends and relatives informed and other essential jobs performed, are not conducive to harmony.

“COMING OUT OF HOSPITAL”
Hospitals can decide you are well enough to go home with surprising suddenness – particularly if they need the bed, and you will feel like a bug suddenly shaken from its warm rug onto the floor. The cruel irony of it is that you do not have to have liked it while you were in hospital to feel defenceless when they let you out.

Since coming out can happen relatively quickly, work out ahead of time how you are going to get home and who could help during your first few days back. Even if you have been chasing the student nurses round the ward and mending the sash cords on the windows for days, you will suddenly feel unexpectedly weak once you are out in the world. It’s partly psychological: while you were on the ward you could moan and complain and carry on like a four year old but, like a four year old, nothing much was expected of you. Now suddenly your life’s problems are dumped back on your lap again. And you are not as strong as you think you are: in hospital, at least you did not have to cook the meals or clean the floor. Most men, of course, do not anyway which is why I think this problem is worst for women: “ah, Mum’s back, I can stop doing the ironing” is rather the family attitude, though Dad would doubtless have been left off cutting the grass for months – if not forever.

Realise that you are still convalescing on your return from hospital. Let the dirt and dishes go hang if the family will not clean them up. Do not be alarmed if you burst into tears for no apparent reason: it’s weakness not weakmindedness. Above all, take it easy.

Do not expect those bosom buddies you might have made in the ward will really be your friends for life – except on rare occasions. There’s something about a hospital which precipitates confidences, gives you a common bond; it doesn’t necessarily last any more than your mates at work are friends at the weekends or get on with your partner. Such, I fear, is life.

When you are discharged from the ward, ensure that you know exactly what medicine to take, if any, what exercise to perform, and what to avoid in the wide world outside.

Do not forget to ask the staff what the drill is if an emergency occurs – do you go back to your own family doctor, ring the hospital consultant or ward? When you are being driven home, usually at a sedate twenty miles per hour, be prepared for this to seem as if you are taking part in a Formula One Grand Prix race. I suggest sitting in the rear seats with your eyes tightly closed.

Make a note of your symptoms, reactions and problems, if they occur, when you come out of hospital – especially if they are related to either food or you medication. Pass them onto your family doctor or to the doctor or nursing staff if you will be returning to an outpatient clinic appointment at the hospital. You never know if your experience will be helpful to someone else.

© David Elliott, for Birmingham’s BHBN, 2003.