Pick a teaching hospital
For complex surgical procedures, you’re generally better off at teaching hospitals, which usually stay at the forefront of health research. Medical students and residents ask questions, providing more eyes and ears to pay attention and prevent errors. Teaching hospitals have lower complication rates and better outcomes. —Evan Levine, MD, a cardiologist and the author of What Your Doctor Can’t (or Won’t) Tell You
Shop around for rehab
If you’re being released for rehab, shop around for a place that has experience with your particular condition. We found that rehab facilities that handle more than two dozen hip fractures a year were more than twice as likely to successfully discharge seniors within a month as less experienced facilities were. —Pedro Gozalo, a public health researcher at Brown University in Providence, Rhode Island
Superbugs that can negatively affect your health live everywhere, and they can travel. Even if your doctor washed his hands, that sparkling white coat brushing against your bed can easily transfer a dangerous germ from someone else’s room. Ask for bleach and alcohol wipes to clean bed rails, remotes, doorknobs, phones, call buttons, and toilet flush levers. Wash your hands before you eat. —Karen Curtiss, author of Safe & Sound in the Hospital: Must-Have Checklists and Tools for Your Loved One’s Care
Join the conversation
Ask your nurses to do a “bedside shift change.” This is when they share information in your presence instead of at the nurses’ station. You can better correct any errors. [Studies show it also improves communication and care.] —Karen Curtiss
Here are 13 Things Your Nurses Won’t Tell You!
Don’t be a distraction
Don’t interrupt the nurse when he’s preparing your medications. One study found that the more times you distract him, the greater the likelihood of error. Each interruption was linked to a 12 per cent increase in errors. —Sally Rafie, a hospital pharmacist with the UC San Diego Health System
Ask what your doctor will be doing
The surgeon who performed the best in our complication rate analysis said he and his partner drape their patients, do the whole operation, and close the incision themselves. He said, “I just know nobody is going to do it as carefully as I’m going to.” Ask your doctor if she will be doing your entire procedure and whether she will do your follow-up care. —Marshall Allen, a reporter who covers patient safety for ProPublica, a nonprofit news outlet
Nurses are overwhelmed
Hospitals often force nurses to handle more patients than they should—even though studies show if your nurse is responsible for fewer patients, they have better outcomes. Researcher Linda Aiken at the University of Pennsylvania found that each extra patient a nurse has above an established nurse-patient ratio made it 7 per cent more likely that one of those patients would die. —Deborah Burger, RN, copresident of National Nurses United
Hospitals side with doctors
The hospital is incentivized to keep doctors happy. Surgeons bring in patients, who bring in dollars. If a patient has a complaint about a doctor or if a doctor has a high complication rate, the hospital’s financial incentive is to protect the doctor. —Marshall Allen
Have kids? You’ll want to read 13 Things Your Child’s Pediatrician Won’t Tell You.
Fifteen to 30 per cent of everything we do—tests, medications, and procedures—is unnecessary, our research has shown. It’s partly because of patient demand; it’s partly to prevent malpractice. When your doctor orders a test, ask why, what he expects to learn, and how your care will change if you don’t have it. —Marty Makary, MD
Check out our roundup of Diagnostic Procedures That Can Do More Harm than Good!
We’re not prepped for Ebola
Hospitals say, “Don’t worry. We’re prepared for a serious disease like Ebola.” But nurses on the front lines treating these patients are scratching their heads and thinking, We are not prepared at all. We are fighting to get the right equipment and training to take on these infectious diseases. —Karen Higgins, RN, copresident of Nurses United
Worried about getting sick? Learn how to better fight everyday germs.
Hospitals are getting violent
There is more violence than ever before. Nurses have been attacked, bitten, spit on, and choked. It’s partly because our mental health system is broken, so [people who suffer from addiction and mental illness] are coming into the hospital and acting out. —John M. White, a hospital security consultant
We’ve seen it ALL
We see crazy things. I had a patient run buck naked into the ER waiting room. A patient asked me out while I was holding a basin, catching his vomit. We pull bugs out of people’s ears regularly. —An ER nurse in Dallas, Texas
Check out these 12 Mysterious (and Terrifying) Symptoms—Diagnosed!
