keepitsecret

Here is an updated version -- and some thoughts on my recent hospital stay (which was about a week ago) which was recently in question. I'll share how it went with applying your advice and how the nurses were in their care. And I'll also offer some observations from a patient's point of view as to what I found good and bad with the different nurses I had over almost 3 days inpatient. I ended up actually having 2 different surgeries about 2 weeks apart because of an unforeseen tumor discovery during #1. It ended up being benign and harmless but it was a scary couple of weeks until I got the news. In the end, I got my vertical sleeve for weight loss and since May I am down 50lbs. Happy day. Only about 70lbs more to go! Here's how it went: 1. Bringing my typed medical record and medication list made me feel very prepared and on the ball. However, because the hospital called and preregistered me, the nurses didn't even pay attention to those pieces of paper. It was kinda weird. I tried to tell the nurse who preregistered me all the details about my different conditions (including the incontinence), but she seemed pretty rushed to get it done fast so idk. Anyways, seemed like good advice (and still does), but in this circumstance, it felt like it was not used. 2. I really did my very best to be polite. I always said thank you. I always said please. And I tried to stack requests on single call lights. (I.e. rather than calling the nurses station in separate requests 10min apart for: another blanket, help getting up to go to the bathroom, more pain meds, an IV alarm, etc. -- I did my best to wait on the non-urgent things until a more urgent thing came up. I'd then ask for several things in just that visit. Seemed courteous. An observation I had about asking for what I wanted/needed is that it really pays to be direct in that setting. Expressing a wishy-washy attitude about things was a good way to end up not getting what I wanted and to end up feeling disappointed. I perceived that the nurses were far more eager to hear precisely what I had on my mind -- regardless if they were actually able to what I was hoping for. This was a little difficult for me because I tend not to be very direct by temperament; but I pulled it off. 3. Some of you talked about how its important to advocate for your own pain control. After having spent 2 nights in the hospital and essentially 3 full days, I see the wisdom in this. The first day I had a PCA so this is a mute point. But once they transitioned me to liquid oral pain killers, it was a big deal. Some of my nurses were like clockwork; in my room right on the dot of when I was able to take my next dose... I didn't even have to ask. Others however, wouldn't come until a couple hours after that point unless I called them...this was particularly true for night shift nurses. Perhaps they do this so that the patient can sleep more? I'm not sure...but what ended up happening is that I would certainly sleep through the three hours or whatever, and then wake up in real agony -- way past when I should've had my previous dose. And then it would take several hours through the night of not sleeping at all, trying to catch up. It wasn't a good situation. I really would have preferred to be awoken for a moment to make sure I stayed comfortable for the rest of the stretch. 4. Regarding my night time incontinence. Your advice about how 'normal' this problem is was spot on in my experience. None of my nurses batted an eye at the issue. What a relief! I wore my normal briefs that I use at home and although I only had a couple accidents during my stay (I ended up wearing my disposables pretty much day and night since I was totally unconscious sleeping the majority of the time), I felt like the staff respected me for taking responsibility for a condition I knew I had -- and trying to save them from extra work. Interestingly enough, I ended up having a lot of urine retention (like my bladder would build up to 800ml+ and then wouldn't release at all) - and so they had to straight cath me a number of times to release all that pressure (this was actually quite a bit more painful than the actual catheterization process which I wouldn't have expected). Each time, it was pretty unavoidable for the nurse to see me in my incontinence brief and each time they acted like it was no different than underwear anyone wears. That was helpful and stress-relieving. Most of them even passed my condition off to the next nurse during report quite nonchalantly and without drama (report was given right in my room each shift change which seemed novel). 5. As many of you indicated. Although I was polite and had it in my mind to be pleasant, 95% of my attention was on how uncomfortable or sore or whatever I was.... I was in the hospital for a reason. My health was in need of serious care and monitoring. I felt horrible and had major hurdles to get over before I could get out. Worrying about being 'a good patient', while seemingly important far before I actually ended up in the hospital, was far from the front of my mind. My primary concern was getting better. It was feeling better. It was being sure to report details and issues surrounding my condition to the nurses. It was advocating for good care. 6. There was some conversation on the previous thread about balancing dignity/modesty with the need for good nursing care. As a patient now, I really can't imagine doing this while at the same time maintaining modesty. I mean, come on. From the first moments of check in, I was stripped, scrubbed with CHXD washcloths, and put into a backless gown before I knew what had happened to me. I was poked and prodded and rolled and touched. I mean - I guess I respect the impulse some of you have for maintaining privacy - but any patient checking in to stay in the hospital who expects to have privacy needs to work through that expectation… I found my experience overall to be an exercise in being immodest. I accepted this. Had a sense of humor about it. And I think my nurses appreciated the comic relief. 7. And this leads me to my final observation. For the most part, my nurses really seemed to like having me crack gentle jokes as they were doing their work. My positive mood and willingness to be a little light about my situation seemed to put them more at ease, make them more personable to be around, and happy to assist me with what I needed. I understand it's not in everyone's personality to make light of difficult circumstances; but as a patient, doing my best to be an encouragement in this way I think ended up getting me better care. I want to thank you all again for your feedback and support on this. You have been very helpful! Now: here's a couple observations/tips from my point of view as a patient: 1. Not all nurses were equal. Perhaps this is obvious for those who are in the field. But for people who are professionals outside the medical world, it might be easy to assume that pretty much a nurse is a nurse is a nurse. Nope. Some of my nurses were more or less absentee; I had to remind them of things; they'd leave to get a medication or a treatment or something I needed, only to not show back up again for several hours and having forgotten about our whole prior conversation; others were curt, short, and/or didn't explain what and why they were doing as they were doing it. Of course, many many factors go into this dynamic — and I'm sure something as simple as ‘having bad day' or a terrible patient next door, or too heavy of a load, or an ******* doctor — could render a normally great nurse who's on top of everything into a seeming dead beat. Regardless of the cause however, I COULD TELL THE DIFFERENCE. And I'll tell you what. It was 100% EASIER FOR me to trust the nurses who were on the ball than the ones who were hanging on by their shoelaces. And one more thing: In general, the older nurses were by far the best, followed by the youngest, and then followed last by those who were middle aged 40's-50's. 2. I was a little disappointed that none of my nurses (my initial intake nurse or any others) didn't ask me any questions about my concerns, worries, issues with them. They didn't ask me if I have questions. If they could help me with any problems, etc… They simply asked questions they needed answers for in their check sheet and moved on. While I know some of that info I might've shared wouldn't be 100% privy to my recovery, how I feel as a patient still matters…and if a quick answer to a worry or concern could put anxiety to rest, why not take the extra 30 seconds? I'm already on an anti-anxiety and an anti-depressant — which they gave me throughout my stay in the hospital, so at the very least, they could've seen that being stressed out was a likely problem I'd face. I was disappointed to never receive that personal touch. How're you coping with all this?” would've been a really thoughtful question for SOMEONE to ask. Even if it took up 5 extra minutes of time. 3. Some of my nurses were really good about explaining what they were doing, giving timelines for upcoming treatments procedures or scans, forecasting the next steps in my recovery, etc. Others were pitifully sporifice with this information. This information is probably not universally wanted by patients, but I really appreciated the effort those nurses made to make sure I understood what was happening to me. Again, it helped me trust them more and relax in their care — feeling that they knew what they were doing and that I was going to be alright. It's a vulnerable position to be in and if a nurse just assumes that his/her credentials and position earn the trust of patients, they are sorely mistaken. A careful explanation or two could've gone a long long ways. 4. I was confused about the CNAs at the facility I was in. The only thing they did, and I mean the ONLY thing they did – was vital checks every few hours. Literally everything else was done by the RNs… This seemed kind of odd to me because it would seem that the RNs would be a little too busy to have to deal with blankets or delivering fresh water or helping me get out of bed for the bathroom. I mean, what are the CNAs there for other than these kinds of things? From a patient's perspective, I didn't mind having more contact with my RN, but I'd hate to end up having a medication missed or some major sign/symptom that I had developed – because they were too weighed down by banal things someone else without their medical training could've taken care of. Maybe this is nothing, and maybe hospitals are staffed in a lot of different ways. But it just kind of seemed weird to me. 5. Finally – an observation about doctors. My surgeon showed up once per day. Only. It was in the morning. And it was very very brief. That was fine. Other than that, I saw no other physicians from check in to check out. What this highlighted for me is the incredible importance and value this places on the nursing staff. They were the ones taking care of me. They were the eyes and ears. If they didn't see something or catch something, likely no one would. Sure, the doctors would need to interpret that information and give the final order. But I don't think it's too much to say that I really was in their hands. I think this is something missed by a lot of patients (certainly by me before I was in the hospital). It's much easier before having this experience, to assume that nurses' jobs are really about cleanup and food serving, and helping with basic needs. While this is part of it, it was very clear to me that there is so much more. Thanks for what you do!! I'm even more grateful for your service than I was before.

