Tuesday, December 09, 2008

How to be a Prepared Patient

The Agency for Healthcare Quality and Research (AHQR) has a number of good publications that advise patients how to be better advocates for themselves. We expect our caregivers to be our advocates while the sad reality is that we must be an advocate for ourselves and our loved ones in the healthcare setting. I recently attended a nurse educator seminar at which the very experienced educators at my luncheon table emphasized to one another the value of bringing your own nurse to the hospital with you when an overnight stay is required!! (When you are the "nurse in the family" you find yourself helpful in a lot of extended family situations. The same applies when you live in a close-knit neighborhood such as we did at our dear old "Loma Roja Drive" in El Paso, TX.) Actually the educator's advice about having a nurse or a loved-one at the bedside to advocate for the patient is what I and many of my nurse colleagues have been recommending for quite some time. However, these nurse educators are responsible for bringing the new generation of nurses into the profession; therefore, I was surprised and disappointed that even their idealism and confidence in the hospital "care" setting has been lost. Perhaps I should appreciate that at least they were pragmatic . . .

On their website AHQR provides a Question Builder that patients can use to guide conversations with their physicians.

ARQR suggests asking these questions about a new diagnosis:
What is my diagnosis?
What is the technical name of my disease or condition, and what does it mean in plain English? What is my prognosis (outlook for the future)?
What changes will I need to make?
Is there a chance that someone else in my family might get the same condition?
Will I need special help at home for my condition?
Is there any treatment?
What are my treatment options?
How soon do I need to make a decision about treatment?
What are the benefits and risks associated with my treatment options?
Is there a clinical trial (research study) that is right for me?
Will I need any additional tests?
What organizations and resources do you recommend for support and information?

Here are some of the suggested questions regarding a planned surgery:
Why do I need surgery?
What kind of surgery do I need?
What will you be doing?
What are the benefits and risks of having this surgery?
Have you done this surgery before?
How successful is this surgery?
Will the surgery hurt?
How long will the surgery take?
How long will it take me to recover?
How long will I be in the hospital?
What will happen after the surgery?
How much will the surgery cost?
Will my health insurance cover the surgery?
Is there some other way to treat my condition?
What will happen if I wait or don't have this surgery?
Where can I get a second opinion?

Please have several copies of your medication list available. Your doctor does not keep track of every medication you are taking. If you have several doctors--be assured that they are NOT necessarily going to communicate regarding your medications. Do you use more than one pharmacy to fill your prescriptions? Are you taking oral supplements and/or vitamins? Hopefully you will be conviced to be responsible for keeping an up-to-date list of all the medicines and over-the-counter supplements you are taking. Don't forget to include creams, salves, topical skin patchs for pain, blood pressure, etc. I also like to include any medical supplies needed on an ongoing basis, insulin syringes or insulin pump supplies with specific size information, specific ostomy supplies, bladder catheter supplies (including size and type of equipment).

AARP provides helpful form to organize medication information. You can download their Personal Medication Record or order free copies (Stock No. D18358) by calling 1-888-OUR-AARP.

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