Bedside Manner: Advocating for a Relative in the Hospital

[question everything]

OCTOBER 28, 2008

Bedside Manner: Advocating for a Relative in the Hospital
By MELINDA BECK
The WSJ

Don't go to the hospital alone, if you can possibly avoid it.

A friend of mine slipped on the sidewalk recently and broke her hip. She had surgery in one of the best hospitals in the country. But it was my friend's grown daughter who noticed that she was having an adverse reaction to a pain medication. And that her IV drip had pulled out of a vein and was pumping her arm full of fluid. And that the hot compresses to reduce the swelling in her arm had left blisters on her skin. And that the blood-sugar test she was about to be given was meant for her roommate instead.

Having someone with you in a hospital who is alert and asking questions can help stave off all kinds of potential problems, from mistaken identity to medication mixups to MRSA infections. An estimated 100,000 hospital patients die every year in the U.S. because of preventable errors. Many hospitals are under financial pressures to keep nursing staffs lean. A personal advocate can be a valuable resource. It doesn't have to be a relative -- and it can be more than one person -- as long as they know you and are willing to speak up.

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A growing number of hospitals are doing just that -- including unlimited visiting hours, letting family members accompany patients to procedures and even stay during emergencies. "We're drawing on the strength of the family. They're not out in the waiting room, wondering what's going on," says Pat Sodomka, senior vice president for Patient and Family-Centered Care at MCG Health Inc., which runs a 630-bed hospital in Augusta, Ga. Some hospitals now have nurses give change-of-shift reports at the bedside and encourage families to share observations.

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Initially, some staffers worried that family involvement would take up valuable time, but in the long run, it saves time because doctors have more information, says Ms. Chatman. After MCG Health's neuroscience unit became more family-centered, average length of stay dropped 50% because discharge planning went faster. Patient satisfaction rose, and nursing turnover dropped.

Still, it can be difficult for family members to know when to raise an alarm and how. Karen Aydt Curtiss, a market researcher in Lake Forest, Ill., often felt helpless while her 71-year-old father was recovering from a lung transplant in a big teaching hospital in 2005. He was faring well until he fell, hit his head and was made to lie flat until a neurologist could evaluate him. While he waited -- all weekend -- his new lungs filled up with fluid. He developed pneumonia, then a pulmonary embolism and had three MRSA infections. He died seven months after the transplant, having never left the hospital. "I wish I had grabbed the neurologist by the sleeve and dragged him to my father's room," says Ms. Curtiss, who is writing a book on how to help a loved one in the hospital, titled "Someone With You."


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