Communication in the hospital: answering patients’ questions

change of shift report, walking rounds, communication in the hospitalYou complain that no one seems to know about your condition when you are in the hospital and that you can’t get answers. Miscommunication is the primary reason why medical errors occur and lead to medical malpractice. Here are some ways that staff can share information about you.

  • The nurse from the off going shift meets with the nurse on the oncoming shift. They walk together to each patient’s room. The oncoming nurse introduces himself or herself to the patient. The nurse who is completing her shift discusses:

    • the important events of the shift,
    • your condition and symptoms,
    • any calls that have not been returned by the physician,
    • important laboratory results, and
    • anything else that might affect your care for the next shift.

    This is called change of shift report. While it is occurring, the nursing assistants should be on the nursing unit answering call lights.

  • The nurse, physician, patient and family may make rounds together. What does this mean? The nurse and physician together go to the physician’s patients’ rooms. The nurse shares information with the physician, and they discuss your condition and the plans to move you along through your hospital stay. This close coordination and sharing of information can shorten your hospital stay by bringing to light any barriers to your discharge or transfer to another facility.
  • Your room has a white board on the wall. Physicians, nurses, patients and their family members can write messages to each other on the white board.
    Your nurse leaves notes for the physician on the front of your chart. This tried and true method is effective if the physician comes to see you soon every day and sees the note and your needs are not urgent.

What can you do as a patient to help enhance the flow of information?
1. Ask the nurse caring for you to tell the next nurse about a specific problem or request that you might have.
2. If your nursing unit staff make walking rounds at change of shift, be open about your needs. Be direct and tell the nurses about your concerns or symptoms.
3. If your room has a white board, write messages to your doctor or nurse so that it comes to their attention when they enter the room.
4. If your room does not have a white board, develop a list of questions for your doctor and bring out the list when you see him or her. Create a similar list for your nurse, and batch your questions. Nurses appreciate being asked 3 questions at one time than being asked 3 questions 10 minutes apart, therefore interrupting their care of another patient.
5. Ask your nurse to contact your physician if your question is urgent. If it is not urgent, ask your nurse to leave a note for your physician.
6. If your nurse gets nowhere with reaching your physician, use your hospital phone to call your physician’s office. This is usually effective in getting attention. It disrupts the protocol- the nurse is supposed to call the doctor, not the patient in the hospital.
7. Be firm in asking your questions and insisting on answers.
8. If you are a family member, use these techniques to get attention for your family member.

Patricia Iyer is a registered nurse who worked in hospitals for 35 years before she started AvoidMedicalErrors.com.

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