What to expect during a hospital stay

Host Amber Smith: Upstate Medical University in Syracuse, New York invites you to be "The Informed Patient" with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith. If you've never been hospitalized, you may not know what to expect. So today I'm talking with two people from the Office of the Patient Experience at Upstate University Hospital. Tina Passett and Karen Wentworth, welcome to "The Informed Patient."

Tina Passett: Thank you, Amber. Thank you for having us.

Karen Wentworth: Thank you, Amber. We're happy to be here today.

Host Amber Smith: Now it can be scary coming to the hospital, especially if you're the patient and you're sick or you're about to have surgery. I know everyone's situation is different, but I wanted to go over the basics of what to expect. As someone prepares for a hospital stay, what do they need to be thinking about packing and bringing with them? Karen, do you want to go first?

Karen Wentworth: Sure. So usually for a hospital stay, we provide toothbrush, toothpaste. We can give you shampoos and lotions, mouthwash. You're happy to bring your own. You can bring your own if you'd like. But we would provide those for you, if you forgot those items.

Host Amber Smith: What about clothing items? Should a person bring their own nightgown or slippers, robes, those sorts of things, Tina?

Tina Passett: They can bring their own slippers. And we actually recommend comfortable clothing, especially if they're on a rehab floor. But they really should avoid big blankets and that kind of thing.

Karen Wentworth: Any constricting pajamas probably wouldn't be ideal. Hospital gowns are made for a reason. In order for the care team to be able to access certain parts or areas of your body easily, or if you have injuries, it can be hard struggling out of pajamas to let them take a look. So we suggest that you try to wear the hospital gown if you can.

Host Amber Smith: What about things to pass the time -- magazines, knitting, electronic games. Should people anticipate that they'll have some down time? They could watch TV, I'm sure, but if they wanted to bring some things from home, is that advised?

Tina Passett: Yes, it's actually, and they're actually great gift ideas for our patients as well. So books and magazines, maybe some puzzles. We discourage, actually, our patients bringing in electronic devices. However, the hospital does provide iPads for entertainment purposes.

Karen Wentworth: And we know people need to bring their cell phones. However, we just want them to keep in mind that sometimes by accident they can get knocked off of tables. If they don't come in with a charger, we do have some chargers we can lend out, but obviously we don't have enough if everybody forgot their chargers.

We think you should keep jewelry home. All jewelry, including wedding rings, should be home. You certainly wouldn't want your wedding ring cut off your finger. It would be devastating if something were to happen. So please keep all of your jewelry home and any valuables that you have, including cash. You should not have to bring any cash into the hospital.

Host Amber Smith: I was going to ask about cash. So there's nothing you would buy -- a newspaper or magazine or something like that -- where you would need cash?

Karen Wentworth: Well, you, you do need cash for those things, but not... We've seen people bring in very large amounts of cash. So, I would rephrase that and say large amount of cash needs to stay home.

Host Amber Smith: Gotcha.

Karen Wentworth: But a few dollars, yes, for the gift shop would be fine.

Tina Passett: And in addition to cash staying at home, all medications should stay at home as well. The hospital does provide medications for all of our patients, so they don't need to bring their meds from home.

Host Amber Smith: So if I'm on prescriptions for whatever I'm on, you guys will medicate me with whatever I need during my stay?

Tina Passett: Correct.

Host Amber Smith: What about if I use a CPAP machine to sleep at night?

Tina Passett: We do have CPAP machines (for sleep apnea) to provide for our patients as well, so it's not needed to bring in their CPAP from home.

Karen Wentworth: Eyeglasses, dentures, hearing aids, canes, walkers, anything like that should come with you if possible, and should be labeled with your name and a phone number. In case it gets lost in the hospital, there's someone we can contact to get that right back to you.

Host Amber Smith: What about snacks? Is someone able to bring a favorite snack to have at the bedside?

Tina Passett: Absolutely they can bring in snacks. We actually do allow food from home as well. We do have pantries on all of our units, and as long as it's labeled with the patient's name and their room number, they're allowed to store it in our refrigerators for up to 24 hours.

Karen Wentworth: They can also have food delivered, if it's appropriate and according to their diet in the hospital. We do accept deliveries from restaurants. They're delivered to the visitor desk downstairs, and then one of the staff members will go down and get it for the patient.

Host Amber Smith: Are there special considerations for the pediatric patients coming in? Are they encouraged or allowed to bring a stuffed animal, for instance?

Tina Passett: Absolutely, they can bring in a stuffed animal. And we actually encourage parents, if they want to stay with their child, even overnight, they are allowed to do so.

