Empowering patients: Emergency department palliative care
Millions of people find themselves in a hospital emergency room each year. You never know when it will happen to you. Whether you dial 9-1-1 and ride by ambulance, or if a friend or loved one rushes you there, a trip to the emergency room is a frightening proposition.
Spend some time reading these tips for safe and effective care in the ER. They may give you enough confidence to reduce the amount of wear and tear on your nerves. They may even shorten your stay, or help you get better care than you might receive otherwise.
In the Ambulance
- In a life-or-death emergency, you’ll want to be taken to the nearest hospital that treats whatever problem you seem to be having. For example, if you are in a bad car accident, you’ll want to be taken to a trauma center. If you think you’re having a stroke, you’ll want to find the nearest facility that knows how to care for stroke patients. Most ambulance services are staffed by EMTs (Emergency Medical Technicians) who are trained to know enough about whatever medical problem causes the emergency that they know where to take you. Let them make the decision as to where you’ll get the best care.
- If your emergency is less time-sensitive, meaning, you don’t need immediate care, then you may have options for choosing the ER you prefer. In some areas of the country, by law, EMTs may have no choice but to take you to the hospital they deem the best to treat you. They will know which hospitals are overcrowded already and not accepting new emergency patients. In other locations, even if the EMTs tell you a specific hospital is closed to emergency patients, you may still choose to go to that hospital. This might be important if you know your doctor is affiliated with a specific hospital, or if you know something about a hospital’s reputation.
- Try not to arrive during a change of shift, typically 7 am, 3 pm, and 11 pm, although not all hospitals follow that system. The medical personnel who are already at work are getting ready to end their workday. The incoming personnel may not be able to care for you right away because they must be briefed on the dozens of other patients who are already there before they can treat anyone. You, arriving during the change-of-shift, will be last in line and you’ll be waiting much longer for your care.
- If a loved one is following you, and there is time, have your loved one call your family doctor and ask that she call the ER to tell them you are coming. As a professional courtesy, the ER doctor will keep his eye open for you.
Once You’ve Arrived
- Provide as much information as you can about your medical condition. Know the names of the drugs you take, the allergies you have, your blood type and other important information. Better yet, prepare that information ahead of time so your caretakers can find the information they need.
- Ask a friend or loved one to go with you. If you can’t, ask emergency personnel to phone someone on your behalf – a relative, neighbor or friend. Spending time in the emergency room can be overwhelming, and it’s difficult to pay attention. Having someone by your side to advocate on your behalf can reduce your stress and calm your nerves.
- Ask questions continually. The more questions you ask, the more engaged you will be with the staff, and the more attention they will pay to your care. Don’t be overbearing or annoying, but when they’ve taken the next step in your care, be sure to ask what will happen next.
- Ask everyone to wash and sanitize their hands before they touch you. Infections from hospital care run rampant and it’s possible that the illness or injury that got you to the ER, to begin with, could be less invasive than an infection you might pick up while you are there. Most personnel will be cooperative, even if they are surprised you asked. They’ve been taught to wash their hands, but they don’t always remember.
While You Wait… and Wait… and Wait
- Try to keep your own situation in perspective. If you are suffering a life-threatening emergency, then you will probably get the immediate care you need and deserve. If personnel aren’t treating you immediately, then it’s likely they don’t think it’s quite the same level of emergency you do. Other patients will be sicker. Other patients will die. If you have the where-with-all to remember these tips, then chances are your situation will turn out just fine.
- Find your sense of humor while you wait, too. You may be in pain, or you may feel sick, but you are just like every other patient who is hurt or sick. Your sense of humor will make you more memorable, and staff will look in on you more frequently because they’d rather do that than visit the person behind another curtain who’s not so entertaining.
- Ask for copies of any test results, and ask that copies of the results be sent to your doctor. Plan to visit your doctor for a follow up a few days later just to confirm that you received the care you needed and to decide on next steps, if necessary.
- Make sure the staff gives you written instructions to follow once you get home. And follow them! By complying with the follow-up instructions, you’ll reduce your chances of having to go back to the ER, and you’ll probably heal more quickly, too.
- Take the time to thank those who helped you, looked in on you, and made your stay as pleasant as a visit to the emergency room could be. They will appreciate it.
“Staying” means one of two things. Either you will be admitted, or you’ll be held for observation status.You do NOT want to be kept for observation! There are many problems that can occur under “observation status” that can become very expensive (your insurance may not cover it) and/or be detrimental to your health.An empowered patient plans for medical surprises, including emergency room visits.