Dos and Don’ts At Hospitals During COVID-19

After my recent family emergency, I felt it was important to say some things about how hospital etiquette has changed during COVID-19. So, I decided to do a post about dos and don’ts for hospital patients and family members during this pandemic. I will also say some more things that I didn’t say in my previous post. Again, I will be talking about medical issues that people may find disturbing.

Additionally, if you want to share my post with credit, please do! It’s important information. Please note, my post is kind of location-centric though.

Dos:

Be Familiar with the Current Hospital Situation:

I can’t emphasize this enough. When we were in the Bay Area between March and October last year, we knew that some of the hospitals had COVID-19 under control and some didn’t. We kept an eye on whether or not that changed.

When we moved to Calgary, we learned that right before the pandemic, our newly elected Premier was starting to cut public health spending. Obviously, Alberta Health Services (AHS) knew that our Premier was hoping the pandemic would be the death of public healthcare. So, they clearly had to gird their loins! This scene from the Devil Wears Prada sums the situation up perfectly. Think of Anne Hathaway’s character as the provincial doctor who does whatever our Premier says.

Jason Kenney gets elected, then the Pandemic hits

At the end of September, when the hospital situation was dire, Mum and I promised each other we wouldn’t do anything stupid that would have us end up in the ER. Of course, my Mum’s emergency was different. You have no control over when your appendix decides to quit on you. Fortunately, it happened when things were starting to calm down just a little bit. That didn’t mean the defunding of healthcare stopped though.

Within this past week, it’s been found during this fourth wave that 15,000 elective surgeries have been cancelled in Alberta. There is no timeline for resuming the surgeries. The province only allows surgeries that must be done within a 3 day period (aka emergency surgeries). Even though I was super happy that this situation didn’t affect my Mum’s care, my heart goes out to those 15,000 people needing surgery in Alberta.

Talk to A Trusted Healthcare Provider:

If you want to make sure you need to go to the ER or need to take someone to the ER, talk to a healthcare provider that you trust. Get a recommendation from them on a hospital that has their COVID-19 situation under control. I said in my previous post that under normal circumstances if my Mum said she had abdominal pain, I wouldn’t have consulted the nurse at our family practice. I was glad I did talk to the nurse though because she told me that all the hospitals in Calgary have a super strict triage protocol. She had been to the ER right when the pandemic started and she assured me the hospitals aren’t letting COVID-19 run amok in their wards. All I had heard was how the hospitals have been stretched to breaking point. I hadn’t heard much about which ones had it under control.

A week later, when my Mum wasn’t getting better, she had further questions. We called our practice nurse again and our doctor called us back. There are 24-hour health lines in Alberta that you can call and speak to a nurse, but you might have to wait a while. The lines are busier because of people calling in with COVID-19 symptoms. We did call one of those health lines when we had a question about what was going on, but we did it too soon. Plus, sometimes there is a certain inaccuracy calling a nurse that doesn’t know your case. That’s why we prefer to speak to the nurse at our family practice. She and our doctor were very helpful and told us to call if we have any further questions or updates. I could tell when we visited the office for Mum’s follow-up that they were sincere.

Find out about Hospital COVID-19 Policy:

Some things you find out as you go. For instance, I couldn’t be with my Mum when she was in the ER, or right before she had surgery. Mum noticed in the ER, they automatically separated COVID-19 patients from regular patients. Our hospital kept the COVID-19 patients in an entirely separate building. Mum said the only reminder that there were COVID-19 patients was that sometimes the PA system would call nurses to the COVID-19 building. I’m glad the hospital did its best to limit the reminders of the pandemic. No patient or their families want to be constantly bombarded with that.

The second time my Mum was in the hospital, she was allowed two visitors, maximum, and they had to be on a pre-approved list. I was only allowed to see her for an hour a day. I never enquired about this, but I noticed none of the patients had flowers. That might have been banned because of COVID-19. I did something better for my Mum though. I brought her some essential oils and rubbed them on her before my time was up.

Find out about Hospital Practices during COVID-19:

I’m pretty sure that hospitals are improvising when it comes to regular patients needing intensive care. After my Mum had emergency hernia surgery, two nurses worked all night to keep her stable, but she was on the ward. She was not moved to an ICU. No one explicitly said that she required intensive care, but I pieced it together. After all, no one just has emergency surgery for the fun of it, and you don’t just end up on 100% oxygen all night. The ICUs really are all occupied with COVID-19 patients, but there was nothing to worry about. They did some good improvisations in that regard.

