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DrG's Medisense Feature Article
Tactics for Managing Hospitalization
By Ann Gerhardt, MD
March 2024
Print Version
One of my relatives recently had problems with anger during his hospitalization, as I did during mine in 2022. Here is what I realized then and recently shared with him.
1) Recognize that unexpectedly
finding yourself in a hospital with an illness or injury is not the
fault of the hospital staff or doctors. There is an adjustment
period during which one must deal with depression and anger over a
sudden health problem and unknown people telling you what to do.
2) Understand the difference between agency and autonomy. Agency is the right and power to make major decisions, like consent to a procedure and leaving or remaining in the hospital. By law, every patient or their power of attorney, if the patient’s brain isn’t working, has agency.
2) Understand the difference between agency and autonomy. Agency is the right and power to make major decisions, like consent to a procedure and leaving or remaining in the hospital. By law, every patient or their power of attorney, if the patient’s brain isn’t working, has agency.
No hospital patient has autonomy to make minor decisions, since they and their nurses have to follow doctors’ orders and hospital rules for safety reasons, and also schedules, to prevent chaos, even if they feel inconvenient.
Patients and family may negotiate minor decisions with doctors, ancillary staff like dietitians and nurses (bedside or supervisory). Remember that all personnel have the agency to leave hospital employment and we should not make their life so miserable that we give them reason to quit, unless we’ve been harmed. So, using our polite words has a place in the hospital. That and a sense of humor usually helps to make us a VIP and receive better care.
My example of hospitalization compliance:
Autonomy: I understood that a night nurse had to help me get out of bed to the bathroom safely, but I would have personally fired her over her nagging me to poop faster. I negotiated with doctors about medications with unpleasant side effects. Too bad that nurse wasn’t working the night a new medication gave me uncontrollable diarrhea.
Agency: I verbally lambasted the doctor who tried to schedule me for a procedure that I had refused, suggesting that he do it in my place.
I’m not claiming to have been a perfect patient, but I and everyone on my care team made it out alive, including the kitchen staff who refused to give me pickles😊.╣