We bet on (or against) you
Hospital staffers have placed bets on patients. Guess the Blood Alcohol is a common game, where money (or drinks) changes hands. Others try to guess the injuries of a patient arriving via ambulance. Surgeons have been observed placing bets on outcomes of risky procedures. —Alexandra Robbins, author of The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital
Making bets isn’t the only faux pas doctors make. Here are 6 Shocking Mistakes your Doctor May be Making.
VIP patients can affect your care
In many hospitals, VIP patients get special treatment. They may stay in special areas or have a VIP notation on their chart, which means that whenever their bell goes off, we are expected to make that patient’s request a priority, whether it’s “I need some water” or “Can you get me some stamps?” Hospitals don’t add more nurses; they just take away from the care everybody else gets. —Deborah Burger, RN
Do you know that hospital staff have their own language? Here’s How to Decode the Outrageous Lingo That Doctors and Nurses Use Behind Your Back.
Surgeons multitask major operations
Your surgeon may be doing someone else’s surgery at the same time as yours. We’re talking about complex, long, highly skilled operations that are scheduled completely concurrently, so your surgeon is not present for half of yours or more. Many of us have been concerned about this for decades. Ask about it beforehand. —Marty Makary, MD
Scheduled for an operation? These are the 6 Best Vitamins and Supplements to Take After Surgery.
Electronic paperwork annoys us
Most of us hate electronic medical records systems. We don’t like that we have to click off boxes instead of focusing on the patient. The choices they give us to click on don’t give the doctors a real understanding of what we’re doing. A lot of things get missed. —Karen Higgins, RN
Be detailed about your meds
Bring a clear, printed list of exactly what medications you take at home and when you take them. Don’t just say “daily”: We need to know if you take them at night with dinner or when you wake up. —Kevin B. Jones, MD, a surgeon and the author of What Doctors Cannot Tell You: Clarity, Confidence, and Uncertainty in Medicine
Check out these 6 Tips for Taking Medication Safely!
Admitted? Log everything
Keep a notebook. Write down your questions, log who’s coming into your room, and track conversations with different doctors. It’s easy to get confused and disoriented in the hospital. —Deborah Burger, RN
It’s not always easy to be your own advocate. Check out these tips on How to Get What You Want (Without Being a Jerk).
Bring your own toiletries
Hospital toiletries are awful. The lotion is watery. The bars of soap are so harsh that they dry out your skin. There is no hair conditioner. The toilet paper is not the softest. Come with your own. —Michele Curtis, MD
A pillow is nice, too
Want to be comfortable? Bring your own pillows. We never have enough of them. —A nurse at a North Carolina hospital
Frustrated by Canada’s doctor shortage? Read Why Is Canada Shutting Out Doctors? for an interesting take on the situation.
We can monitor you from a distance
Hospitals try to lower the number of patients readmitted through remote patient monitoring. They may have you wear a monitor that tracks your vitals and alerts your team if they go out of range. They may ask you to download an app that reminds you to take your pill. If you don’t mark that you’ve taken it after a few reminders, a nurse calls. —Bill Balderaz
Stay with your loved ones
Don’t let loved ones spend the night alone in a hospital. It’s important someone is there if they get confused or need help getting to the bathroom or if their breathing pattern changes. If the hospital has restrictive visiting hours (many are eliminating them), ask if it will make an exception. —Michele Curtis, MD
Supporting a loved one who becomes ill is never easy. Here’s What to Say When Someone is Sick.
