Tips for Navigating the Emergency Room
While taking care of my mom, visits to the emergency room became a regular occurrence. The practice never made the experience easier emotionally, but it did teach me some valuable tips that made things run smoother.
Don’t be afraid to speak up.
Circuses are one thing, hospitals are another. With everyone rushing to do their job around you, it’s easy to feel in the way or ignored. Coming up with a concise version of what happened to tell the doctor can help a lot with the diagnosis. Try to keep it short and sweet but also detailed. And don’t lie, usually they will know you’re fibbing or it can cause for additional, unnecessary tests wasting time.
It’s natural to assume that after an exhilarating 10 hours in the emergency room, all your information would additionally be passed on to the nursing staff on the hospital floor. Unfortunately, this is not always the case. Don’t assume anything! Review, ask, don’t be afraid to make sure all the bases are covered.
My mom lost her sight from diabetes, and I can’t tell you how many times people would set a giant stack of forms under her nose and say “sign these”. I repeatedly had to remind people that she was legally blind, and I would need to sign and review all the paperwork. Eventually, we made signs to remind those around her of my mom’s condition. Hospital staff see hundreds of people in a day, so don’t expect them to remember all the elements of your individual case. But because of this, don’t be afraid to speak up and inform them of information that you may think is necessary.
It’s a good rule of thumb to establish a rapport with the charge nurse. Especially if you cannot be there when the physician is in the room. Communicate your concerns with the charge nurse so they can be shared with the appropriate parties. Hospital staff may be reluctant to communicate with you if you do not have the proper credentials. If so, this is the time to speak to your family member or friend about establishing if a medical power of attorney is necessary.
Keep a personal record.
Try to find out when the doctor will be in and who they are. In many cases, there are teams of physicians called “hospitalists”. There is a chance you may see your primary care doctor, but most likely you’ll be addressed by one of the hospitalists making their rounds. Their role is to identify specialty care that is needed and get you the correct medical evaluation to develop a plan of care. If you feel it necessary to communicate with an individual physician, you will likely have to reach out to them on your own.
Write down the name of your doctor, the charge nurse, and the pending physician so you have a record and know who to ask for. Also, keep a record of times. If your senior had blood drawn, ask how long it will take for the results. If they said an hour and an hour has passed, you can give them a friendly and polite reminder.
Should I be allowing visitors?
Hospitals typically have set visiting hours, but it is up to each individual to decide what is best. I remember when my mom was really sick, she didn’t want to see anyone. The visitors were always well intended, but they weren’t always welcome. For others, visitors may be just the thing they need to make their day. Check with your loved ones wishes and let your friends, family and the nursing staff know when it isn’t appropriate for visitors.
This is a time when you can ask these well-wishers for a commitment that actually makes a difference. People always say let us know if we can help. Take them up on the offer, but be specific. You can start a calendar to plan for your return to home. If you need a little push in asking for help, consider giving this post a read.
About to be discharged?
If you start hearing talk of discharge plans/dates, ask to meet with the discharge planner as soon as possible.
Here are some things you may want to ask:
- Will you receive home health services once you go home? This is something the doctor must prescribe, and it is covered by Medicare. It is intended to support people who need a higher level of care at home. Typically, these people are unable to access services in the community so the care follows them to home.
- Have any medications changed? If so, you need to plan on picking them up. The hospital usually gives you new prescriptions at discharge and you have to drop them off or ask them to be called into your pharmacy. Keep in mind that some medications require you to deliver the prescription in person.
- Will I need more help once I get home? People often do not realize how much help they have in the hospital. If they are going home alone they may need additional help.
- What is the back-up plan? Going home can mean a lot of things. If plan A does not work out do you have a plan B?
- When do you need to follow-up with your doctor? Since being hospitalized can change things you will need to make sure to make an appointment as soon as possible.
If you feel that you are being asked to leave before you are medically ready, and are a Medicare recipient you will need to contact them as soon as possible. You may be able to file for a “fast appeal.”
“If you believe you’re being discharged from a hospital too soon, you have the right to an immediate review of your case. The Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in your area will conduct the review. You may be able to stay in the hospital (coinsurance and deductible may apply) while the BFCC-QIO reviews your case. The hospital can’t force you to leave before the BFCC-QIO reaches a decision.”
Day of discharge
The nursing staff and social worker will give you an approximate time so you can plan to return home. Here are the top five things you should know about planning for discharge:
- You will need a signed doctor’s order for your release.
- The time they give you is approximate so make sure your transportation is flexible.
- Have something comfortable to wear home.
- Once the doctor has signed off for your release the hospital staff will call for transportation. Typically, the patient is escorted by wheelchair to the front door.
- If you are unable to transport your loved one by car ask about medical transportation options.
ER starting to look like your loved ones second home?
Consider preparing a hospital bag for your senior. Hospitals will provide you with basic necessities but they’re not exactly comforting, and you’d be impressed at how much they charge you for a toothbrush.
Having your own things really does a lot for one’s spirits. Gather up some of the items such as a lotion you know your mom likes, their own shoes, medications, an extra phone charger, anything to make them feel more comfortable. When at the hospital, be sure to gather up your valuables such as jewelry, watches, wallets, etc.
Otherwise the hospital staff will remove them and put them in a safe, but unfortunately, things sometimes run off. My mom had a necklace that was removed and put in the hospital safe, but when I asked about it, they told me that I could pick up her belongings downstairs. Low and behold the necklace was missing. Since there was no record and I did not have any evidence that the necklace was ever on her person there was nothing we could do.