Books on Health: Surviving the
Healing
February 17, 2004
By JOHN LANGONE
"The sooner patients can be removed
from the depressing
influence of general hospital life," Dr. Charles Mayo
observed in 1916, "the more rapid their
convalescence."
Indeed, hospitals are essential, but
too often they are
bastions of bureaucracy, neglect and sometimes
outright
ineptitude. One often cited statistic from a 1999
Harvard
study puts the hazards of a hospital stay in chilling
perspective: hospitals kill nearly 100,000 people a
year
because of human error, faulty techniques,
malfunctioning
equipment, wanton carelessness, oversights or
assaults.
"Many more leave the hospital worse
off than when they went
in," writes Mr. Sharon in his book, one of these
three that
outlines the pitfalls of a hospital stay and how to
make
the best of it.
Mr. Sharon, a registered nurse and
legal consultant, offers
what he calls "insider tips for avoiding hospital
mistakes," information that includes ways to prevent
mishaps in intensive care units, play the "emergency
room
waiting game," communicate with staff to get better
service
and deal with managed care when you're told that
"your
request for treatment has been denied."
Much of his advice depends on the
patient's asking
questions and being observant and insistent. In the
I.C.U.,
for example, he advises asking the nurse what each
wire and
tube is for, checking for swelling and redness from
the
insertion of intravenous lines, and seeing to it
that, in
the case of a transfusion, the nurse matches the
serial
numbers and the blood type between the transfusion
ticket
and the label on the blood product unit - in the
presence
of a second nurse.
"Pay attention to how many patients
your nurse is assigned
to," he writes. "If there are three or more, lodge a
complaint with the health administration and follow
up with
the health department if you do not get a
satisfactory
response."
Dr. Sherer is an anesthesiologist,
and a chapter in his
book addresses what to expect and ask for in his
specialty.
The team should know, for example, if
you use more than one
pillow at night (people who need to be propped up may
experience breathing difficulties because of "the
unfamiliar distribution of weight on your
diaphragm");
where major dental work has been done to avoid damage
to
crowns and implants; and whether you are right- or
left-handed so an IV can be placed in the opposite
arm to
allow you to write, eat and drink more easily.
Dr. Sherer also suggests avoiding
elective surgery in July
because of "the July syndrome." Then, those doctors
who
have finished training are replaced by "fresh faces."
If
you find yourself in a hospital in July, he writes,
"and
see a young person hovering over you nervously with a
needle, you are hereby warned that you, too, could be
in
for the pincushion treatment."
Dr. Sacco, a medical director at
Bronx-Lebanon Hospital
Center in New York, offers a comprehensive analysis
of a
hospital's workings and of ways to deal with the ones
that
affect patient care. He also provides a detailed
primer on
diseases; qualifications of various professionals;
and
information on tests, medicines and equipment from
Foley
catheters to nasogastric tubes; and end-of-life care.
He advises patients to ask doctors on
rounds to wake them
so questions can be asked, and to question if they
really
need an IV instead of antibiotics or other
medications by
mouth, or a transfusion. As to whether someone needs
to be
in a hospital, Dr. Sacco says patients have a variety
of
choices. "More and more," he writes, "conditions once
felt
to require in-hospital care are now being managed at
home
or in subacute settings such as nursing homes or
rehab
centers." Doctors admit people for many reasons, he
says,
"not all of which have to do with the need to be in
the
hospital."
http://www.nytimes.com/2004/02/17/health/17BOOK.html?ex=1078060711&ei=1&en=9d2506fa4a419855
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