Making the Best of a Hospital Experience
BY SANDRA BOESCHEN

Spending time in the hospital can be a two to seven day event with Hip Resurfacing and it is helpful to learn what to expect, who to contact, and how to ask questions.

WHY IS THE "SYSTEM" SO DIFFICULT?
There are so many layers to our current health care system, from insurance coverage and the increased specialization of caregivers to the various policies and procedures unique to the facility caring for you and the regulations that govern how that care is given. It is more and more common that patients will find challenges when making their way through the system, which is why asking questions and having an advocate to ask questions on your behalf is so essential.

KNOW WHAT TO EXPECT
Just as it is important to know as much as possible about the procedure you're going to have, so too is it important to be knowledgeable about what to expect from the entire hospital experience. As soon as your hospital visit is scheduled, ask your doctor who he or she recommends you contact at the hospital to get more information.

Advocates, Navigators & Educators
The next step is to locate an hospital advocate to help you through the system. This is either a registered nurse, a person with a social work degree, or someone with similar training whose entire role is to ensure questions are answered and resources of that facility are explained. This is especially true if you are traveling out of state for your treatment. This advocate will often be the one helping to organize delivery of your needed supplies after Hip Resurfacing and will help you arrange physical therapy.

If your physician does not know of such a resource at the hospital where you will be admitted, call the patient relations department, the nursing education department, or the community relations department. Persist until someone links you with someone who can help you understand what to expect during your hospital stay, including details on how the admissions process works, what kinds of professionals will be involved in your care, what tests will be needed in advance, what to bring and not to bring, who to call after hours once you are discharged, and how to be in touch with the billing department should that become necessary.

TAKE A PARTNER WITH YOU
Having an personal advocate is incredibly important. When you are the person having the procedure, you will find that you may miss things that people say, be groggy from anesthesia, or otherwise not be quite yourself due to the uncertainty of the new circumstances you find yourself in.

It's a good idea to take someone with you, be it a friend or partner, to listen, take notes, and gather materials both when you visit your surgeon. A second set of eyes and ears ensures that you'll have access to all the information you need later. A diagnosis of cancer and the subsequent strange new world of the hospital system make it difficult to absorb information, no matter how competent at listening you usually are.

SURGERY
In addition to your orthopedic surgeon, other physicians maybe involved in your care include your general practioner and anesthesiologist. Other staff during your stay will include the person who admits you, the nurses who are with you prior and during surgery, and the nurses who are with you during post-operative care. Often, volunteers cover the waiting room so that updates can be given to friends and family. If you've indicated an interest in a visit, a chaplain and other supportive staff may stop by to see you.

Read everything you're given about your procedure by the hospital. It doesn't hurt to ask if there have been any recent changes in procedure that are not captured in the written materials. Reconfirm where and when you are supposed to arrive the day of surgery; inpatient and outpatient areas sometimes have separate admitting areas.

If you have specific requests about what goes on in the room during your surgery, make them known to your surgeon and the anesthesiologist. For example, some people feel strongly that conversations are absorbed by the patient, even while under anesthesia. You can ask your surgeon and anesthesiologist to assure that only positive things are said, such as "it is going very well." If you encounter a caregiver who scoffs at a such a simple, humane request, ask another member of your surgery team to act as your supporter during surgery.

I have personally found that using a guided imagery tape prior to a procedure (one that reinforced concepts like "minimal bleeding" and "awakening feeling good with my stomach calm and settled") was very helpful. I used Health Journeys: For People Undergoing Surgery, an audio book by Belleruth Naparstek, which turned out to be one of the best tools in my kit.

Lastly, it is standard for nursing staff to be constantly present during the pre-op and post-op phases of your care, monitoring your vital signs and seeing to your comfort and safety.

COMMON MISTAKES
Since most of us are not medical experts, we may think of mistakes as only occurring on the caregiver side of the equation. But patients make mistakes, too. Some common examples include:

Being passive. Study after study has shown that engaged patients have better results overall than any other category of patient.
Being hostile and suspicious in your approach to caregivers and the hospital experience. The people caring for you mostly got into this field to be of service. Hostility and suspicion make it hard to establish a positive relationship. An attitude of cooperation and trust elicits the same from your caregivers.
Not complying with your treatment plan. If you've asked questions and fully understand what your physician wants you to do and why, commit to and follow the plan. If you don't agree with something your physician is recommending or are uneasy about a particular medication, bring that issue out into the open. If necessary, politely ask for a second opinion. For example, my post-treatment medication was somewhat open for debate, so I spoke with four different experts (it turned out the best choice was what my oncologist recommended initially).
Being overly persistent or disorganized about your needs. Like hostility, persistence that wears your caregivers down will result in a strained environment. Similarly, being disorganized and calling repeatedly rather than grouping your questions to busy caregivers is very disrespectful of their time. If you really need something and are not getting it, move up the chain of command (as described earlier in this article). Don't badger the caregiver at your bedside as he or she may be unable, due to policies and procedures, to provide the help you're seeking.

INSURANCE
Volumes could be written on this topic. Basic advice is to read everything that comes to you carefully (or ask a friend or partner to do so) to be sure you are being charged correctly. If you have a question, check to see if there is a web-based resource to research your questions or call the customer service number of your insurer. Charges can and do appear on your bill erroneously, and the bills themselves are often incredibly complex, making it difficult to differentiate the provider's original billing, your share, and what costs are covered.

Your bill may reflect a charge for services at a price that astonishes you and which you will most likely not pay because of the discounted rates that insurers negotiate with physicians and hospitals. If you are not insured or have a plan with a high deductible, get in touch with the hospital or physician to see what kind of payment plan can be arranged.

FINAL THOUGHTS
In the end, we are very fortunate to have access to the level of care now available to us as patients. As with most experiences, with a little preparation, an inpatient or outpatient visit can be the healing event you need. Remember to have someone with you along the way and to treat the staff caring for you as assets in advancing your return to health.