The In-Patient Experience

As many readers know, I had a total hip replacement aka total hip arthroplasty a week ago.  This procedure was not part of the retirement plan and forced many other plans to be revised and postponed.  Leading up to this surgery I had many worries, most of which proved ill founded.  Up to this point in my life I was blessed with relatively good health which meant that I had little knowledge of the intimate workings of hospitals or the Canadian medical system.  As with all life experiences, the in-patient experience provided learnings for postworksavvy.

The competence of the caregivers was amazing.  Each person from the orthopaedic surgeon to the food server was excellent in his/her role.  The professionals and support people on the team whether they were pain management specialists, nurses, physiotherapists, occupational therapists, lab technicians, imaging technicians, cleaners, patient advocates, social workers or pharmacists provided true patient-centered care.  There was no doubt that they were the experts but they never failed to explain, consult and provide options so that I felt involved in every step of my care plan.   The nurses were skilled at recognizing how helpless I was in the initial phases of recovery but ensured that personal dignity was maintained.  What was done and how it was done was not likely referred to so crassly as excellent customer service but that was precisely what was given to me.

The way that I was included in the decision making gave a sense of control even when I was completely helpless and unable to move.  Regardless of whether the intervention was minor like raising or lowering the bed, or whether it was more important like a change of medication, I was briefed on what was happening and my agreement was sought.  Sometimes the choices were limited but my active participation provided a sense of empowerment which meant a lot.

Hospitals are complex institutional environments.  I knew that there were standards in place because I had researched the hospital’s accreditation status.  More importantly, I counted on these non-negotiatble standards as a method that would minimize medical errors, mistakes or inappropriate decisions.  Within the two hour period between my 6 am admission and the 8 am transfer onto the operating room table, I was repeatedly asked to verify which hip would be replaced.  A resident was verifying an operating room checklist as I succumbed to the anesthesia.  Some requests I made were politely refused because acquiescing would mean not meeting my medical needs nor the standard of care.

Through the 4 day hospital stay I was gratified that my personal dignity and privacy were maintained.  Losing the capacity to care for myself was one of the biggest worries I experienced prior to admission.  I did not know how I would respond to having someone else assist with every aspect of my body’s needs.  By using expert bedside manners, listening to me, and using efficient lifting and bathing techniques, I felt respected and cared for.  It was a bit of a shock to be cared for by several male nurses but I quickly understood that in the professional environment, my old stereotypes needed to be left behind.

I was also amazed on how technology was used for accountability, efficiency, and inter-professional communication.  No medication was administered without a nurse scanning my hospital identification bracelet as well as the barcode on the sealed medication packet.  Automated charting was used by the professional team.  Sometimes it appeared that nurses spent as much time on their computers as at the bedside but I knew why this happened and it gave me comfort to know that this is how modern medicine has evolved.  Given the technical aspects of the surgeries of the patients on that orthopaedic ward I took solace in the use of technology to monitor and track all aspects of patient care.

As the days progressed, more emphasis was placed on teaching self care techniques to empower and to expedite discharge. Prior to leaving the hospital I  learned to inject a blood thinner.  I learned how to properly use a walker and how to go up and down a flight of stairs with the support of a cane and a bannister.  I learned how to care for the incision as it heals.  I was given some absolute prohibitions regarding bending, crossing my legs, twisting and other movements that may create a dislocation.   I was taught about the signs and potential dangers of a blood clot.

Having good knowledge about what to expect after discharge has helped me to manage my care since coming home.  Obviously this information has also been transferred to the home care service in my region and a follow-up visit from a physiotherapist has already occurred.

Prior to going into hospital I had done my own research and, from a lay perspective understood the procedure and the risks involved.  It was gratifying to undergo the hospital experience and receive consistent and courteous care.  I assume that all technical aspects were covered but I am in no position to asses these aspects of my experience.  From a patient perspective, it is the non-technical aspects that make all the difference — aspects such as feeling respected, having opportunities to express feelings, and having someone to listen to concerns.  Yes, there were aspects of the hospital that I could criticize — but my heart tells me that my progress and healing will be expedited if I focus on the many positive features of the care I received.

I’m sure many readers have had their own experiences with in-patient care.  Hospitalizations and illnesses are not what most of us think about as we prepare for a postwork lifestyle but life happens.  My hope for each of you is that, if you have needed in-patient care,  you have been blessed with professionalism, expertise and skill that is similar to my recent experience.  I am interested to hear about your experiences and to receive other feedback on this blog post.  Please provide your comments.

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