Think Your Hospital Is Looking Out for You?

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If you think when you are in thehospital that the hospital is looking out for you, you are in theminority. Day after day, we see news of people that have stories totell that are not showing hospitals in a good light. We hear offriends or relatives of friends that have died because of medicationerrors, errors in medical judgment, and errors in operationsperformed on the wrong patient. It will soon be apparent to even themost careful of patients that they will need a patient advocate ifthey are to be admitted to a hospital.
Even then, patient advocates will havea difficult time. Hospitals do not like patient advocates and dotheir best to work around them or even conceal what is happening. Yes, several decades ago, there were accidents and errors, but not atthe ratio of today. We had doctors that spent time with patients andchecked in regularly. We had nurses that knew what to do andcommunicated with the patient’s doctor(s) and the patients. Theywould alert doctors of changes in a patient's condition and testresults.
Then came larger hospitals and morelawsuits. To protect their profit margin, nurses were marginalized,doctors restricted in their duties by the hospitals. Patients in thehospitals are being seen less often and not by their own physician. Is it any wonder there are more errors and improper medicationsgiven? Allergies are not checked and communications are limited.
This article in a DiabeticConnect newsletter says a lot and lays out many of theproblems we encounter as people with diabetes. This from the articleneeds to be quoted, “The problem withhospitals is that they standardize care much more than theyindividualize care. This is due in large part to the huge volume ofpatients they service, and the need for general protocols. Generalprotocols, however, do not work all the time for patients withdiabetes. If you have never used insulin and the plan is to give youinsulin in the hospital, work with your health care team tounderstand what to expect. I would advise family members to carryblood glucose meters with them and have them available for a quickcheck if necessary so that you can alert the hospital of a potentialproblem with high or low blood sugars.”
These general protocols can make itimpossible to manage blood glucose levels in the range that you areaccustomed to. Most hospitals do not want you to use your pump ifyou use one. They even discourage continuous glucose monitors. Occasionally you will find a hospital that will allow the patient tomanage their diabetes while in the hospital, but this is rare andmust be decided upon before admission. I would even suggest gettingit in writing.
Another issue the article raises that Ican appreciate is some hospitals are giving rapid-acting insulinafter a meal. This surprisingly allows the patient to not eat thefood that you will be served and/or eat what you think will besufficient for your needs. Then the amount of insulin can beadjusted for the food eaten. Most hospital food is not very enticingand is loaded with carbohydrates. This is because of the dietitianmandate that people with diabetes should have 60 grams ofcarbohydrates at every meal.
I do appreciate the author's commentand I quote, “I do not in any way wantthis to scare you, but rather to encourage you to be an activeparticipant in your healthcare. Any and all family members and lovedones should be involved as well.”
Hospitals need to learn how to treatpeople with diabetes. This will mean every family member will needto be on board and maybe even a diabetes patient advocate. If thepatient is going to be incapable for any period of time and a familymember is unable to be present, even a medical power of attorney willget their attention as long as the persons present are listed on thedocument. Even then, many hospitals will try to circumvent thisdocument.
If you are the patient, make sure thatyou dot all “I's” and cross all “T's” and that your wishesare known, if possible, before admission to the hospital. Rememberthat the hospital protocols may not be in your best interests fordiabetes management. Hospitals have protocols that are in theirinterest to protect their profit margin and prevent lawsuits.