There was another thing the hospital did that was different because of COVID-19. If patients exhibit any symptoms that are the same as COVID-19, they are put in isolation. Further COVID-19 symptoms mean being moved to the COVID-19 ward. A common symptom of appendicitis is vomiting. Unfortunately, COVID-19 has the same symptom. Mum was in isolation until her diagnosis of appendicitis was confirmed. She said that someone said to her, “We know why you threw up, but we’re making sure it’s not COVID-19.” Strangely enough, when she went back to the ER because of the complication, they didn’t put her in isolation, even though she had thrown up a few times. I guess they knew for sure that she was exhibiting classic signs of a blockage in her bowel.

Wear A Mask:

This is the point where I am going to whip a few dead horses and this is one of them. If you are a family member visiting the hospital PLEASE KEEP YOUR MASK ON! If you happen to be a patient if you can keep your mask on, do so! The first time my Mum was in the hospital, she kept her mask on all the time, except when she was in surgery and post-op. The second time she was in the hospital, she couldn’t wear a mask because she needed a nasogastric tube. I was a little worried, but then I saw that the nurses on the ward were careful, and some of the patients were able to wear masks, so that was okay.

One thing I hope to see after the pandemic ends is visitors continuing to wear masks while in the hospital. I was in the hospital before the pandemic, and as happy as I was for visitors, I did feel a little concerned about germs. I think it’s a sign of respect to wear a mask in a hospital, even if there isn’t a pandemic. My hope is that it continues, even when the pandemic ends.

Show A Little Respect:

I can’t believe I have to whip this horse. Manners cost you nothing! Even when she was feeling her worst, my Mum made a point of being respectful to her healthcare providers, so being sick is not an excuse for being a jerk! Mum could barely talk with the nasogastric tube in, but when the nurses did simple things like their health checks, she always said, “Thank you”. Whenever she felt a little better, she would interact with the nurses and doctors more, and continue to praise them and thank them for being the heroes that they are! She also wasn’t openly obnoxious to other patients. She has always been like that. I followed her lead when I was hospitalized too. People don’t call me my mother’s daughter for nothing!

Additionally, the nurses were happy to answer whatever questions I had about Mum’s care. They and the surgical team were supremely grateful when I brought some quality goodies to thank them. I know it’s their job to save lives, but a little appreciation makes their day!

Mum knows as well as I do that if we have to say that we are US citizens here that people might be suspicious of us (thanks Trump!). She had to reveal her nationality at one point, but she talked about the five countries we have lived in and compared their healthcare systems. That, combined with the respect we all showed to the staff assured them that we aren’t “like that”. Her nationality didn’t affect her care in any way though, for which I am very thankful. I am aware not a lot of people are as lucky though. Watch John Oliver’s show on bias in medicine if you don’t believe me.

If You See Something, Say Something:

Yep, whipping another dead horse. This point is especially true these days with Covidiots around, and also applies more if you are visiting a patient. If you’re a patient and too sick to deal with it, this doesn’t apply to you.

If you see people behaving badly, whether it’s yelling, physical violence, or another type of violence, report it! Remember how I said in my previous post how my Dad noticed an empty room on the ward where someone had defaced a patient whiteboard with Covidiot slogans? If my Dad had told me he had seen that while we were at the hospital, I would have asked at the nurse’s station if they knew about it and gone from there. Seriously though, I hope they caught the person!

Hearing stories about healthcare workers experiencing violence from Covidiots made me a little warier about visiting a hospital. Seeing peace officers at the hospital affirmed with me that the Covidiot situation is serious! Mum did tell me a story from the ER that affirmed with me that even though the nurses are kind and caring, they don’t take any crap.

Don’ts:

Shame Anyone Who Needs Emergency Care:

For the people who need emergency care during this pandemic, don’t shame yourself either! It’s not the people who need non-COVID-19 related emergency care that are tying up the hospitals. The Covidiots are the real problem. It’s completely normal to feel guilty for adding to an already stressed healthcare system though. Mum and I initially felt guilty too. This is why we called the nurse at our family practice. I knew I had to take my Mum to the ER for abdominal pain, but it was great to get confirmation and reassurance.

