– Dr. Ukot –
People visit a hospital for various reasons. I chose to start this article by taking your mind to the fact that not everybody goes to hospital for themselves. Many people that you find in the hospital work there; others have one form of business or the other to do there – there are contractors who supply sundry consumables, carry out construction and renovation, effect routine maintenance of parts of the facility and its grounds, or install and service equipment. In some hospitals that are accredited for training there are also students. Occasional visitors are there to pay courtesy calls and others are representatives of arms of government that have one thing or the other to do with government hospitals or private hospitals. At certain times of the day a good number of people that are in a hospital are visitors of admitted patients. The rest of this article emphasizes that person or those people that go to a hospital for the purpose of consultation. A visit to a hospital can be treated as having three parts viz.:
Your frame of mind: It is very likely that you either intended or did not intend to go to the hospital. Most patients do not like to go to the hospital; this is whether they intend to go or do not intend to do so. The reason that most people do not like to go to hospital is because they do not like what they are taking to the hospital i.e. the illness that is the subject of the hospital visit. A lot of times an illness is seen as a distraction from planned and desirable activities of the day.
General preparation: After making the decision to go to a hospital you must prepare. Why prepare and what do you prepare for? The reason you prepare is simply because you normally do exactly that before you go anywhere for anything. What you prepare for are the things you expect will happen during your visit for consultation. If you have visited a hospital before you will have an idea of what will happen. However, the fact that you have visited a hospital even for the same thing does not mean that other experiences will be the same.
Time: Before you arrive at the hospital you should know the time that the clinic starts and finishes – it is bad planning for you to leave your house one hour to the closing time for consultation when you are not certain of the traffic situation between your home and the hospital; even if Google maps gives you an indication of your arrival time it is not likely to inform you of how many patients are already waiting to consult the same doctor. Before you arrive at the hospital you should remember that there is a procedure in many hospitals and the hospital you are going to for consultation may operate a procedure or schedule that is different from the hospitals that you are familiar with – in some public hospitals the procedure could be cumbersome and you may need to queue for more than one thing e.g. to make payments and registration or obtaining your records from medical records personnel. You prepare for these and other things. You should even prepare to meet patients whose illnesses are obvious to you and other people, unlike yours that you need to tell even the doctor before they can figure out what the diagnosis is.
Funds: Prior to your arrival at a hospital you should have more than one option for payment unless you are not a fee-paying patient. Some patients who go by public transport may lose their cash, wallet, or purse and become stranded; other patients may go with a certain amount of money and discover that the cash is not enough; at yet other times a patient who intended to make funds transfer electronically may find that internet service for the chosen network at home is not satisfactory at the hospital; if POS machine was hoped on, there may be one annoying fault or another at the time you are frantically attempting to make a financial transaction.
Dressing: You should also plan your dressing details before you leave your house. It may be counterproductive to wear your most expensive and delicate clothes to a hospital. Before you set out to consult a doctor in a hospital you should be prepared to have the dress dirtied or suffer some degree of damage. Since you are not going for a party and your “neighbour” may not appreciate your exquisite dressing in a particularly busy hospital due to preoccupation with their medical condition there may not be need to dress to impress. Whether you go to a high profile hospital or the one that every member of the public resorts to, my opinion is that your dressing should be “functional.” What do I mean by functional dressing? It is dressing that will not be an encumbrance to you, nursing personnel, laboratory staff, or your doctor. If you wear long-sleeved or tight tops it may be difficult for you to expose your arm for measurement of your blood pressure as part of taking your vital signs for documentation. During the same vital signs check station your tight fitting high-heeled shoes needs to be removed and it will be with more difficulty than if your footwear was something simpler. For men wearing shoes meant for a boardroom meeting with the full complement of long socks/stockings and properly tied laces consumes not only your time but also the hospital personnel’s time and the time of fellow patients waiting for you to be done with your check.
