Hospital Hedonist

Health care practitioners definitely have their own language and no, it is not meant to confuse the layman.  Abbreviations have been a way for doctors and nurses to communicate quickly and efficiently for centuries.  We don’t say “the patient has inflammation around his heart,” we say it’s “endocarditis.”  When we want a patient to fast after midnight for a procedure in the morning, we simply write “NPO” in the chart.  If a doctor wants to stop all antibiotics he or she will write “d/c abx.”  Patient do not need to know all abbreviations but there are a few that will keep them “in the know” while in the hospital or after discharge. 

Common Abbreviations Everyone Should Know:

NPO= Nothing by Mouth (Do not eat or drink!)

BID= Twice a day (take medication twice daily)

TID= Three times a day (take medication 3 times a day)

HS= At bedtime (take medication before bed)

QD= Daily (take medication daily)

D/C= Discontinue (stop medication or medical treatment)

AC= Before Meals (take medication before meals)

ASA= Aspirin

OTC= Over the Counter

DM= Diabetes

HTN= High Blood Pressure

MI= Myocardial Infarction (Heart Attack)

CVA= Cerebrovascular Accident (Stroke)

AMA= Against Medical Advice

Start with those and interject if you don’t understand what the doctor or nurse is saying!

      “One of my favourites tells the story of two disciples of a guru, called Chaitra and Maitra.  One day the guru gave them one rupee each and took them to two empty rooms.  He asked them to use that one rupee to fill each room.  Maitra rushed out to the bazaar and tried to find something for one rupee with which he could fill his room.  Of course there was nothing for that price.  And then he thought ‘I will go to the garbage seller,’ and from him he bought a mountain of stinking rubbish and proudly piled it high in his room.  But Chaitra meditated in his room and then calmly went out and bought a matchbox, an incense stick and an oil lamp.  He lit the flame, filling the room not just with light but also a beautiful fragrance.

      When the guru came to inspect the two rooms, he turned away in disgust from the room with the garbage, but happily walked into the illuminated room which smelt of jasmine and sandalwood.  The song tells the listeners to ponder the beauty of the story, and the lesson it contains: that good acts and good karma will bring people to you and cause them to love you, but bad acts will disgust them and send them away.”

It is that time of year again for New Years resolutions.  Such easy words to say, but such hard words to actually follow.  We could be simple like my dad and say “For the 15th year in a row, I am going to give up eating potato chips.”  Usually by February, he is asking my mom why she hasn’t bought potato chips. Mission failed, but not much lost with the chips.

Or we can be lofty and say things like I am going to make a mends with my -insert family or friend that drives you insane- and accept them as they are.  I think by the end of January that one will go out the window.  The reason being, you will most likely want to change that other person.  But isn’t the point of resolutions to change yourself for the better?  

Last year, I boasted that I would be healthier and more honest.  I think I’ve marginally accomplished those goals and will continue to try. This year, I am going to try to “let the little things go.”  For example, yesterday I had a patient’s family member come to the desk and say, “Is Florence back tomorrow because my mother loves her as her nurse.  I mean, you are good and all but she really likes Florence.”  I can’t include how I responded because it was inappropriate.  My new goal will be to respond gracefully and just let it go. 

“This is a good time to let the little things go, accept life on life’s terms, and be open to what is.  If we learn to respond to life with all the grace that is in us, grace will reward us back.”

***The name florence was a farce but the story is true.
***Family and friends please remind me about what the little things are throughout 2012.

When admitted to the hospital or while in the office, have questions for the doctor prepared.  Write them down and be assertive.  It will save the doctor time and provide you with faster care.   Nurses spend a lot of time paging doctors and awaiting call backs when patients could easily have asked when the doctor rounded.

      As a nurse I often get asked the question, “What is the hardest part of your job?”  Most expect to hear about blood, guts, and death.  Although, I find those aspects of my career difficult, I never respond with that answer.  I always say, “Dealing with the patient’s family members.”  There really is a sense of dread when you see a certain patient’s family members approach the desk.  Dread in the sense of “what could they possibly complain about now” and “what did I not do now?”  It has become a brutal part of healthcare and improvements are necessary.  Here are a few tips to help patients and families improve their communication skills and in effect, improve their hospital experience.

• Know your loved ones baseline. 

      Baseline, to healthcare providers, means what is a patient’s normal blood pressure, heart rate, oxygen level, blood sugar, and neurological status.  So basically, vital signs and are they normally acting this crazy?  Family members are the key piece of this puzzle.  They can be such an advocate when a patient is deteriorating.  Knowing that your mother’s blood pressure is never low can help healthcare providers make faster interventions.  The biggest red flag to me is when a family member says, “Something is really wrong.”   I hear those words and I usually develop a pit in my stomach, and get moving to help the patient!

Have an organized, updated medication list and past medical history

      Past medical history and medications are two very important pieces of the puzzle to safely admit a patient into the hospital.  With all of the technology in our world today, there are still families and patients that have a small lined piece of paper that gets crammed into a wallet with a list of medications.  This paper usually looks like it is 15 years old and usually has things like “take pink pill on Tuesday,” or “Coreg 12.5mg.”  The problem with those two examples is that, A) there are a lot of pink pills on the market, and B) how many times a day are you popping your Coreg?  My plea is simple.  Please get on a computer, make your parents or grandparents medication list, and keep the list updated with changes the doctor has made.  The same goes for past medical history.  I am often rudely asked “why are you giving my dad that Lasix, he’s been off of that pill for weeks?”  In response I want to say, “Remove it from his medication list that you just handed me and we’ll move on from there.”  Keep us informed by being informed about your loved one.

• Your feelings matter, but not in the patient rooms

      Your loved one is in the hospital, and they are anxious and scared.  They just received word from the doctor that it is cancer and we have to run more tests.  This day is about the patient.  It is not about you and your emotions.  It is about supporting your loved one through the process.  We all react to negativity differently and if you want to react negatively come with me to the family waiting room and let’s have a good cry.  Then compose yourself and go hug your mother once you have recovered.  Selfishness is not allowed.  Turning around and getting mad at the staff that we are taking too long to get the ultrasound or blood test will not help your loved one.  Breath, talk with me in the hallway about your concerns, and be strong for your family. 

• Find a way to trust us again

      When I say us, I mean hospitals, doctors, and nurses.  Our culture has shifted into malpractice suits and because of this shift, healthcare providers are more stressed out and are busier.  We have to document for a longer time on computers because it is grilled into our heads that if we don’t document, 5 years from now when a ambulance chaser is questioning why I didn’t document a bowel movement, I can’t respond with, I was spending too much time at the bedside, sir.  I want to be at the bedside, and when I am not, I am fielding calls from doctors, family, helping a crashing patient, and documenting for what seems like forever.  We are not out of room posting on twitter.  We are facilitating your care, being your advocate, and working hard to make your hospital stay a safe one. 

      All I can hope from this short guide, is that more effective communication will develop between healthcare providers and the community.  Please don’t let one negative experience affect your faith in hospitals and its providers.  Let’s keep talking and let’s help improve the quality of life for our patients together.