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Critical Conditions: The 8 Rules Every Caregiver Must Follow When a Loved One is Hospitalized

By Martine Ehrenclou, M.A.

The following tips are based on Martine’s new book, Critical Conditions: The Essential Hospital Guide To Get Your Loved One Out Alive, which stemmed from her personal experiences with her mother and godmother. As Martine recounts, after interviewing fifty families, she realized that the problems her relatives faced during multiple hospitalizations were the norm, not the exception. And after interviewing over eighty-five registered nurses who worked in hospitals, dozens of physicians, physician assistants, hospital social workers, psychologists, and other medical staff to find out what was going on in hospitals and why so many family members were distraught over their loved ones’ hospitalizations, Martine also realized that hospital care was in crisis. She set out to do something about it. She understood there was no way for her to fix hospital care, but knew that if she could educate family members and get them involved, patients would have safer hospital stays. Patients need an advocate to be there around the clock, a job none of us gets training for…until now. In Critical Conditions, Martine takes loved ones and caregivers through everything you need to know, from establishing a relationship with the primary nurse to charting the patient’s tests and results. She addresses the intricacies of each of the following tenets in careful detail and with indispensible, step-by-step advice for how to handle all likely contingencies, plus patient and caregiver stories that show you how the advice works in action.

     
  1. Be in the hospital room during doctors’ rounds to meet them face-to-face, ask questions and get updates. This is when to begin your initial conversation with all the doctors. Ask the primary nurse when the doctors are expected. Get to the hospital early and wait in your loved one’s hospital room until they arrive.
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  3. Carefully monitor medications and treatment. This is a key part of preventing medical errors, which requires checking and rechecking and asking questions. Don’t be afraid to speak up. Check medications, dosages, the IV, test results, procedures, treatments—in other words, check everything.
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  5. Establish a relationship with each of your loved one’s primary nurses. The primary nurse is the only person who is responsible for the daily care of your loved one and who knows what is going on. Be aware that there is going to be a different nurse for the day shift and for the night shift, and there can be a different primary nurse every single day.
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  7. Research the disease or condition your loved one has. Research enables you to have reasonably educated conversations with the doctors and primary nurses about your loved one’s illness or injury. You’ll be more capable of asking intelligent questions and understanding their answers. If you have educated yourself, you are also much more apt to notice if something goes wrong, such as a medical error.
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  9. You must have someone, a family member, in the hospital with the patient at all times. Patients recover faster when the family is involved. However, assign one point person to coordinate information with health care providers, even if a variety of family members takes turns visiting. If a family member can’t be there at all times, consider hiring a private duty nurse, caregiver, companion or sitter, depending on your finances and the patient’s condition; more help is need if your loved one is confused or very ill or if it’s a holiday, weekend or summer month, all of which can mean the nurse-to-patient ratio is very high, meaning there are fewer nurses to care for patients.
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  11. Record all essential information. That’s why I created the Quick Reference Guide and the Daily Progress Notes sections in the book. Include all physicians’ information; baseline vital signs, lab tests and procedures; and the treatment plan. Don’t leave anything up to your memory; write it all down. And if you can’t be at the hospital to make these notes, have someone else write down everything for you.
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  13. Insist on pain management. Several physicians I interviewed suggested that family members insist on pain management for the patient. If your loved one is in pain, speak to the primary care physician about it and ask them to order pain mediation. Make sure that the order makes its way into the patient’s chart. That way, the nurse won’t have to call the physician to get an OK every time your loved one is in pain.
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  15. Take special care if the patient is bedridden. If your loved one is unable to get out of bed, ask the primary nurse if he or she has been turned and how often; this is how to prevent bedsores, a common problem that can quickly escalate to a severe one
       

Martine Ehrenclou, MA, received her master’s degree in psychology from Pepperdine University in Los Angeles, CA. She has conducted research for the UCLA Neuropsychiatric Hospital and research for a forensic psychologist. Martine has had a psychiatric article published in The Journal of Forensic Sciences and presented her own research paper at a national AAFS conference. She also worked as a counselor at Southern California Counseling Center. To learn more about her book, visit http://www.criticalconditions.com.