Can Hospitals Make You Sick?

It's tough to care for friends.  My friend Jennifer had delivered her third baby.  My patient was baby Julia, who had a rough start, needing oxygen for the first days of life.  Jennifer was exhausted from labor, delivery, and worry.  But the fourth day I had good news: "Julia can go home today!," I said. Jennifer burst into tears.  Puzzled and a little freaked out, I asked  "What's wrong, Jennifer, what did I say?" "How come Julia can't come home?" she sobbed.  I then understood that Jennifer had simply mis-heard me. "Sorry if I wasn't clear, but Julia CAN go home," I explained, and Jennifer recovered.  Whew! Parents and children often feel vulnerable in hospitals.  A recent article in the BBC News Magazine discussed how hospitals sometimes make you sicker, instead of being places of recovery.  The article stated that of patients in the US admitted to hospitals, 20% have to be re-admitted within a month.  For some reason those patients weren't healed in the first try. Hospitalization can be stressful, rather than purely healing.  The most obvious stressor is that your child is sick enough to be admitted in the first place.  You're worried, your kid's scared, and she's tired and hurting. Hospitals also cause sleep deprivation, just when you need your sleep the most! Patients are awakened all night for vital signs and medications.  When the patient tries to nap in daytime, interruptions continue: morning blood draws, doctors' rounds, staff and families chattering away in halls, food carts rumbling back and forth.  It's hard to get even three to four hours of uninterrupted sleep. There's also pain, which of course kids hate- needles for blood draws, IVs, and procedures.  Finally, the food: it's hard to serve hundreds of meals on several floors, hot and delicious, and few hospitals have mastered this. Then they take away your food if you have a procedure- must have an empty stomach for anesthesia! So how can you make your child's hospital stay safer and more restful?  First, hospitals have been doing their part.  Since a 1990 government report on hospital-acquired infections, Lafayette General and others are policing doctors, nurses,and techs on hand washing.  Hand sanitizer stations are now all over.  Programs to reduce IV and other catheter infections have made infection rates plummet. Surgeries have new rules for safety.  The news used to carry stories of surgeons amputating the wrong leg.  Comedian Dana Carvey (who played Garth in the Wayne's World movies) was also in the news after his heart surgery. In 1997 he had bypass surgery for a blocked heart vessel.  Unfortunately, after cracking his chest, the surgeon bypassed the wrong vessel.  So Carvey had to undergo a second open heart surgery. Hospitals now have protocols to ensure that we operate on the right patient, on the right part, at the right time. There's lots you can do to make your child's hospitalization safer too.  First is to have a patient advocate.  For kids, this is usually the parent.  However, some parents are overwhelmed by their children's illness and care- tests, medications, therapies, when can we go home, when will my child get better?  Then parents need their own advocate to help sort it all out. The most important thing an advocate can do is remind staff to wash their hands. And their stethoscopes.  Second is to make sure everyone introduces themselves, and keep straight all the players.  Who is the nurse, the doctor in charge, the specialist?  Third, be sure the right therapy is happening to the patient.  What's this medication you're giving, what's it for?  Why this test or procedure, how necessary is it?  Lastly, an advocate can prevent sleep interruptions, like making a sign for the door requesting minimal wake-ups. And the sign should say "please keep quiet in the hall!" Hospital care is complicated, and not without risk.  Hospitals like Lafayette General are doing their part.  But patients and parents need to do their part too, like Dr. Kate Granger. Though Dr. Granger was a doctor, when she became a cancer patient she was treated impersonally, until she started a twitter campaign to get doctors to simply introduce themselves.  You shouldn't have to go that far, but making a sign for your child's door is a great start.