Hospital Survival Guide:Nurse Tips for Patient & Family

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I hope you won’t be needing my tips on how to survive a hospital stay anytime soon, but if you do, these suggestions are sure to come in handy.  My intention for you and your family is that you will be as comfortable, safe, and healthy as is possible.

1. Legal Issues. We all need to make sure we have a Living Will and a Durable Power of Attorney for HealthCare in place prior to entering a hospital if at all possible. I know these are uncomfortable decisions to make and we would rather put it off; however, when we find ourselves in the situation where we have to make the call on behalf of a loved one, the decisions we make tend to be emotionally-driven rather than thinking about what our loved one may have verbalized at some point as their wishes. We don’t need to put our family in that position. Nonetheless, it is a part of life, and these issues are crucial in order for the hospital and healthcare providers to know exactly what type of care or interventions you do and do not want. It is also important to make sure that who you designate as your power-of-attorney for healthcare is going to uphold your decisions if you are unable to speak for yourself. As a nurse, I have seen situations occur more than once where a family member over-turned their loved ones decision(s) and it’s heart-breaking. Yes, it is rare but it CAN happen, shocking as that may be. The few cases I’ve witnessed this tragedy typically centered on a family member having more to gain financially by keeping their loved one alive on machines rather than respecting their documented wishes. Check with your local hospital, attorney, or state of residence for guidelines on how to prepare what you need.
2. Housekeeping. In case you are not aware, hospitals are not the most sanitary environments. It isn’t necessarily out of neglect to clean or disinfect – for one, hospitals are what we call an “antibiotic-rich” environment. This means bacteria are working very hard to survive and they mutate rapidly. Secondly, the nasty critters are transferred from room to room despite our efforts as nurses to wash our hands countless times a day. The bacteria are also on our uniforms, shoes, and equipment. All sorts of harmful bacteria call home to hospital floors, bed railings, and other surfaces so it’s important to protect yourself.

  • Keep your shoes protected with disposable shoe covers and remove them before stepping into your home or hotel. When I worked in the clinical setting, I always removed my nursing shoes in the garage prior to setting foot in my home.
  • Use a shower cap to protect your purse or small bag. I cannot tell you how many times I’ve had family members toss their purse or small bag in the hospital floor while visiting the patient.  Don’t compromise your personal belongings this way – place a shower cap on the bottom of your purse or small bag before setting it down anywhere in the hospital room. Better yet, invest in a small purse hook and keep it off the floor entirely.

3. Comfort. Hospitals are typically cold environments, especially the ICU or other special-care area. When spending time with a loved one for lengthy periods, it is important to take care of yourself too. There is what is known as “compassion fatigue,” and this is not the time to be a soldier . . . you do need to be there for your loved one front and center when needed, but you must also maintain a certain level of health and self-care for yourself.

  • This is also not the time to be a “Fashionista” so I suggest if you are going to be sleeping at the hospital, be sure to bring or purchase a couple of sets of inexpensive sweats that you can maybe throw out later. These will help keep you warm and as comfortable as possible even if you have a blanket.
  • Hospitals are also extremely dry. Use lip balm and salve liberally, even when your lips don’t feel dry – apply, and reapply often. If you’re sleeping over, use skin moisturizer as well. Help your loved one with these things too – oral health and skin care in the hospital is a priority. Sadly, these days patient care techs and nurses are over stretched but still strive to do their best for you.
  • Stress, worry, and fear especially in an uncomfortable situation or environment tend to produce headaches and constipation. Although hospitals have medication, this is for registered inpatients only. You can’t even get an over-the-counter Tylenol without purchasing it from the gift shop if there is one. So make sure to bring your own ample supply of medicine in case you get a headache or other distressing symptom.
  • A great way to keep things moving along smoothly is to bring in some herbal tea specific for constipation. A blend derived from Senna will keep you regular during times of stress. Use only once per evening though, and not long term. Remember, this is for you and not the patient because it may be contraindicated for them – same goes for any over-the-counter medication you might need for a headache, etc.

4. Odors. Depending on the type of medical-surgical or other unit the patient is on, there may be strange and irritating odors for a variety of reasons. Although the use of peppermint oil is usually an option in the hospital, it has to be ordered by a physician and from the pharmacy for a specific patient. I have found the use of essential oils of peppermint, lavender, and frankincense are very effective and comforting for patients in the clinical setting. And the use of essential oils is within the scope of practice by a Registered Nurse who has been trained in Clinical Aromatherapy. Whether it be for odor control, stress & anxiety, pain, nausea, or a relaxation massage, I’ve used essential oils as a nursing intervention for many patients and witnessed improved appetite, orientation (patient oriented to person, place, & time, etc.), and reduced pain and nausea.  Ask your hospital if they have a contact name for a clinical aromatherapy nurse (many hospitals are now offering this service) or a staff nurse who is skilled in the use of essential oils. Do not attempt to use essential oils yourself in the hospital setting unless you are trained to do so.  Essential oils are contraindicated in certain conditions such as hyper or hypotension (high or low blood pressure) and syncope (fainting spells or passing out).  However, used properly by a trained nurse and for the right issue, the outcome for the patient and family can be very positive.

5.  Advocacy. Hospital stays can be extremely trying and stressful.  Doctors show up at odd hours and the family may be sleeping, or have stepped out. Make sure someone is usually in the room with your loved one if possible. Even if you are in the room when the doctor comes in, it’s generally only for a few short seconds and a lot of information is exchanged.  Ask to record with your iPhone or other device what is being communicated – because in times of emotional stress it is easy to misinterpret what is being said and then when this information is repeated to another family member, and then the next, the information usually changes. So make it easy on yourself and either take really good notes, or record what healthcare providers are telling you about the patient’s status. The Registered Nurse in charge of your loved ones care is his or her best and primary advocate so communicate everything honestly to them, good and bad, so that the plan of care can be structured in a way that is optimal for the patient.

Being practical is the key to surviving a hospital stay for anyone.  Whenever you know a friend is going through a hospitalization of a family member the best gift you can give them is to offer to relieve them for a few minutes.  You could also go ahead and pick up some of these suggested items along with some bottled water and simply leave them in the room. If the family is from another state, the hospital usually has meal tickets available for family members but these are sometimes limited in number.  Consider buying some prepaid tickets or vouchers to the hospital cafeteria for the family.  Flowers and cards aren’t the only ways to be thoughtful!

A word about flowers . . . if your loved one is on an oncology unit (even if for a non-cancer related reason) please do not bring or have delivered to the hospital live plants or flowers.  It’s a courtesy to all the patients on that specific unit who may have very low white blood cell counts – bacteria, mold, and/or fungi that may be harboring in these plants are not harmful to a person of average health but to someone with a low white blood cell count, they can be fatal.

Follow up:  Comments from a friend who is a Registered Respiratory Therapist of which I agree: “Very informative article. So glad you mentioned the flower issue! This also goes for the pulmonary wings as the strong scent of some flowers can trigger asthma attacks and ,in general , difficulty breathing. Most folks with asthma also have allergies. It’s just a bad idea. Hospital rooms are small and the concentrated scent sometimes runs me out of a room sneezing as well.”
Shannon: 
 I very much agree because my friends comments remind me of my mother and how she struggled with COPD.  Every exacerbation resulted in hospitalization and as much as she loved flowers & plants, she simply could not tolerate them while in the hospital.  It impaired her ability to breathe and get stable.

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