A Hospital Guide for COVID Patients

Copyright © American Patient Rights Association, Inc. 2020.

This guide may be freely copied, shared, transmitted and distributed in whole for non-commercial purposes only. All other rights reserved.

ABOUT THIS GUIDE

The following are sections from APRA's soon-to-be-released mobile app The Patient’s Guide to Hospital Safety*  adapted for COVID patients.  * Get the mobile app

COVID-19 threatens us all. If you, or anyone else in your family, become infected this guide can help you to prepare in case hospital treatment is needed. It includes step-by-step instructions about what to do now and after being admitted. Advance preparation is important and can help to put your mind at ease.

                                                               

DISCLAIMER: The following and all associated information is not offered as, nor intended to be medical advice. Always seek the advice of a medical professional for any health-related matter. If you think you have a medical emergency take immediate measures to seek medical help, including calling 911 if necessary. 

TERMS AND CONDITIONS: Upon any use of this website the user agrees to the Terms and Conditions.                                         

How to Prepare for Being Admitted to a Hospital or Temporary Medical Facility

The following is a list of actions you should take now. This applies to everyone in your household:

 

  1. Contact your local municipal offices to inquire about any community resources that may be available to you if you or someone in your family has the virus. For example, there may be local COVID shelters to house people who have the virus and need to be isolated from people they live with; 

  2. Contact your doctor to have him/her decide if you should go to the hospital. Family members will not be allowed into the hospital with you, so be prepared to enter the hospital alone once you arrive; 

  3. Tell your family your hospital of choice; 

  4. Write down and keep in an overnight bag: 

    • your list of medications

    • your health profile 

    • the name and contact information of your personal doctor

    • the name and contact information of your personal representative/advocate who will communicate with hospital staff and doctors on your behalf while you are in the hospital

    • the name and contact information of the people you have been in recent contact with, to be shared with your public health department; 

  5. Make a copy of, and pack your Advance Health Care Directive. If you do not have one now is a good time to prepare it (see also care coordination below);

  6. Pack any personal items you wish to take to the hospital;

  7. Pack a cell phone to communicate with your family and allow them to speak with the doctor/nurse. A smartphone with video chat capability is best;

  8. Pack a charger for your cell phone and a backup battery pack (if applicable);

  9. If you use a CPAP take it with you.

Hospital Personnel: Who is Who and How to Identify Them 

During the period when high volumes of people need hospital treatment due to COVID-19, doctors and hospital staff are deployed to the areas of greatest need. This can be across state lines and may include retired professionals volunteering to serve. 

 

Name badge and credentials should be prominently displayed. Most hospital staff will be in a mask and may be wearing protective gowns and headgear.  No ID badges are worn outside of the protective gown but it is important to know who is who.  

 

With a contagion such as COVID, hospitals strive to assign one nurse to you in the ICU and that nurse will be dedicated to your care.

 

The following are the people who will be directly responsible for your care: 

 

Doctors

 

Hospitalists

They are Medical Doctors or Doctors of Osteopathy (MD or DO’s) and usually, but not always, wear long white lab coats with an Identification Badge clearly stating their name and profession.

 

Many hospitals employ hospitalists and intensivists specializing in hospital acute care. These groups rotate days and shifts. Ask for your doctor's name every day and record it. You may not see the same doctor. 

Interns, Residents, Fellows

Many hospitals are affiliated with a university-based medical school. Residents and Fellows are Medical Doctors (MD). They have graduated from medical school and are receiving further training for a specialty practice such as surgery, radiology, emergency, etc.

 

Chief Residents are Residents in their final year of residency who supervise other Residents and usually are among the most knowledgeable physicians in the hospital. Interns have graduated from medical school but do not yet have a full license to practice medicine unsupervised. 

Medical Students

Medical Students have not graduated as medical doctors and wear short white lab coats. They will wear a name badge clearly displaying the affiliated school and the title.  

Attending

An attending doctor is a physician who has completed residency and practices medicine in a clinic or hospital in the specialty learned during residency. Attending doctors are usually (but not always) in long white lab coats with an Identification Badge clearly stating their name and profession.

 

An attending doctor typically supervises fellows, residents, interns, medical students, and other practitioners. Often the patient does not meet an attending doctor. (Note: because of the risk of transmitting hospital-acquired bacteria, physicians in some institutions no longer wear white coats with long sleeves).