Thousands of people are waiting for non-urgent surgery and procedures. It can potentially cause resentment and concern among those people while non-COVID-19 emergency patients get priority. In this case, mutual empathy is critical. Whenever someone tells me they are waiting, I let them know I am really sorry to hear that and that I hope they don’t end up needing emergency care because of delayed surgery. Thankfully, those people have extended the same courtesy to my family by saying they are happy that my Mum could still get the emergency care she needed. That’s the way to do it! I know empathy probably won’t take away resentment or concern, but I hope it helps a little.

Think Post-Op Instructions are the Gospel:

I have had appendicitis myself and I found Mum’s post-op instructions confusing! We called a 24-hour nursing line because we didn’t know if Mum had to go back to the ER. People’s bodies don’t work according to post-op instructions, and the added pressure to the question, “Do you go back to the ER?” doesn’t help. In this case, it is good to speak to a nurse about any grey areas you find between the instructions and what’s actually happening. Although, we realized later we called the 24-hour line too soon for any definitive answers. We ended up talking to the nurse at our family practice again. Because Mum ended up with a rare complication, it felt more difficult for me to pin down what was happening. I needed help from a medical professional with that.

Hide Information from COVID-19 Screening:

Poor horses, but it has to be done. I was in a bit of a situation though. My Dad arrived from California two days before I brought Mum home from the hospital. I did want to have the option of bringing Dad to the hospital to visit. Plus, I didn’t know if I needed his help collecting Mum when she was released. It worked, so here’s what I did.

I told the ward Dad was flying in from California to help me take care of Mum. They asked me questions about his vaccination status and told me he would have to bring his documents. I also mentioned that he was flying in from the Bay Area and said that in terms of COVID-19, things were pretty good. We kind of had a laugh about, “at least he’s not flying in from Texas or Florida!” Additionally, I assured them that we have lived in a few other countries, so we know to respect the laws of our host country. After all that, they put him on Mum’s visitor list! They also told me to double-check with the screening area at the entrance.

The screening area reiterated what the ward said. The day after my Dad arrived, the COVID-19 screening went smoothly and he was able to see Mum! I think the ward and screening were happy that I checked with them before Dad arrived if it was possible for him to visit. What they don’t like is people acting shady and pulling a fast one on them. Be transparent, and have the necessary documentation. Plus, I could see that they were nervous initially when I said we were US citizens, but they relaxed over the fact I was honest with them.

Be Racist, Sexist, Rude or Immature:

The horses don’t like me now, but this is the last dead one I’m whipping. I promise. Besides, I live in Alberta. I don’t want to get on the wrong side of our ranchers.

We all have biases, but PLEASE don’t act entitled! If you do, you’re not only hurting whoever it’s directed at, but you disturb other patients who are too sick to deal with your crap. Even if other patients don’t call you on your crap, it doesn’t mean you aren’t bothering them. On the other hand, patients may cry out because they’re in pain, or frightened, or something. As long as they aren’t being jerks, don’t shame them for it. I have cried while in the hospital because I wanted to go home, but I didn’t say anything inappropriate.

I will be sharing personal stories on this subject, but I wanted to say this first. A while ago, I learned that it’s normal when you need hospital care, that you’re frightened and your biases surface. Regardless, I didn’t try to hurt anyone and I learned a valuable lesson. The point is to recognize them and don’t lash out because of them. I felt guilty about my biases, but I know now that shame isn’t the point unless I had caused harm.

My Own Personal Stories on This Point:

I wanted to share two different personal stories I have had in the hospital. The first one was when I was in London and had my lower wisdom teeth out. That meant day surgery in the hospital over there.

I was put on the day surgery recovery ward with several other people. There was this woman who was talking too loudly and being generally disruptive. At one point, I was coughing and she called the nurse to help me (even though I didn’t need it). She said, “Sorry, I thought you was going to throw up!” Yes, she said was. Even though I still needed to cough, I held it in. She was also yelling on her cellphone at her deadbeat boyfriend to come and get her. No one called her on her crap, not even the nurses. Later on, I realized no one would put up with that crap in the USA. It speaks a lot about cultural differences.

The next story has to do with realizing my own unconscious bias. I was in the emergency room for a ruptured appendix back when I was in California. I was terrified, had 8/10 pain, and the infection was advanced. Because of all that, I kept thinking that the men were doctors and the women were nurses. I slipped a few times before I realized my mistake and apologized. Once I had more presence of mind, I told myself to look at their uniform. I joked about it later, like, “Damn! That was one nasty infection!” I haven’t slipped up since.

So, here are my hospital dos and don’ts during COVID-19. What do you think? Anything you would add?