HEALTH MATTERS: What to expect when you are hospitalized

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By Dr. Kathryn Robison
   When you or someone you love is hospitalized, it can understandably cause you to worry. But learning about what to expect and who the people are that work there can help put your mind at ease.
   The following questions and answers are a good start to understanding your hospital stay. Knowing what questions to ask also can help you can be more informed and involved in your own care.
   What is a hospitalist? In the past, when patients were admitted to the hospital, their primary care doctors would travel to the hospital to check up on them. However, more recently, hospitals have begun using the services of hospitalists.
   ”Hospitalist” is the term used for doctors who are specialized in the care of patients in the hospital. Most hospitalists are board certified internists who have undergone the same training as other internal medicine doctors, including medical school, residency training and board certification examination.
   A hospitalist manages a patient’s care from admission to discharge. Their role is to ensure patients receive high-quality coordinated care including consultations with specialists or primary care physicians.
   Hospitalists keep the patient’s primary care physician, specialists, nurses, social workers, case managers, and other healthcare professionals informed of what happens in the hospital so that they are ready to resume the patient’s care when they leave the hospital.
   Who else is involved in my care? In addition to the hospitalist, many other people might take care of you depending on your condition.
   • Specialists like a cardiologist, pulmonologist or surgeon may be consulted for specialized care.
   • Nurses and nurse’s assistants have a variety of jobs. For example, registered nurses can administer medicines. Nurse’s assistants can take your blood pressure, help you to the bathroom and assist with personal care.
   • Technicians take blood and perform tests such as X-rays.
   • Physical therapists show you how to strengthen muscle and other tissues, increase flexibility and improve coordination.
   • Occupational therapists work with you to restore, maintain or improve your ability to perform everyday tasks like bathing and dressing.
   • Dietitians plan meals and can teach you how to have well-balanced meals at home.
   • Clinical pharmacists may be consulted about the medications you take.
   • Social workers typically help arrange homecare, rehabilitation, social services, long-term care and support groups, and help families cope with the emotional impact of a hospital stay.
   • Homecare planners generally coordinate services you will need after discharge, such as oxygen delivery, nurse visits, and home physical therapy.
   • Case managers are in touch with your insurance company to determine coverages and costs.
   • In a teaching hospital like University Medical Center of Princeton, medical students, interns and residents may accompany the hospitalist or other doctors on patient rounds.
   What if I have more than one health problem? Often patients in the hospital have more than one health problem, referred to as comorbidities in medical terms. In these instances, the goal of care is to treat the primary diagnosis that led to the hospitalization, while ensuring the other conditions are stable. It is the role of the hospitalist to coordinate the care.
   What are advance directives? An advance directive says what medical treatment you want if you can’t speak for yourself. It also lets you name who you want to make your medical decisions if you are not able to make your own decisions. In addition, if you want to give your family members access to your health and treatment information, you must first give your doctor written permission. Doctors typically request one point-of-contact — a spouse, a child, a sibling — who can disseminate information to other family and loved ones.
   When do hospitalists typically make rounds? While there is a hospitalist on duty at University Medical Center of Princeton 24/7, a patient’s main hospitalist may see the patient between 8 a.m. and 5 p.m., though they typically make rounds in the morning. With on-site availability and lack of typical office time constraints, hospitalists are available to answer questions, discuss test results and engage in family discussions, as the case requires.
   What questions should I ask? The National Institute on Aging offers this useful list of questions to ask your doctor or nurse during your hospital stay:
   • What will this test tell me? Why is it needed, and when will I know the results?
   • What treatment is needed, and how long will it last?
   • What are the benefits and risks of treatment?
   • When can I go home?
   • When I go home, will I have to change my regular activities or my diet?
   • How often will I need checkups?
   • Is any other follow-up needed?
   • Who should I call if I have other questions?
   Keep a pen and paper handy to write down the answers and any other questions you may have.
   To learn more about what to expect when you are hospitalized, join me for a live web-chat hosted by Princeton HealthCare System from 7 p.m. to 7:30 p.m. on Thursday, Jan. 21. I will discuss how you can be become more informed and involved in your own care, what questions you should ask your doctors and the hospitalist’s role in your treatment.
   To participate, go to the USTREAM Channel at www.ustream.tv/channel/princetonhealth on your computer, tablet or smartphone on the day of the seminar.
   If you’d like to ask a question during the web-chat you can log in using your Facebook or USTREAM account or you can create a new account. Alternatively, you can also submit questions in advance by sending them to PrincetonHealth@gmail.com.
   All those who e-mail a question in advance will be entered in a drawing to win one of three $25 gift cards. Winners will be notified via email and the gift card will be mailed via FedEx.
   To find a physician with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Kathryn J. Robison, M.D., is board certified in internal medicine and a member of the medical staff at University Medical Center of Princeton.

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