Mid-level

Many doctors employ Physician Assistants (PA) and/or Advanced Nurse Practitioners (ANP) to assist and expand the practice. They may be in short white lab jackets and will have a hospital badge displaying their credentials.  

Nurses 

Nurses are usually in one color, like white or navy, chosen by the nursing staff. Nurses wear a name badge with a large RN or LPN clearly displayed on the name badge. Pediatric nurses may be in a different color and will also always wear a name badge with RN or LPN.

 

Many nurses wear hospital provided scrub clothing in departments such as the operating room and labor and delivery.  A name badge will be prominently displayed with RN or LPN in these instances as well.  

Support Staff

 

Hospitals have many support staff and volunteers to serve you. Nursing assistants, pharmacy technicians, housekeeping staff, dietary aides as examples of support staff that frequently enter your room. They may be in a color-coded uniform and will wear a name and title badge displaying the department.  

Other Patient Hospital Resources

  • Patient Advocate or Representative

  • Chaplain

  • Administrative Supervisor

  • Social workers

Care Coordination

Due to doctor rotations, the coordination of care for hospital patients is often weak or missing. During a pandemic, care coordination will remain in place, however, it may be poorly coordinated, creating additional risk. You may be cared for by multiple physicians and physician groups.

 

You may have an attending doctor along with residents, fellows, and students consulting on your care. You may be assigned to a hospitalist or intensivist group who rotate shifts. 

You should know the name, title, and position of everyone treating you, and the name and contact information for the nurse in charge, hospitalist or attending doctor, chief resident, and surgeon. 

In addition, you may be too weak to ask or keep track of who is attending to you. If you will be on a ventilator you will not be able to talk. Because of this APRA recommends the following:

Assign someone you know from outside the hospital as your advocate to communicate with doctors, nurses, and professional case managers on your behalf.  This person should be the same person listed in your Advance Health Care Directive and Healthcare Power of Attorney (if applicable). 

How to Protect Yourself in a Hospital During the Pandemic

These guidelines are provided for COVID patients who are well enough to follow them. Some severely ill COVID patients may not be able to monitor their own care.   

 

  1. Know where you are admitted. If you are moved, know where you are being moved to. Many hospitals have off-campus temporary hospital facilities. Have a patient advocate with you (this may not be allowed during COVID treatment) or call your spouse or family to inform them where you are. Many hospitals will be closed to visitors, including your family/significant other/advocate, during the pandemic;

  2. Know your condition and the plan for treatment;

  3. Make sure everyone washes their hands before touching you (no exceptions), and doctors clean their stethoscopes before examining you. If possible, keep a pocket-size hand sanitizer and wipes with you and offer them if necessary. Make sure you always wash your hands when using the restroom and before meals. Make sure no doctor’s necktie touches you (many hospitals now discourage wearing neckties because of the risk of transmitting infections). Make sure your room is cleaned well daily, including all equipment and the floor. Don’t be afraid to speak up. It’s your life that’s at risk; 

  4. Share your health information with all your healthcare providers in the hospital. Do not assume they will know it;

  5. Share your list of medications with your doctor and nurse; 

  6. Know and understand everything that’s happening to you, including what tests are being done and what each is for. Ask for the results and what they mean for your health. You should not be kept in the dark about anything;

  7. Check all medications including IVs that will be given to you. Don’t be afraid to ask questions about them. Know why they are being given to you, what each does, and the side effects. Inform about any medications you are allergic to. If you do not feel you are being properly medicated, make sure you discuss your concerns with your doctor/nurse. Don’t interrupt the nurse when they are preparing your medications. The more times you distract the nurse the greater the likelihood of error. If they are interrupted for any reason double-check the medication with them;     

  8. Above all, ask questions. An informed patient is a safer patient.

ABOUT APRA

American Patient Rights Association (APRA) is a nonprofit consumer organization of patients for fair, safe, affordable healthcare. APRA is helping people to protect themselves and their families from the 3rd leading cause of death - preventable medical errors - and the leading cause of bankruptcy - high medical bills. Join APRA today for free. For more information visit americanpatient.org.

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Copyright © American Patient Rights Association, Inc. 2020.

This guide may be freely copied, shared, transmitted and distributed in whole for non-commercial purposes only. All other rights reserved.