Hearing a new diagnosis for the first time can catch you
Hearing a new diagnosis for the first time can catch you
We are nurses. We are nurse practitioners. We are providers. We have spent years at the bedside caring for patients and their families and listening to issues, concerns, and worries. Each day we answer questions on medications, treatment plans, recovery, and navigating our healthcare systems.Read more
Hearing a new diagnosis for the first time can catch you
Mental health is our overall psychological and emotional well-being. It’s much more than just a diagnosis. It involves the way you feel about yourself and others. It includes your ability to manage your feelings and deal with every day conflicts.
At times taking care of your mental health can mean seeking professional support and treatment. It can also include taking personal steps towards improving your own emotional health on a daily basis. Making small changes can improve all areas of your life including your mood, attitude, and overall outlook on life.
Here are three things you can do to help your mental wellness:
Value and invest in yourself
Be kind to yourself and avoid negative self-talk. Make time in all your commitments for your own self-care. Do things you enjoy such as hobbies, read books, favorite projects or crafts, cooking, or learn something new. Take time for yourself by doing a daily crossword puzzle, tending to a garden, read a book, or take some time to decompress. Learn something new – such as dance lessons, learn to play an instrument, or learn a new language. While it may be difficult at times, try and put yourself at the top of your to-do list and find time for you.
Taking care of yourself physically can help improve your health mentally.
People with strong family or social connections are generally healthier than those who lack a support network. Make plans with supportive family members and friends, or seek out activities where you can meet new people. When times get rough, lean on your support system. Finding your tribe to discuss your worries, stress, concerns, fears, and celebrate your successes and good times is important in your mental health.
There will always be good days and not-so-good days –
No one plans on being sick, but how can you help yourself stay healthy? How can you avoid headaches, congestion, cough, runny noses, and fever? Here are five things you can do to help stay healthy year-round.Read more
In the 1920s there were a few hundred drugs available. Now, almost 100 years later, the numbers are well into the tens of thousands of medications available. Knowing what you take, when and why is important when talking to any of your providers. Following these handy tips can help you become an expert with your own medications.Read more
The odds are that one day you’ll find yourself as a patient in the hospital. Things happen. Illness. Accident. Injury. Chances are “hospital admission” isn’t penciled into your daily planner, either. If you find yourself unexpectedly admitted to the hospital, the likelihood is you started as a patient in the emergency department. So what should you expect when you are the patient?
First, let’s just squash the first myth of the emergency room – it is nothing like it is on TV. Brought in by ambulance or walk in the main ER doors – you’ll be triaged in the same way. Triage? What does this even mean? It is how the ER staff determines which order a patient is seen based on how serious their symptoms or condition is.
If you walk into the ER front desk, you’ll first be seen in a triage room where they will take a set of vital signs (blood pressure, temperature, pulse, oxygen level, and respiration rate) and then later be placed in an ER room for further care. You might have to wait back in the waiting room until an ER room is available. Arriving via ambulance may get you directly into an ER room, but it also can get you directly onto a cot in the hallway.
Depending on what reason, or chief complaint, that brings you into the emergency room, determines the next steps:
If discharge just isn’t the plan, and you aren’t able to go home, you’ll move into a room elsewhere in the hospital. Most hospitals nowadays have all private rooms. Don’t be surprised if you do have a roommate, especially if you are admitted to observation.
Observation? What does that even mean? Thanks to the wonderful world of insurance, once you leave the emergency department you might be considered “observation” instead of “inpatient”. This doesn’t change the care you receive or your treatment options, but could make a difference on how your insurance is billed (and what you ultimately pay). It gets even more confusing if you have medicare and need your “three midnights” to qualify for a rehab stay. Let’s stay focused and get through the hospital admission first and save that for another blog post.
So. You’re admitted to the hospital. Now what?
While each hospital stay can be different, and everyone’s experience is unique – there are some basic hospital expectations you will encounter:
Your overall care will be managed by the attending doctor – this is usually a hospitalist or general medicine doctor. If surgery is involved (general surgery, orthopedics, ENT, etc.) they can be the attending. They can also have a general medicine or hospitalist group overseeing your care. As your team of doctors treat you, other groups can join your care.
For example, you could have fallen and broken your leg. You’ll be admitted under the orthopedic surgeon group, but since you have a history of asthma, they prefer the hospitalist group to oversee your medical care (remember, orthopedics focus on bones, not everyday medicine concerns). So, now you have two doctor groups following you. Orthopedics & Medicine. If they plan on surgery, and you’re old enough not to have your ID checked at a bar, you’ll probably need cardiac clearance before surgery. Now you have Cardiology, Medicine and Orthopedics overseeing your care. If you are admitted with something such as pneumonia, or an infection, the list of groups following you can grow.
