Tuesday, October 23, 2012

When Your Child has to go into the Hospital

When Your Child has to go into the Hospital

Be Prepared.
What should I bring to the hospital to have a smoother admission?
The more prepared you are, the better your admission experience will be. Be sure to bring a list of your child’s medications, allergies, recent surgeries, illnesses, and hospitalizations.  If your child is receiving services such as private duty nursing, therapies, or home medical equipment – bring a list of these providers’ contact numbers and what services your child receives from them. If your child gets nursing, bring a copy of the Plan of Care. You will likely be asked the same questions by more than one member of the medical team. Rather than having to repeat yourself each time, if you have everything written down it will save you time and frustration.
Good packing is another important tool to help with you & your child’s transition. Pack things that are comforting and part of your child’s normal routine as much as possible.  Many times it is more comforting for the child to wear his or her own pajamas rather than a hospital gown.  If your child has special medical supplies and equipment, bring enough backup in case the hospital doesn’t have what your child uses on hand. If they do have what you need, use their supplies and save yours since insurance quantities are limited and you don’t want to run short. Be sure to bring something comfortable for yourself as well as toiletries, snacks, and a relaxing activity to fill quiet time.
Know Your Rights.
How do I know how much say I have in my child’s care? I feel like I have no control over what’s happening.
As a parent, you have a great deal of control and influence on your child’s care while they are in the hospital. It is very important that you talk with the medical team caring for your child on a regular basis and stay informed of the treatment plan. If you don’t understand or disagree with something, tell your child’s doctor. Every time your child is hospitalized you will be given a document called “Patient Rights and Responsibilities”. It is very important that you read this and be familiar with your rights as well as your responsibilities. This could be very helpful in understanding how much control you have in your child’s care while they are in the hospital. The best survival strategy is to keep the lines of communication open. Talk to doctors, nurses, your spouse, and your child. The more information you have, the more in control you will feel.
Who’s who in the hospital?
There are so many people involved in my child’s care, how do I know who does what?
There will be many doctors and nurses involved in your child’s care. When multiple care providers are involved, it is not uncommon for them to have different ideas and opinions about your child’s treatment. This can be very confusing and frustrating for parents, and can make parents worry that “no
one knows what is going on.” It is very important that you identify the person who heads up your child’s team. Parents have also often found that keeping a list of the different medical providers, and information about how they can be contacted is helpful.
Doctors –
Attending physicians are members of the team that determine and supervise your child's medical care. Attending physicians also teach other doctors to care for children. Your child will be assigned an attending physician.
Residents and interns are physicians completing training in pediatrics. They work under the guidance of attending physicians and fellows to provide your child's care.
Specialists are physicians with advanced training in a particular specialty. It is not uncommon for the attending physician to have one or more specialists see your child while they are in the hospital. Some specialists you may see in the hospital could be Pulmonologist, Cardiologist, Endocrinologist, Surgeons, Otolaryngologist, Neurologist, etc.  Be sure to ask if you don’t know what specialty a physician practices or why they are seeing your child. 
Fellows are physicians who have completed their residency training and are now receiving advanced training in a pediatric specialty. Fellows work with an attending physician to provide your child's care. Fellows help teach interns and residents under the guidance of attending physicians.
Nurses –
Registered Nurses (RN) and Licensed Vocational Nurses (LVN) are responsible for providing the nursing care ordered by doctors, completing physical assessments, and notifying your child’s doctors of any needs, concerns, or changes regarding your child’s condition.
·   Charge nurses are responsible for overseeing the nursing care on your child's unit during a shift.
Clinical nurse specialists are registered nurses with advanced education in special areas.
Nurse practitioners are registered nurses with advanced education in special areas. These nurses are able to write orders and prescriptions under the supervision of the attending physician.
Other –
Physician Assistants (PA) practice medicine under the direction of physicians and surgeons. They are formally trained to examine patients, diagnose injuries and illnesses, and provide treatment.
·   Patient care assistants are trained to help nurses care for your child. They work under the supervision of a nurse and provide routine care activities but are unable to give medications. In most cases, this is the person taking vital signs and doing other tasks like checking blood sugar, emptying catheter bag, etc.
 Respiratory Therapist (RT) have specialized training in the respiratory system. They perform respiratory (breathing) assessments, give nebulized breathing treatments that your doctor orders, monitor and regulate oxygen use, and work to make your child’s lungs, breathing, and ventilation are controlled.
·   Child Life specialists help meet the developmental, educational, and psychological needs of your child. They plan and provide activities and support to minimize stress while in the hospital.
Nutritionists offer guidance on nutrition to help your child to grow and heal.
Radiology technologists perform X rays, ultrasounds, CAT scans, MRI scans and other tests to help the healthcare team treat your child.
Discharge Planners / Case Managers help plan for your child's discharge, make referrals to community resources if needed, coordinate insurance coverage, and work with the home care coordinator if home care services are needed.
·   Social workers provide counseling, information, referrals to community agencies and emotional support. They can help decrease stress and guide you and your family during your hospital stay.

Going Home!

I’m so relieved to be going home, but I’m nervous too. How can I be sure we are prepared?

Going home from the hospital usually brings relief to children and parents. However, many children have trouble adjusting after a procedure or hospitalization, especially if they are still recovering or experiencing pain. Such adjustment difficulties are normal, and may last anywhere from a few days to a couple of months. It is important to return to your family routines as soon as possible, and to maintain family rules and limits regarding your child’s behavior.

Before leaving the hospital, make sure you have ALL of your questions and concerns addressed. Do you feel safe taking the child home? Do you feel that he or she is stable enough to go home? Did the hospital staff teach you everything you need to know to care for your child at home? Was there something that you wanted the doctor to address that was not done. Once you have done this and are comfortable and agree that your child is ready to go home, the next step is getting things in order to go home. Have someone at home prepare your child’s room by changing their linens and freshening up their space. It is important that they come home to a clean environment. Also, have a list of follow up doctor appointments that your child will need after discharge. If the nurse didn’t make the appointments for you, do this as soon as possible and no later than the next day after discharge. Ask your child’s doctor to send any prescriptions to your pharmacy before discharge so that they will be ready for pick up when you go home. Be sure you have a list of what medications were ordered so that you can ensure you get the correct medicines at pick up. The nurse will review the Discharge Orders with you before you leave. Make sure you understand the doctor’s discharge orders, especially regarding medicines, dressing changes, diet, activity, and any home medical equipment or treatments. If you are receiving services at home, be sure to contact these providers to ensure they are prepared to resume services. If they are not, be sure to relay this information to your child’s doctor and the discharge planner/case manager working with your child.