Host Amber Smith: Well, I want to ask about the visitation policy, and I know that it was necessarily restricted during the pandemic, but in normal times, what are the rules? Can people who are hospitalized have visitors?

Tina Passett: The simple answer to that, Amber, is yes. And it is 24/7. There is no actually "visiting hours." We're open 24 hours a day, and they're welcome to come and visit any time within those 24 hours.

Karen Wentworth: The number of visitors is always limited by the available space. If it's an ICU (intensive care unit), there obviously can be fewer visitors. If it's a private room, there can be more visitors. It just depends, Amber, where they are in the hospital, but we certainly do our best to accommodate that.

Host Amber Smith: Is it ever okay for someone to sleep overnight in a patient's room with the patient?

Karen Wentworth: During normal times? Absolutely. Absolutely. Again, where space permits, staff will do all they can to accommodate a family member or a support person to stay overnight with the patient.

Host Amber Smith: Now, I know there's no smoking on campus, and even within 100 feet of the hospital. Are there alternatives for someone who's a smoker who has to come in and be hospitalized? What can you offer them?

Smoking as well as vaping are not allowed in the hospital, like you just stated. However the hospital can provide nicotine patches or nicotine inhalers, and / or gum to help patients with their cravings.

Host Amber Smith: So tell me what the rooms are like these days. What do they contain?

Tina Passett: Each room has a bed, of course. They also have a nightside table where patients can put a few of their belongings. They also are provided a bedside table to put some belongings on, as well. And that's usually where their meal trays are placed. We also have lockers in rooms so that they can put some personal belongings in those.

Many many, many of our rooms are private rooms. But in the north tower at the downtown campus, as well as particular floors at our community campus, do have floors that have semi-private rooms, meaning two patients in a room.

Host Amber Smith: What about television? Does every room have a television for every patient?

Karen Wentworth: It actually has a TV and a telephone. The telephones are free. The TVs do have a fee. And then most rooms do have iPads as well.

Host Amber Smith: What is the wifi situation in the hospital?

Tina Passett: Wifi is free, and it is available at both campuses.

Host Amber Smith: Well, let's talk about how meal service is handled. Do meals come at preset times, or do patients order their meals? How does that work?

Karen Wentworth: So meals are available from 7:00 AM to 8:00 PM daily. Each unit has a preset time when the meals are going to be delivered. There are printed menus available for the patients on every unit. Any food that's brought in from the outside that we discussed earlier, just needs to be labeled and could be put in the refrigerator for up to 24 hours on the unit. And again, we do accept deliveries from restaurants for patients, too, if appropriate.

Tina Passett: In addition to that, there are individuals that work here at Upstate. They're called catering associates. And the catering associates actually round on patients and take their orders for the day, actually for the next day, isn't it, Karen? I believe It's for the next day.

Karen Wentworth: Yes. For the next day, yes.

Host Amber Smith: So that person must be aware of the patients, if they're in the hospital for, obviously for a medical reason, they may have a restriction on what they can eat, right?

Tina Passett: Correct. If they're aware of whatever diet order has been placed for them.

Host Amber Smith: Are there foods that are always on the menu in case somebody just doesn't like the entrees that are being offered that day? What are the items that people can kind of always count on being able to obtain?

Tina Passett: For beverages, I would say coffee is always going to be on the menu, as well as our standard drinks like orange juice and milk and different types of juices. There are always salads.

Karen Wentworth: I think if people don't like the hot meal, they can always have a sandwich. We always do our best to accommodate our patients. If they don't like any hot foods, there are cold foods available. As you can probably understand, we can only do so much, but we do our best to accommodate them.

Host Amber Smith: Sure. If patients are hospitalized on a holy day, are religious services available in the hospital?

Karen Wentworth: Yes. The chapel in the hospital is always open, with weekly services. And spiritual care is on call 24/7.

Tina Passett: A patient only has to ask their nurse to have spiritual care services, and that nurse will reach out and have that provided for them.

Host Amber Smith: And the spiritual care provider would come to the patient's room, I'm assuming?

Tina Passett: To their bedside. Correct.

Host Amber Smith: What about interpreter services? What do you have available for patients who don't speak English, or maybe they're deaf? What sort of interpretation is available?

Karen Wentworth: A pretty large interpreter services department. And it is a patient right to be able to understand what is being said to them, especially with their care. So we have live interpreters that can sit at the bedside, if that's appropriate. We have video interpreters. Those are used a lot. That is a video stand that comes into the room, and a live person is called and speaks the language that the patient speaks and is able to talk back and forth to them. And then, Tina, we also have the Vocera badge as well -- Is that correct? -- Where they can call interpreter services?

