“Visiting a Patient in the Hospital” by Ken Schueler

“Visiting a Patient in the Hospital” by Ken Schueler

Having a serious disease like cancer often makes a patient feel they’ve lost control of their bodies. Plus being in the hospital, wearing institutional gowns and constantly on everybody else’s schedule, is a depersonalizing experience for most patients. It’s especially important when visiting a patient/client of yours in the hospital that you make every effort to respect your patient’s autonomy and self-esteem and promote their empowerment . This begins with making a precise appointment for your visit which is convenient for your patient and within visiting hours. Ask the patient (or patient family) what would be a good time to visit-sometimes a patient may have more energy at night than the afternoon. Sometimes a patient may want you present when her/his doctor is making rounds(which can vary by hours-but can often be more accurately pinned down by the Nursing Supervisor). Arrive at the appointment precisely on time. When you enter the room, announce yourself first with your name and ask “is it OK to come in?” After putting down your coat ask “may I sit beside you?”. Before getting into any particulars ask “is there anything you need right now like ice chips, water, pain meds or for me to get the nurse or a health aide(e.g., linen is soiled)” Don’t interrogate your patient-instead do active listening with open questions like “how are you” and see the direction that takes. If a patient is confused by their diagnosis(or lack of) or treatment, tell her that you will have her doctor(or covering doctor or fellow-often the most forthcoming) paged. It’s often very effective to call the doctor’s private office and leave a message with a secretary or office manager(preferred) or service and request a call back(to your cell phone) or request that he visit his/her patient as soon as possible if he’s in the hospital. Also call the hospital’s main number and ask for the doctor to be paged. If the doctor has provided your patient with a business card indicating a pager number you can use that. Tell the doctor: “I am ______’s(name of patient) Patient Advocate and that she/he is extremely anxious because she/he doesn’t understand her diagnosis and what treatment you have in mind. Also she’s constantly getting breakthrough pain, Pain Management hasn’t visited once, the Nursing Station can’t increase her dose and we can’t seem to find an attending doctor. Could you please come to her hospital room as soon as possible(get a time estimate from the doctor)”.  Always make sure your patient has executed a HIPAA release granting you authorization to speak with her physicians or nurses. If she hasn’t signed a HIPAA release bring two copies with you(make sure it’s format is valid for the state you are in) and have your patient sign both copies. Provide one copy of your patient’s HIPAA release to her specific nurse and ask her to place it in your patient’s chart and ask her how your patient is doing, has her doctor visited her today, has Pain Management been notified that her baseline pain is not controlled and that she would like a PCA (Patient Controlled Analgesia)rather than receive oral pain pills because she’s been nauseous lately. During the entire visit have a notepad and write down requests made by your patient for action when you return to the office or which you need to inform the nurse of (e.g. health aides are touching her or her bed but they have not put on fresh exam gloves nor used antibacterial gel), and write down medical notes concerning her condition, treatment plan, etc. If family members are present ask your patient for permission to speak with them but only if the family wishes to talk with you. Now, there are situations of family dysfunction where your patient will not feel free to speak with you candidly while family members are in the room. This issue can become delicate if you were retained by the family and not by the patient. You can say to your patient, “if you don’t mind I’d like to speak with you privately; may I ask your family to wait outside or if perhaps they may want to take a break and go to the cafeteria”.