Hello again, Thanks again for your responses (especially about my specific issue). If you have more input, I'd welcome it. You gave me the courage to talk with one of the offices nurses about it this week. He was extremely kind and supportive about it -- I didn't at all get the feeling that he was chuckling at me behind my back or making fun of me. It's a serious issue; but somehow we have taboos about it. So he was super nice. And like many of you said, he told me to not worry about it at all. That I should 'please' bring my nighttime incontinence stuff with me to the hospital and that they'd appreciate me being proactive. He also suggested the printed medical history piece as well. Anyways, I'll give you an update in a few weeks after the procedure to let you know how it went. I'll do my best to put your tips into action. Thanks again.

Greetings everyone. Wow! So many super helpful responses. Your reactions and advice really cast a picture of what it will be like -- and kind of what the priorities are for those in nursing care. The tip about bringing along a written medical history and medication list makes a lot of sense. I wouldn't have thought Of that. I'll also be sure to do my best to communicate well about my enuresis. I'm actually going in for Bariatric surgery. I'm a pretty big human being, 6'1" and 295lb. My bmi is kind of on the low side for this procedure but I feel like it's the best choice for me to get to a healthy weight. I'm not sure if any of you have much experience with it but it seems like I'll be fairly mobile pretty quickly after surgery. I'm kind of a young guy, 34. And it seems like the bed wetting thing isn't common for people my age, so I'm rather sensitive about it. That's why I ask. Anyways, thanks much for engaging me on this stuff, I feel better about it already!

I am not a healthcare professional although I am a professional in another field. I am scheduled to have surgery next month and will be in the hospital for at least two nights following the procedure. Would any of you be willing to provide some tips for being a "good" patient, promoting good rapport with my nurses, and hopefully receiving quality care? One specific concern I have is that I suffer from enuresis at night. How will this be dealt with in the hospital? I don't want to make myself and this issue into a huge inconvenience for the staff. It's embarrassing but it's also the reality. Should I tell them about this problem or just let it happen if it happens? Should I bring my night time incontinence supplies with me? thank you for any advice you can offer.