Tina Passett: Yes, they can. They can request interpreter services through their Vocera (communication device.). And it is available 24 hours a day, seven days a week, 365 days a year. And we highly discourage families to be interpreters because they might not understand what treatment regimen is being prescribed to the patient as well. That's why we highly encourage to use the professionally trained interpretors.

Host Amber Smith: So even if a patient has, obviously, their family members with them, you still would advise to have an interpreter as well?

Tina Passett: Correct.

Karen Wentworth: Correct.

Host Amber Smith: You're listening to Upstate's "The Informed Patient" podcast. I'm your host, Amber Smith. And my guest are Tina Passett and Karen Wentworth from Upstate University Hospital's Office of the Patient Experience. We're talking about what to expect if you or someone you love is hospitalized.

I wonder if either of you has looked back historically at what hospital stays were like 50 years ago, 100 years ago, because I imagine things have changed quite a bit.

Tina Passett: Amber, things have changed drastically over the last 50 to 100 years. And just as a prime example, I'm not sure if you were aware, but hospitals 50 to 100 years ago actually were only located in cities. There weren't any in the suburbs. Hospitals were comprised of the poor. And patients actually went to hospitals to die. Patients were actually treated by providers in their homes. So if you had the wealth and the finances, doctors would come to your home to treat you. There was a lot of segregation back then, not only by ethnicity. So they separated patients by their ethnicity within the hospital, as well as their gender. There was no such thing as a private room. You were lucky if you had a curtain. They allowed smoking in the hospital, everywhere in the hospital. you were allowed to smoke in the waiting rooms. You were allowed to smoke in the ORs (operating rooms.) You could, you could smoke anywhere.

Karen Wentworth: Up until 45 years ago, they were no nurse practitioners or physicians assistants to offload all the patients the doctors had to see. So that was really a great thing that came to be in the hospital, helping out the physicians as well.

Tina Passett: Yeah. And surgeons actually performed surgical procedures in street clothes, and they just wore an apron. So things have changed a lot.

Host Amber Smith: Well, let's do this in reverse and kind of look ahead. Do you have some ideas for how hospital stays may change in the future?

Tina Passett: I do. And ironically enough, Amber, I have to tell you sometimes we really can be going back into the past and looking forward to the future, meaning we have a new program here at Upstate called Hospital at Home. So we're going right back to treating patients inside the home. Currently Upstate is only treating. We have about maybe one to three patients at a time that are being treated at home, but this program, we're foreshadowing it to really launch and get off it its feet within the next several months to a year. So we're kind of going back into the past in regards to treating people in their homes.

Host Amber Smith: Well, let's talk about what happens when a patient arrives to be admitted at the hospital. I know there's a parking garage. Is there a special parking rate for someone who's going to be parked there for several days?

Tina Passett: There is. Unfortunately Upstate doesn't own our parking garage. If we did, I don't think that we would charge. But currently patients and family members do have to pay for parking. And if they're going to be at our organization for an extended length of time, they are able to acquire an extended stay pass, and that would be for the week. And that's at a rate of $32 and 40 cents, I believe. And there is, I believe, a $10 deposit for the access card.

Host Amber Smith: So when someone comes to check in, do they come alone or do they need to have a family member with them when they come to check into the hospital?

Tina Passett: They can have either. Patients do come by themselves, but most often they are accompanied by a loved one.

So I'm assuming they would need identification, probably their insurance cards, anything else? Along with what you had said, in addition, they should probably bring any advanced directives.

Karen Wentworth: A driver's license, social security card, just for identification purposes.

Host Amber Smith: And if they don't have advanced directives? I mean, this may be the first time they hear about that. How do you handle that?

Tina Passett: Patients receive a folder, kind of like if you went to a hotel. Everything that encompasses what your hospital stay is going to be like, contact information. In that folder, they also have a healthcare proxy form that staff can help them fill out if they don't have one.

Karen Wentworth: They can also discuss it with their physician, as well, in the hospital. And they are very happy to help them make a decision.

Host Amber Smith: Now, what happens if a patient has a problem during their stay? Do they contact your office?

Tina Passett: Actually, no. They can, but we encourage if they have any major concerns or complaints about their treatment, or anything, if they have anything that they really want to file a grievance with, we encourage them to contact Patient Relations. It's funny that you asked us that because we're asked all the time. Patient Relations is different from our office, but they are like our sister, a sister department to us. We work very close with one another.

Karen Wentworth: It's important that they know, because patient relations tracks all of the complaints. And if they see trends, then that's where we find out we need to make improvements. That's one of the ways we can find out, so very important that they contact them.