Food: Before you go for consultation you should know or consider the likelihood that you will need to have certain investigations carried out on you. Certain tests like fasting blood glucose (sugar) require you to fast overnight for the correct result to be obtained. There are some abdominal ultrasound scan procedures that require an empty stomach while for others the state of your stomach in terms of food is immaterial.
Water: In the very early stages of pregnancy the sonographer or sonologist requires you to fill your bladder for the dating of pregnancy to be precise; a full bladder is also a requirement for carrying out scanning for men with prostate challenges. In such cases part of your preparation (unless you were unaware of or forgot the requirement) is to start drinking water before you leave home or to commence drinking water just before you exit your vehicle to enter the hospital building or medical imaging unit. The decision on when to start drinking water and how much of it you consume should depend on the distance and time to the hospital or the anticipated waiting time for your turn to have the investigation carried out.
Your shopping list: I call it a shopping list! I use this expression because many people forget to do what they do when they are about to go-a-shopping; when you have to go to a hospital for consultation you should do something similar. Sadly, what are expected to be on this particular list are predominantly complaints or symptoms; they are undesirable things that stare you at the face as you write them on paper – or preferably using your phone notes app. You should start writing down this list before you leave your house; if the time frame permits you may start hours before you leave your house, office, business place, or school hostel. Apart from these matters that trouble your body or mind you should not fail to write down the names of all the drugs you are taking now and the ones you have taken recently.
Do not bank on the fact that your hospital uses electronic medical records system that readily indicates your previously prescribed medications because the system may fail, network may fail, or there may be public power failure and, depending on how long power has failed, the uninterruptible power supply (UPS) may also fail from prolonged use. When things really go wrong and the back-up generator has to be used the power supplied may be directed to the wards and operating room (theatre) and not the out-patients department. If in such cases you consult a doctor who does not know you, your medical condition(s) or specific drugs that you use, the time you have already spent may be wasted as the doctor cannot safely prescribe your previous medications for refill/replenishment without knowing the correct name(s) and dosage(s). The doctor may simply prescribe drugs meant for just the current medical challenge you present with.
Emergency: Everything I have written so far pertains to patients who have ample time to prepare to go to hospital. There are those whose medical conditions present as emergency. They do not have the time to do much or most of what is written above. It is in such patients that some other person (driver, neighbor, spouse, adult child, relative, colleague, etc.) may be the one to take them to the hospital – and they do it “just as the patients are.” Patients with emergencies, especially the unconscious ones, have discovered on recovery from their illness that hospital personnel had slit their tops at the seams (or anywhere if undoing buttons zipper did not suffice) just to be able to do what was necessary to stabilize the patient on arrival in the emergency room.
When you get to the hospital you may return home some hours later, much later but on the same day during daylight hours or at night, and at other times admission is warranted. I am here discussing a few, certainly not all, things that happen or should happen when you are in the hospital mainly as an out-patient.
Patience: Interestingly most patients do not know why they are called patients! One of the essential requirements for obtaining the most and the best from any hospital is patience – patience with yourself, your medical condition, the hospital process for consultation, and the personnel starting from the hospital entrance gate to the departure gate – and everything, everywhere, and everybody in between. Starting with yourself, you should realize or remember that no matter how great the ambience of a hospital is (or how unimpressive the environment is) the medical facility is not your home or office. You do yourself a lot of good when you focus on your target – achieving a restoration of your good health or maintaining the relatively good state of your health. I just mentioned two things. You should have the patience to ensure that you, at least during the consultation, commence the process of ensuring that your good health is restored. Do everything possible to snatch your good health from ill health. It may surprise you that my over 40 years of practice as a physician show that a patient’s patience is their greatest asset and a patient’s impatience is frequently their undoing. The second thing I mentioned is that you should maintain your relatively good state of health – this is because it is not every time that you go to hospital because you are frankly ill; you may go for pre-employment medical examination, for follow-up consultation after receiving treatment for your last episode of illness, or just for your annual medical check-up. When any of these is the case and you are worked up by impatience you may simply “acquire” a minimum of headache by the time you get home – if not before you leave the clinic or hospital. Being patient does not mean that you should not (or do not) know your rights as a patient.
