10 of Commandments of Hospital Care

I’ve spent a lot of time in hospitals, as a family member, nurse, executive and consultant and have learned a few things in my time. Some of the things that are important don’t always ‘rank’ high enough on anyone’s radar to write about them, but they are practical and helpful to know.

It is in this spirit that I’ve put together my list of “Do’s and Don’ts” or, '10 Commandments of Hospital Care.'

And this is certainly not comprehensive, so please add comments so all of us can help make hospital care more safe, humane and high quality.

1. Always Wash your hands any time you touch anything in the hospital: Most germs that cause serious infections in healthcare are spread by people’s actions and hand washing can prevent many of these infections from occurring. And, on average healthcare providers wash their hands only 50% of the time (according to the CDC) and of course, no one measures if patients, family members or visitors ever wash their hands. So, do everyone a favor and wash your hands, or use hand sanitizer after you touch, well anything in the hospital, including hand rails, food trays, door knobs, etc.
2. Never lean on a wheelchair (they roll): I bet you haven’t thought much about this but I’ve seen visitors in hospitals lean on wheelchairs more than once, only to lose their balance when the wheelchair ‘gives way.’ This is caused by the wheelchair tires not being locked into place. And it’s estimated that upwards of 100,000 wheelchair-related accidents occur every year due to slips, falls, and the like!
3. Always write down all medications you are taking because the nurses will ask you for this information: Besides it being a requirement of hospitals and doctor’s offices to ask you for this information, it’s important for you, your doctors and nurses to know what your taking. This is important to ensure no new medications are prescribed that could interfere with your current medications. Also, it’s good to re-check that your current medications are still the right ones for you, given your change in health.
4. Always visit friends and family in the hospital: Hospitals are lonely places even if the nurses (and the doctors, lab techs, care assistants…) are friendly. There’s a lot of ‘open hours’ to the day in the hospital and a patient’s mind can start to wander and worry. Having friends and family around helps with the boredom and anxiety that comes with spending time in the hospital!
5. Never wear high heels or open toes while visiting the hospital: For healthcare workers, slips and falls account for the second most common cause of workplace injuries! There are lots of wet spots, spilled fluids, floor mopping, and equipment in the halls and rooms, which creates many opportunities to trip and fall! And when you are not wearing closed toed, well-fitting shoes, this problem is amplified. Remember, hospitals (and doctor’s offices) are where you find needles and other ‘pokey’ items that can fall onto exposed feet—no good!
6. Always look away when the nurse or phlebotomist is drawing blood drawn or when you are getting a shot: And speaking of needles, my advice to everyone (except the professional drawing the blood sample) is to look away! This is true when getting shots too. No reason to look—just let the professional get their sample while you are watching TV or staring out a window. This technique will help you stay calm while keeping your blood pressure low!
7. Never eat the hospital food because it’s almost always bad and unhealthy: For some reason that no one can explain—besides cost and inertia—hospital food is almost always unhealthy. Perhaps its because those who are in charge of ordering the food think about it in the same way they order medical supplies and hospital gowns, but hospital food is just mediocre at best. Do yourself and your hospitalized loved one a favor and bring in food. Just like we do when planning a long airline flight—bring your own food!
8. Assume your doctor does not remember everything about you or your loved one but always assume they’re doing their best: Hospitalists (doctors who are responsible for patients in the hospital) are responsible for upwards of 25 patients a day. That’s a lot of patients, and so there is no way they will know everything they should about you or your loved one. And even your beloved primary care doctor or specialists are managing a lot of patients. Sometimes they have a ‘panel’ of upwards of 2,500 patients! So, be prepared to ask questions and point out the gaps as you see them occur.
9. Always insist on understanding everything being said to you or your loved one: And speaking of this, when going into the hospital or visiting your physician, make sure to bring notes and to be explicit about your medical history, your medications, your past hospitalizations, your symptoms. And make sure you raise concerns as they come up and that you understand absolutely everything regarding the diagnosis, treatment and care plan. The truth of the matter is—you know more about you than the doctors and nurses know!
10. Know that the job of hospitals (and doctor’s offices) is to ‘diagnose and treat’; and that ‘healing’ takes place at home and in the community: Think healing happens in the hospital? Think again. Most of the actual improvement in your medical condition happens because of the daily actions you take once you leave the hospital or doctor’s office. Most of our lives are not spent in the hospital or in doctor’s offices so don’t expect them to ‘heal’ you….Doctors, nurses, care providers are there to set you on the right path, provide the correct diagnosis, give you the right medications, perform the correct procedures and surgeries and that’s it! (It’s plenty, by the way.) But it’s not healing. Healing is what happens when you are at home, surrounded by the people, pets and community you love. And surrounded by the food you enjoy eating and the rituals that bring you spiritual or community support.

I hope the above 10 Commandments helps you and your loved ones navigate the complex and sometimes idiosyncratic health care maze. 

Bottom line: you’ll be happier (and safer) for knowing what health care providers institutions do well and what they don’t do well!

About the author: Julie Kliger is recognized by LinkedIn as a "Top Voice" in Health Care in 2015 & 2106, & 2107. She is a Healthcare ‘Strategic Realist’ who is passionate about improving health care and improving lives. She specializes in future-oriented healthcare redesign, optimizing existing operations, implementing new care models and strategic change management. She is an advisor, clinician, health system board member, speaker and author. 

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