Host Amber Smith: We've talked a lot about people who know ahead of time and can plan that they're coming to the hospital, but I'd like to shift to the emergencies, because I know a lot of people are admitted through the emergency department. They weren't planning to be injured or ill that day. How is the hospital experience different for them?

Tina Passett: I would say the biggest difference between an inpatient that had planned to stay versus an emergency room patient that did not expect to be in our organization for that day, the biggest difference between those two patients is anxiety. Every patient that we have has anxiety because no one wants to be in the hospital, but that person coming in through the emergency room, their suffering is a lot greater when it comes to their emotional well-being. That, I would say, is the biggest difference.

Host Amber Smith: They may arrive with all their valuables with them, their jewelry and that sort of thing. Is there a safe to put that stuff and lock it up?

Tina Passett: I think the first thing our staff do is hand over most valuables to a family member. Get it out of the hospital, get it back home, get it in the right hands. But those valuables that the patient does want to keep on them, we have a safe for valuables that are worth a lot of money, right? But the number one thing is, we try to get it back into a family member's hands and get it out of the hospital.

Host Amber Smith: What happens when someone arrives without identification, maybe they're unconscious. What do you do to figure out who they are and notify family?

Tina Passett: Well, the first thing is they are put into our electronic healthcare system as an alias, and a social worker works very hard to find the next of kin to identify that patient.

Karen Wentworth: We just wanna let families know that when they come into the hospital, knowing that patient is there and they're still an alias, they need to be patient, because a lot of times they'll come to the front desk knowing that person's here and we can't tell them that person's here, technically. So we understand the stress and the anxiety in that moment. And we just ask family members to hang on until the appropriate process could be followed. And then once that happens, we will reunite them with their family member.

Host Amber Smith: And obviously the care happens when they arrive. They don't wait to take care of the person until they identify them. They're taking care of this person and doing what needs to be done long before they know who it is, perhaps.

Tina Passett: That's correct, Amber.

Host Amber Smith: Well, before we wrap up, I'd like for you to give us some advice about what we can do to help a friend or family member who's hospitalized. What are some things that would be helpful?

Tina Passett: I would say listening to that patient, maybe calling that patient and trying to pass the time, having that patient vent any stresses or concerns or worries that they have, and just being there for them emotionally.

Karen Wentworth: A lot of patients who are alone, and sometimes people don't want to come and visit because they feel funny about it. But we really encourage people to come when they're able to. Please come and visit. You're more than welcome here. And the patient, actually, it contributes to their wellness and helps them get better sooner.

Host Amber Smith: And I know you said it's available 24 hours a day. Is there a better or worse time? Should people avoid meal times for instance? Or does that matter?

Tina Passett: I don't think avoiding meal times is the biggest time to not come. I think that the time when too many people could be in the room -- let's put it that way -- is first thing in the morning, like 8, 9, 10, 11, those morning hours. Those first two to four hours nurses are really struggling to get their assessments in, figure out a plan for the day, making sure that tests and procedures are ordered for that day, passing out medications, bathing patients. A lot of activity is happening between, I would say, 8 and 11 in the morning. So after 11, I would highly encourage visitors to come.

Karen Wentworth: Patient centered care is very important to us here at Upstate. And a lot of times, the families do come in after the attendings have rounded with their team. We encourage them to ask the bedside nurse to see if one of the members can come back. They always have questions. We're happy to answer them. And we certainly want to be available so the family's included in the care plan with the patient.

Host Amber Smith: What sorts of things have you seen that make great gifts for someone who's going to be hospitalized for a prolonged stay?

Tina Passett: Amber, I think many individuals in our community think it's flowers. Flowers is not the answer. Flowers are difficult when patients are discharged to get those flowers back home with that patient. I think the biggest gift ideas are, like we had talked about earlier: magazines, books, puzzles, using the iPad, really anything to entertain and pass the time for patients, but not flowers. Even though our patients do receive flowers, and it's OK if they absolutely want to give flowers, but we discourage flowers being given.

Karen Wentworth: No latex balloons, for obvious reasons, for allergies. But we have mylar balloons in the gift shop here. We have a great gift shop. And you can also send mylar balloons in to the patient. We just, cannot accept latex.

Host Amber Smith: Gotcha. Well, this has been very informative and I want to thank both of you for making time for this.

Karen Wentworth: Thank you.

Tina Passett: Thank you for having us, Amber.

Host Amber Smith: My guests have been Tina Passett and Karen Wentworth, both from the Office of the Patient Experience at Upstate University Hospital. "The Informed Patient" is a podcast covering health, science and medicine, brought to you by Upstate Medical University in Syracuse, New York, and produced by Jim Howe. Find our archive of previous episodes at upstate.edu/informed. This is your host, Amber Smith thanking you for listening.