Your nurses should be able to help keep track of which specialist groups are overseeing your care. Many hospitals give out little notepads and pens when you are admitted. U
In general, there are two main shifts that nursing can work; 12-hour and 8-hour shifts. These hospitals shifts are usually 7a-7p and 7p-7a, or the 7a-3p, 3p-11p, 11p-7am shifts. Many hospitals promote bedside handoff – so you can wrap up your care with one RN and meet the next RN. This means you should expect staff in your rooms during these hours for report handoff.
Nurses are the eyes and ears for the doctors. They will assess you each shift, carry out treatment plans, administer medications and report change in condition to the providers. Now is not the time to tell them “I feel fine” if you truly do not.
The overall goal for pain management is not to be
Pain can be good. It can tell us when something is not right, so completely covering pain can cause more harm than good. Pain is also expected – if you have an injury or have surgery – you should anticipate to be uncomfortable. If you had surgery because of an injury – not only do you have to recover from the surgery but also from the injury itself.
Pain medication use should be expected as well. Everyone responds to pain medication differently, and you should always take the least amount of pain medications necessary. Your
When we refer to diet in the hospital setting, it isn’t about a weight loss. If you have anything concerning abdominal pain or issues that require surgery, you won’t be allowed to eat. We refer to it as “NPO” (“nil per os” for all you latin experts). Nothing by mouth. Sometimes you can have sips of water or ice chips, just don’t get your hopes up until your treatment plan is more concrete.
The types of testing that can be done in a hospital could be its own post. Usually, blood draws are done daily until labs are stable. Yes, they tend to wake you up early so results are ready when providers start making their rounds. You may also be sent to other areas of the hospital for test – x
If you want quiet, uninterrupted sleep – the hospital is the last place you want to be. Every nursing unit will try its best to keep the chatter, alarms, and lights low at night. But the nursing staff is still working and part of the job is to ensure your safety. This can be checking your vitals overnight, ensuring medications are administered and monitoring your overall status. Even during the day, if you have the chance to nap, that’s usually when someone will walk into the room to visit
Most Hospitals have open visiting hours – which is wonderful for our busy schedules. Visitors can be quite helpful being that second set of ears or an extra set of hands to take notes. Keep in mind – your job is to focus on your recovery, and not entertain guests. If you have trouble asking for visitors to leave, ask your nurse to help encourage them to let you rest.
What determines when you go home? Who actually has the final say?
While that all depends on a few factors, your discharge should start the moment you are admitted. This doesn’t mean the hospital wants you out ASAP – but discharge planning takes time. This is why the discussion needs to begin almost within the first 24hrs of admission, especially if additional help or resources is needed to get you home safely. Hospitals have a general idea of how long your condition will keep you in the hospital, barring any additional complications. You and your family will have contact with the discharge planning team which can include discharge planner, social worker, and care coordinators.
Your attending doctor will be the group that has the final say on when you can go home. However – every specialist group that has been consulted during your stay also has to give the thumbs up to leave. Remember the example earlier, with the broken leg scenario? Orthopedics might think you’re ok to discharge “from their standpoint”, but cardiology might be concerned about your blood pressure or heart rhythm. Maybe your blood work was a little off, and medicine will want the labs checked again the next morning before deciding to send you home.
Once everyone has given the clearance to discharge you home – both the discharge planning team needs to have everything in place and nursing has to have your discharge orders, teaching and medication review completed and ready to review with you.
There are two important things you should have at discharge. The first is your medication list. Each medication should have the reason you are taking it, how much and how often you should take it. The second item is your list of all your providers (names and specialty) as well as when you should schedule
And yes, you will probably be discharged out of the hospital via wheelchair. Enjoy the ride to freedom and thank the volunteers who usually are your discharge escort.
Most patients are discharged home as it really is the best place to be for recovery. Sometimes you need extra help once home, and your discharge plan could include scheduled home health care services. They can provide both nursing and/or physical therapy services at home 2-3 days per week. However, you might need more intense therapy or nursing care before you are ready to be home. The bridge between hospital and home when more care required is referred to as skilled nursing or extended care facility. They will provide both nursing and therapy services to ensure you are strong enough to finish your recovery at home.
No matter your discharge path, the most important thing to remember – your recovery will still continue once you are home. This could take a few days, a few weeks or even a few months. The most important first step is to follow-up with your primary care provider once you are home. Keep in mind – you will not be 100% back to normal when you first go home. Rest when you need to. Listen to your body. Make certain you are eating and drinking enough each day. Your body will heal at its own rate, and in our fast-paced society it’s never as fast as we want it to be.
Today, office visits and hospital stays can be overwhelming. The list of providers you can encounter during your care is astounding. Medical Assistants. Hospitalists. Nurse Practitioners. Physician Assistants. Specialists. CNAs. PCTs. Interns. Students. Different colored scrubs. Lab coats. And not a familiar face in any uniform. Who do you reach out to? Where do you start? Who is in charge of your care?Read more