Welcome to the Light Keepers podcast. I'm Clayton
Vandiver, your Light Keeper, with the show dedicated
to everyone who wants to get the most quality
out of life that they can. We don't talk about
the end of life here. We focus mainly on the
quality of those days getting there. My co -host
as always, Charlene, our licensed clinical social
worker certified in the state of Florida, and
we invite you all to join us in this conversation
this week. about the typical hospital stay from
start to finish on this episode of the Light
Keepers podcast. Hey, before we start, I'd like
to invite you to please leave your questions
or comments below. And please join the conversation.
Questions this week will be answered during our
next show that appears online every Wednesday
evening at 7 p .m. Eastern. The Light Keepers
podcast is an exclusive production of A Guiding
Light Incorporated. We'll tell you more about
A Guiding Light at the end of the podcast. But
we don't have much time, so let's get right into
this week's conversation. Charlene, thank you
for joining us again. And what are the different
reasons that someone might wind up going to the
hospital? And how does that change how it all
begins for the patient, the process of their
hospital journey, their stay from start to finish?
So that affects everything. For example, if someone
walks in the doors to the emergency room versus
rolling in in an ambulance makes a big difference.
And what some people don't know, if they've been
super fortunate in life, is that when going to
the emergency room, obviously if you walk yourself
in, you're not that injured and most likely you're
going to be... treated and hopefully not hospitalized,
but if you have to be brought in by ambulance,
even with that, there are different levels. We
talked about different levels of care. There
are different levels of need when someone goes
to the hospital, whether they're a standard admission
or a trauma call. Oh, so the emergency room sort
of dictates the direction that some of your care
goes from the moment you walk in the door. Absolutely.
Absolutely. Because, you know, if you walk in,
then most likely you're going to be able to provide
them with your personal information. They're
going to have what they need. You're going to
be able to tell them your symptoms versus, for
example, if you were a trauma call. Even with
trauma calls, there are different levels. You
have your tier one, two and three traumas. And
depending on what level of trauma you are, you
may or may not be able to give them any information.
That's true. That's true. I see a note here that
sometimes the trauma call means you're not going
to be undressing yourself, whereas other times
that you go to the emergency room, you might
be asked to undress and get into the gown. That's
the other big difference. If you take yourself
to the emergency room, or if you come in by ambulance
but you're not a trauma call, you... pretty much
are able to interact with that visit. You're
able to kind of direct the show, so to speak.
If you come in as a trauma call, then odds are
the paramedics have cut off your clothing en
route to the hospital and hope you're not wearing
anything that was really valuable. And by the
way, this is why mom always tells you to have
on clean underwear because... I always wondered
about that. You may not be the one removing them
if you are taken in as a trauma call. That's
a good thought. Now, are there different levels
of trauma? Absolutely, absolutely. So a Tier
1 trauma call is basically if you have someone
with a life -threatening situation and there's
going to be an immediate need of severe intervention,
possibly even immediate surgery. So, for example,
some... Tier 1 trauma calls that I've been present
for is gunshot wounds to vital areas. If you
have an older person maybe taking blood thinners
that fell and sustained head trauma, this is
a potentially life -threatening situation. Of
course. So that's a Tier 1 trauma. A Tier 2 trauma
is less severe but still very serious. may require
surgery, maybe not immediately, but within a
few hours. This is someone who's going to need
a lot of intervention, but not necessarily life
-threatening. They might need to stabilize them
first. Exactly. Do some tests, perhaps run labs.
This would be a bad car accident where you have
someone who's really banged up. but not necessarily
life -threatening. A Tier 3 trauma is if you
have to be a trauma call, this is the one you
want to be because this is not life -threatening,
almost no risk of surgery. This is someone who
needs that immediate help, needs that urgent
attention, but they're most likely, barring something
severe happening, they're going to walk away
from it. Okay, so we find ourselves in the hospital.
Who are some of the team members that we're going
to be meeting? So if you walk yourself into the
emergency room or if a family member takes you,
you're going to be working with nurses, with
a physician, definitely. And depending on if
you need any specialty care, for example, if
you need x -rays done, there may be doctors that
see your chart and are involved in your care
you may never see. the technician that reads
those x -rays or reads the MRIs or the CAT scans.
There may be doctors that your doctor consults
with that you may never see. You may get a bill
for them, but you may never see them. So some
of the team you may never actually meet. Correct.
If you are going to need care when you leave
the hospital, then you're going to get to interact
with a case manager. These are usually social
workers or nurses who have additional training
in. setting up hospital discharges and coordinating
care for when you leave the hospital i was going
to ask what does a case manager do for you what
do they do for the hospital so last episode we
talked about different levels of care and if
someone is discharged needing rehab skilled nursing
care so your case manager is going to be the
one who helps coordinate that and set that up
for you they're also going to be the ones if
you need care at home so if you need home help
coming in home health care or if you need follow
-up wound care or anything like that in the home
or if you need equipment, they're going to be
the ones that are going to be setting that up
for you. Well, when do family members typically
get information from some of these players in
the hospital, some of these behind -the -scenes
folks, that you may never even meet? Will family
members get information from them? Hopefully.
