hospital tips from a migraineur in medicine

Hi folks! I work in medicine (currently hospice chaplain, formerly hospital chaplain & for a bit before that, skilled nursing nursing assistant), which means that when I went into the hospital this year for thorazine and again for DHE, I wrote a guide for my visitors & support people to getting sh*t done for hospital patients. I figure many of you already know this stuff, but others may find it useful. It's written speaking to visitors & support people.

Privacy & finding your loved one: Unless you're a spouse, parent, or child, staff may not be able to give you any information because of privacy laws. If possible find out the room number & floor from someone who's already visited, and if not, asking for someone by specific full name (even better if you know when they came in) is more likely to get results. Check about visitor passes and protocols at hospital front desk. If it is after hours (typically after 6 or 7 PM) you will likely have to enter through the ER, and a security desk will probably be your first contact point.

Getting the right person for help: There is usually a whiteboard posted near the nurse's station (sometimes also in individual rooms) listing what CNAs (certified nursing assistants) and RNs are assigned to which rooms on the current shift. Check here to get a name & when you're asking, specify "looking for Jane for room 123" in case it's changed. ERs often move too fast for this to be practical so you'll just have to ask whoever you can grab for "the nurse for room 123." An assertive and compassionate approach is much more likely to yield best results than confrontation, so take a breath even if you're frustrated or worried. Some floors have a unit clerk who runs administrative business for the floor, and is front and center at the nurse's station. The clerk and the charge nurse (both typically at the station) run the day-to-day operations of the entire floor and know everything about everything. The CNA helps with physical care (including helping patients get up & walk to the bathroom), and the med nurse, well, does meds. On high acuity floors these roles are both RNs.

Pain meds & other needs: If your loved one's call light goes unanswered for 15-20 min, see above about who to talk to to get sh*t done. You can start by letting the unit clerk or charge nurse know what your loved one needs if you don't see the med nurse or CNA you need. It's ok to go physically find someone--politely and also firmly, stating how long it's been since the initial call--every 10-15 min until answered, or even after several attempts, to complete a conversation in which someone at the nurse's station promises a response and then to quietly stand there (hugging the corner of the station so you're not physically preventing anyone from attending urgent business) smiling and innocently assuming that means they'll get up any minute. Will they be annoyed? Yes. Will they help you faster? Also yes.

Nursing shift changes: Some hospitals have rolling shift changes with no more than half or one third of a shift changing at once. Otherwise, shift changes are usually around 7 AM, 3 PM, and 11 PM, and it's typically hard to catch a nurse during these times--they are all busy wrapping up from or preparing for their shift, and conferring about important updates to ensure a safe pass-off. You'll see the staff numbers double and a lot of pair conversations. Acknowledging that it's a busy time and asking who is most available is your best shot for getting help.

A probably unnecessary safety note: no candles or other flame in any hospital room, for any reason. Oxygen is piped directly into each room whether or not the valve is turned on for a given patient. Explosions are not good for anybody's health.

One more practical note for my fellow migraineurs: if you're going in for DHE or thorazine, you will have an IV in your arm for a week. I recommend shawls and arm warmers rather than messing with all-one-piece layers that will be obnoxious to deal with around the IV. I actually made myself a pullover fleece vest (it can be as simple as one long rectangle with a neck hole in the middle) where the front and back were fastened together with buttons up both sides so that I had a fitted layer I could add or remove easily with the IV in.

I hope you won't need this information... and that it will be useful if you do!