Hospital food could make you sick
Don’t assume the hospital food provided is what you should be eating. There’s no communication between dietary and pharmacy, and that can be a problem when you’re on certain meds. I’ve had patients on drugs for hypertension or heart failure (which raises potassium levels), and the hospital is delivering (potassium-rich) bananas and orange juice. Then their potassium goes sky high, and I have to stop the meds. Ask your doctor whether there are foods you should avoid. —Evan Levine, MD
Request a furry pal
If you love animals and miss yours, inquire if the hospital has a program for service pets to come and visit. —Michele Curtis, MD
Schedule surgery early in the week
On weekends and holidays, hospitals typically have lighter staffing and less experienced doctors and nurses. Some lab tests and other diagnostic services may be unavailable. If you’re having a major elective surgery, try to schedule it for early in the week so you won’t be in the hospital over the weekend. —Roy Benaroch, MD, a pediatrician and the author of A Guide to Getting the Best Healthcare for Your Child
Extra reading: Is Your Doctor Out of Date?
Go ahead, hydrate before surgery
Many hospitals say no drinking or eating after midnight the day before your surgery because it’s more convenient for them. But that means patients may show up dehydrated, uncomfortable and starving, especially for afternoon surgery. The latest American Society of Anesthesiologists guidelines are more nuanced: no fried or fatty foods for eight hours before your surgery and no food at all for six hours. Clear liquids, including water, fruit juices without pulp, soda, Gatorade, and black coffee, may be consumed up to two hours beforehand. —Cynthia Wong, MD, an anesthesiologist at University of Iowa Healthcare
Too much rest could impede recovery
Get up and move. Walk the halls, walk to the cafeteria, go outside. It will help you avoid blood clots, and patients see psychological benefits. One study found that older patients who get out of bed and walk around reduce their stay by an average of 40 hours. —Roy Benaroch, MD
Here are 9 Tips to Help You Get Walking!
Take notes, especially at discharge
One study found that patients forget 40 per cent to 80 per cent of what doctors and nurses tell them, even if they’re nodding their heads. Have someone with you to take notes or tape-record what the doctor says on a smartphone. (Ask, “Do you mind if I tape-record this?”) The most critical time to record is at discharge, when you receive crucial information about medications and next steps. —Karen Curtiss
Get your papers right away
Get copies of your labs, tests, and scans before you leave the hospital, along with your discharge summary and operative report if you had surgery. It can be shockingly difficult for me to get copies of those things. Even though I have a computer and the hospital has a computer, our computers don’t talk to each other. —Roy Benaroch, MD
Once you have your medical tests and scans and such, but should you hang onto them forever? Read How Long Should I Keep Documents?
Request a full night’s sleep
If you’re feeling good and you are stable, ask your doctor whether you can sleep undisturbed between midnight and 6 a.m. I can write a note directing the nurses not to wake you up to check your vital signs. —Michele Curtis, MD
Schedule your follow-up before you leave
Before you leave the hospital, demand that your follow-up appointment is already scheduled. I’ve found that is the single most effective strategy hospitals can use to reduce your chance of readmission, but it still rarely happens. Make sure you’ve been connected to the next person who will take care of you. —Elizabeth Bradley, PhD, a professor of public health at Yale University
Consult our handy checklist of Must-Schedule Appointments for Women.
Try to be patient in the ER
Emergency rooms used to have just curtains between the patients, so they could hear the chaos. As a result, I think they were a lot more understanding about delays. Now most hospitals have individual ER rooms that are very isolated. When patients get upset that it took me 20 minutes to come back to their room, I often wish I could tell them that I wasn’t sitting out there doing nothing. I was comforting someone who just lost a family member. —An ER nurse in Texas
We never forget devastating moments
My worst moment ever was on New Year’s Eve in 2008, when the code-blue pager went off. A baby we had operated on had stopped breathing. Ten of us were frantically doing everything possible, but we couldn’t resuscitate her. I had to tell her parents that their firstborn daughter had died. I was up all night grieving with them. Every New Year’s Eve, I think about them. —James Pinckney, MD
Doctors deal with patients dying every day but what happens when they face illness themselves? Read this powerful piece about how some doctors face their own mortality.
Originally published as 50 Secrets Hospitals Don’t Want to Tell You (But Every Patient Should Know) on ReadersDigest.com.