December 2015

IN THIS ISSUE

What's New at

Guardian Nurses?

Rules Were Made

to be Broken

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What's New at
Guardian Nurses

Presents, Presents, Everywhere!!!

This holiday season, besides their "other jobs," the team at Guardian Nurses reached out to Pathways PA for their Adopt-a-Family Program to adopt a family for Christmas.

The Adopt-a-Family Program provides the opportunity for PathWays PA client families to experience the many joys of the holiday season that they otherwise may not have been able to afford.

Our family was a mother and three daughters who thanks to the generosity of our GN team, will enjoy a present-filled Christmas morning. Including an EZ Bake Oven! Who knew they even still MADE them!!???

Santa Plans to Again Visit the Kindergartners

One of the most fun (and meaningful) days of our year is the Wednesday before Christmas. This year it's December 23rd.

That's the day that we get to "play Santa" to the 5 or 6 kindergarten classes at the Frances E. Willard School in the Port Richmond section of Philadelphia. Although we sponsor the gifts, we have help from the "elves" from Mastbaum High School.

Stay tuned for new photos from THIS year's Santa Day.

Rules were made to be broken. That's what my mom used to say. Well, at least that's what I think my mom used to say. It's not that I disregarded rules growing up. Quite the contrary. Through my childhood, I was taught by the Sisters of Saint Joseph, an order known for their 'no-nonsense' classroom management. At a certain point, however, I began to question some of their rules and that, my friends, was the beginning of my asking, "Why?"

Recently, a patient's husband questioned me about the knowledge of one of my nurse advocates. He asked, "The nurse manager told me it takes 48 hours to organize a meeting. Why didn't your nurse know that?" to which I responded, "Because it doesn't." And that got me thinking about the things that patients and their families may be told by hospital personnel to explain why things are the way they are, to maintain the status quo or maybe to simply avoid conflict.

Though the holiday season is in full swing, healthcare issues continue. This issue of The Flame presents a few "rules" that are often presented when someone is hospitalized, and gives suggestions for getting what you need.

Happy Holidays!

Betty
Betty Long, RN, MHA

President/CEO

Guardian Nurses Healthcare Advocates

"Rules" Were Made to be Broken

Each industry has its own unique set of workplace operating procedures, rules and norms. Manufacturing is different from service while technology is different from say, government.

Hospitals, like any other workplace, require rules. There are job descriptions that provide roles for employees, policies and procedures that exist to enhance patient safety, regulations that guide compliance with existing safety laws and, of course, employees who carry out all of those responsibilities.

But during the day to day operations of a hospital, patients and families may bump up against 'rules' that really may not be rules, but perhaps responses that have been crafted over time.

1. "I'm sorry, visiting hours are over."

Remember the days when visiting hours began at 11AM and ended at 8PM? Most facilities still have published visiting hours and policies regarding how many visitors can go into a room.

These may differ based on which unit you want to visit, like critical care, for instance, but the flexibility does exist for families to ask for exceptions depending on their own circumstances. More facilities are amending their visiting policies to be more inclusive believing it to be more patient friendly so it may not be as challenging as you think to visit your loved one during 'off-hours.' Honestly, most patients spend so little time in the hospital that it's usually easier to visit once they get home, but for a long hospital stay, check in with the nurse manager on the unit to understand what the established visiting policies are. If you anticipate a need for some flexibility, talk with her early on and explain. Make sure that any decisions are communicated in writing to the appropriate resources---security, the nursing office, and a copy for your family.

2. "The doctor is not able to speak with you."
Depending on the facility, there is typically a hierarchy in place for physician coverage. In an academic, tertiary care center, the attending physician is the top of the food chain while the intern, resident, nurse practitioner or physician's assistant will likely be the most visible provider on the unit. What you may see in smaller, community hospitals are hospitalists, doctors who work shift-work and oversee the care of patients and who may be unknown to the family. These physicians often are assigned weekly so it can be troubling to families because it's a new face and a new 'style' every week. Regardless of when it is, however, you are entitled to know which physician is making the decisions on treatment, how long the coverage period is (a week, a day, a weekend) and how you can reach the physician when you want to talk with him or her.

3. "I'm sorry, the nurse manager went home."
In any hospital, during the evening or night shifts, there is a nursing supervisor who is working as the administrator in charge of the facility. Not only may they be responsible for staffing, but they should be making sure things are running smoothly. Should you not be getting the help or support you need from the clinical staff (or anyone else for that matter), you should ask to speak with the nursing supervisor. Call the hospital operator and ask to speak with the nursing supervisor. She may be out 'making rounds' but she should be able to be paged or called on a cell.

4. "We can't change your room."

From time to time, there may be the need to separate patients who may not be 'getting along.' If you're lucky enough to be in a facility that only has private rooms, this won't be an issue. But, if you've just had surgery and want to sleep but your roommate wants to watch television all night, you're in for a long, not very restful night. You can request that your room be changed. Tell your nurse and ask her to notify the nursing supervisor. It may have to wait until an appropriate bed opens up (after patients are discharged in the morning), but you can request a room transfer.

5. "We can't give you that information."
This can be a terribly frustrating response for family members who call in to the facility to find out how their loved one is doing. With HIPAA well known by now to most healthcare consumers, we fully understand the need to maintain confidentiality. However, short of having a signed HIPAA consent on the chart identifying for the staff who is allowed to receive clinical information, some facilities are offering families the use of a 'password.' Anyone inquiring on a patient's status needs to know the password, usually established and protected by the family, and known by the staff. Once the caller shares the password with the staff, patient updates should be shared.

As with most conflicts we face, good communication is the best method for a successful resolution. Know that you and your hospitalized loved one are entitled to knowing what's going on, and that talking with your care providers, both physicians and nurses, can be a good first step to getting what you need. Many facilities understand that better "customer service" makes sense all around but just in case, remember that it's all about the patient!

Guardian Nurses Healthcare Advocates
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