Priorities: A doctor with any amount of experience can attest to the fact that they discover, sometimes to their chagrin, that various patients have priorities that are appropriate or completely surprising or unrealistic. There are patients whose words and actions show that the state of their health is paramount to them and they will do everything to help themselves and the doctor. There are other patients whose demeanour or what they verbalize is a reflection that there are more important matters in their lives than their health. You wonder where the expression “health is wealth” sits in their consciousness. Some patients have been known to walk out of the hospital/clinic while waiting for their time to enter for consultation because they had financial matters to attend to. Others leave the consulting room and do not take the next required steps that the doctor advised.
Talk to the doctor: I like listening to patients and want them to talk. My experience shows that the patient who has a list of complaints is an asset during consultation. The next good thing is when a patient is organized in their thought process and is chronological in presenting the story of the illness. As a patient, please talk to your doctor. Talking to your doctor is not the same thing as stating and going into details of things not related to the consultation. When you are face-to-face with the doctor you should know that the doctor’s mind works with the information you provide. Some doctors, like me, do not like a patient repeating what they have said; such repetition makes me feel that the patient assumes or has concluded that I am not paying attention. When the doctor asks you to slow down when they are writing down or typing your complaints and history, kindly oblige (not many doctors are like me for I acquired the skill of speed typing as a teenager).
Listen to the doctor: I place this just after the previous paragraph. There is not much value in you doing all the talking and putting the doctor (especially the young doctor) in the uncomfortable position of simply listening. Because the doctor’s mind is working they may ask you a couple of questions during the consultation. It is important for you to listen to the doctor and understand their question(s). Do not answer the question that is unclear to you; rather ask for clarification if you do not understand or ask for the question to be repeated if you did not hear well. Some patients consider certain questions “irrelevant” or “intrusive” and they either ignore the questions or take offense. When this happens and the doctor notices it they may decide to tell you the relevance of the question; this is when you find a doctor tell you or your wife (or husband) the reason for asking about the last menstrual period when there is refusal or vacillation to provide the date. In the same vein the doctor will explain the request for exposure for examination of certain parts of the body that the patient considers private or intrusive – if the patient still objects, the doctor will simply indicate in the patient’s record that they requested but the request was declined by the patient.
Ask your doctor questions: Many patients and patients’ relations have the erroneous belief that they should not ask the doctor questions. You must be wiser after every consultation with a doctor than before that consultation – at least pertaining to the condition that made you decide to go to hospital. One of the worst things I find is patients who want to teach the doctor something or those who argue over their ingrained beliefs/opinions on certain conditions. An example is patients who believe that certain conditions or symptoms are spiritual and they use expressions as “spiritual attack”; when the doctor attempts to explain some of them on medical grounds these patients take offence, refuse to listen, and sometimes see the doctor as being unspiritual. When that happens, a wise doctor will not argue with you but the downside of that is usually that you will think that you have won the “argument.” Doctors are generally not interested in arguing with patients. Yet another observation that I make is the danger that some patients expose themselves to by googling medical facts on the internet. I may write on this in another post.
To stay within the limit of what I set out to write I can summarize this as follows: Take note of what your doctor said pertaining to laboratory, ECG (EKG), x-ray, ultrasound, MRI, CT scan and/or other investigations that are ordered for you. Commence treatment as soon as possible, if not immediately. Follow the instructions on taking your medications strictly. Document the date for your follow-up appointment and keep the appointment; keep a reminder – it is better to reschedule your appointment slightly earlier than later, but both are better than ignoring the appointment especially when you feel that you are well and do not need it.
A hospital visit for consultation is something that virtually every adult has done at least once. You need to get the greatest reward for making this effort. The benefits you obtain depend on how well you prepare for it as well as what you do during the consultation and after. This short write-up should give you adequate guidance.
