I think sometimes hospitals forget that patients often have a choice of several hospitals, particularly in urban or highly populated suburban areas. While perhaps a bit personal, I've decided to share my experience of more than 30 in-patient days in the past year at three different hospitals. To protect each hospital's privacy, I will not disclose hospital names or cities.
After my daughter's birth, I was diagnosed with a very treatable cancer (and am totally cancer-free now), so my experiences have been very varied, some great, given the circumstances, and some fairly unpleasant.
Duration: 4 days
I was completely prepared. I had an awesome doctor, my favorite nightgowns, baby gear, and my own pillow. I knew what to expect from my c-section and a pain management plan. From arrival until recovery, things went fabulously. The spinal block needle didn't hurt, I cracked jokes with the doc, and I had an awesome, perfect little girl. Unfortunately, post-delivery nursing staff ruined my entire childbirth experience.
What worked for me: Private rooms with easy access showers, unlimited Italian ice, and a comfortable hospital bed.
What failed: Nurses who refused to respect my pain management requests (meaning I don't need pain meds), lack of privacy and positive support while nursing my daughter, uncoordinated 24/7 interruptions for care of me and Penny, and just plain not being heard at all. This stay was bad enough that I spoke to the charge nurse and after release, had a conversation with the head of nursing. You don't need the details, but I'm a really easy patient and they just absolutely pissed me off. There was one more problem, inedible food. I couldn't even cut my chicken with a knife it was so dry and hard. Yuck!
Reason: Removal of a major organ
Duration: 11 days
Less than a week separated cancer diagnosis and surgery, so while I was well prepped, the whole craziness hadn't quite sunk in yet. I was in what I like to call "vacation mode". While going through tests and appointments, I treated everything like a tourist would, documenting the experience with photographs and shopping for fun items at the gift shop. I didn't do the best job of communicating my issues with pain medicines and there were a few emotional breakdowns but the overall experience couldn't have been better given the circumstances.
What worked for me: A gorgeous private suite with hardwood floors, big TV, huge private bathroom, and lovely view of the city. Respectful intelligent nurses were empowered to care for the patients without having to run to a doctor for every little thing. I was listened to. I was supported, and more importantly, my husband was treated with care and respect while visiting me.
What failed: Very little went wrong. I had some complications requiring unpleasant intervention multiple times. It was painful, miserable, and I fought and fought. Even when I was crying and protesting, the nurses were calm and helped me understand why I needed to give in. Other than that, I really just wanted to go home but I can't say that the hospital had any control over that.
Hospital #2 (again)
Reason: More fun surgery
Duration: 9 days
I thought I was prepared for this but my recovery wasn't as smooth as anticipated. There were a few hiccups but overall, I once again had amazing nurses. Nurses who understand respect and compassionate care, who have a low patient-nurse ratio, and who believe in the hospital mission are the backbone of pleasant care experiences.
What worked for me: Nurses who took the time to just hang out and get to know me, the unlimited food ordering system, the movie channel, freedom to walk around the hospital whenever I wanted to get away, spacious and well-appointed family areas. My pain management request (refusal of anything but Tylenol) was honored. I appreciated that.
What failed: I wanted a private room and was willing to pay for it but there was a chance I would have gotten one as "medically necessary". The registrar assured me I could request a private room later if I wasn't assigned one automatically. When I awoke in a shared room, I was not pleased and it took several days and many requests to finally be moved. The rooms were not like the suites of my previous visit, very small, hard to manuever with IV and equipment poles. I got stuck under the TV stand several times. The bathroom was so small I usually left the door open because my poles didn't quite fit. Also, not having a private shower is just unpleasant for anyone.
Reason: Post-Release Complications
Duration: 5 days
After an ambulance ride and a night in the ER, I was admitted for some unknown problem that caused excruciating pain. This was a moment where I begged for pain medicine rather than refusing it. I was miserable and admitted to a private room ward.
What worked for me: No matter how nasty the rooms are, privacy is important. I can't think of anything else that went well. Seriously.
What failed: Nurses weren't communicating at shift change so I had to tell my story 4-6 times a day. When I wanted to be removed from pain meds, there was another communication glitch and days later, I realized I was still hooked up to a pump. That is really uncool. The room was dirty and resembled a 1970s schoolroom that hadn't ever been updated. The ticking of the old clock annoyed the heck out of me. And while the bed was brand new, it was so uncomfortable that I had back pain for a long time after my stay.
Hospital #1 (again)
Reason: More Post-Release Complications
Duration: 4 days
After my previous bad experience, I asked the ambulance driver to take me to hospital #1. I can't stand their ER but I didn't want a repeat of the last stay. The nurses were nicer and seemed like they had received better training. The shift-change procedures were better and I felt more confident that the hospitalists (attending physicians) understood my situation.
What worked for me: Really nice nurses. Can't say enough about that. I even told the charge nurse about a particularly great experience with nurse Erin. Unfortunately I can't tell you where Erin works but if she ever sees this, I hope she knows that she really made my stay bearable. Once again, I had a private room and though like the last one, it was dirty and dingy, I'll take that over a super polished shared room.
What failed: This hospital has a reputation for a really bad patient-staff ratio. I experienced it during childbirth and this stay was about the same. There are two situations, either you are seen a bunch of times in a few hours when you want privacy, or you wait 15-20 minutes after pressing the help button. During this stay, there was one time I waited 40 minutes after pressing my button. I was in excruciating pain again and my nurse was stuck with a patient who wanted to chit-chat. Since the nurses had so many patients, it was impossible for another nurse to cover for my nurse when I needed help.
The fact is, after all these experiences, I am now empowered to select a hospital based on my experiences. For the first-time patient, going to the closest hospital may be good enough, but those who may return a few times are likely to choose based on experience. Hospitals are a business and they can lose their highest paying customers because the bathroom was grimy, the nurses are too busy, or the clock ticks too loudly.
Experience isn't just about getting better, it's about feeling like you've been cared for, that you are respected, and that someone is listening.
I hope hospitals are listening because experience matters and as you have read, there are a lot of bad experiences out there. I'm sure you can guess that there are one or two places I will avoid in the future.
I'd like to hear about your experiences, whatever you feel comfortable sharing. Don't tell me the name of the hospital, but do share what either worked or didn't work for you. What makes a great hospital experience?