So there again, this depends on how the hospital
admission starts. If you bring yourself to the
hospital or if you're alert when you come into
the hospital, the first thing that they're going
to ask you once they get past your medical history
and current situation is, who can we call? And
that's not just because they want you to. have
someone there with you, but that's also because
that's someone who can make decisions for you
if something happens and you're not able to make
them for yourself. That's a very good point.
And I've heard you tell me on many occasions
that it is best to have a family member or some
caregiver, someone that you trust with you in
the hospital at all times. Absolutely. Medical
professionals are wonderful people. you know,
speaking as a medical professional. But we're
also human and mistakes can happen, especially
if you have someone with an allergy. You know,
doctors, not to play into the stereotypes here,
but doctors don't always read charts. They don't
always have time to, especially if it's someone
needing urgent care. They're going to come in
and they're going to triage the situation, which
means they're going to treat it as it presents.
And if you have someone with an allergy, if you
have someone with a pre -existing situation that
the medical team needs to be aware of, you're
most likely going to be better off if you have
someone with you. The medical setting is no different
than any other setting where you have someone
who is vulnerable, and that is that it's always
best to have someone there to advocate for you
just in case. Well, that sort of plays into a
few weeks ago we were talking about DNR, do not
resuscitate, and how sometimes when in the heat
of the moment or if you're nonresponsive, there's
no one there to tell them that you have one.
They may not know. And you may get resuscitated.
Absolutely. The medical professional's first
and foremost thought is going to be to serve
and preserve. So they're going to treat and they're
going to do everything they can to keep someone
alive. Now, if that someone is maybe not wanting
that care, maybe they don't want to be kept alive,
maybe they're coming to the end of a long illness
and they don't want that to be prolonged, then...
there's no one there to tell that medical professional.
If they don't have time to read the chart, they're
not going to know that there may be documents
already in place talking about the level of care
that you want. Absolutely. Well, you know, I've
noticed that time seems to stand still when you're
in a hospital, in my experience. Whether you're
a visitor or a patient, have you had that happen?
Why does that happen? So, have you ever seen
a clock? In an emergency room? Come to think
of it, I haven't. A lot of emergency rooms don't
have clocks. And there's multiple reasons for
that. Sometimes it's just an oversight. You know,
the hospital didn't think to put one there. Maybe
they do have one and you just can't see it from
where you are in the room. Sure. Time does seem
to stand still in a hospital, and a lot of the
times that's because when someone is in the hospital,
it's a very stressful situation. Understandable.
Time passes differently when you're not having
fun. And a moment can seem to last a lifetime.
That is true. Now, as a counselor, what can be
done to sort of pass the time or to help that
situation? So if you are a family member that
is there with someone, you can pass that time
by being that moral support to them. Holding
a hand, saying words. Talking to them. And if
you have someone who is very sick, Talk to them
about what they're experiencing because if something
happens and they lose that ability to speak,
your information is going to be very valuable
to the medical team in helping to treat that
person. So if they're able to communicate to
you along the way. Save that information. Jot
that down. Take a notepad and a pen with you
and keep those notes for the doctors. And it's
always a good idea, no matter how old you are,
how healthy or not healthy you are, it's always
a good idea to have... either saved in a folder
that you can grab quickly and easily, or maybe
even saved on your electronic device, be it a
tablet or a phone, current list of medications,
current contact information for all of the medical
professionals that you're seeing, especially
any specialist, because what that's going to
do is that's going to make the hospital's job
a lot easier in pulling in all the information
they need to be able to treat the situation.
Absolutely. Well, when you're discharged from
the hospital, What happens at that point, or
is that something that since we're running a
little short of time, we ought to save for the
next show? That is something that we could cover
over several different shows. Let's save that
for the next one. Discharges are different depending
on how someone's discharging, what care they
need. Right, right. Well, thank you for that
great information about the hospital experience.
For a lot of folks who have never been to one,
or who have been to one in different situations
or just been the family member of someone, that's
important. That gives us some perspective to
understand what to expect and how to handle ourselves
once we're there. Absolutely. The most important
thing is to remember that despite what they may
believe, doctors are not gods, and the family
and the patient does have the right to know what's
going on. at all times absolutely absolutely
and i have an advocate there speaking on your
behalf absolutely Well, of course, this is all
a highly personal choice and no conversation
we have on the Light Keepers podcast. Should
ever take the place of your own medical care
team or other medical advisor, professional advisor,
who should always be consulted by you on your
own specific situational needs. It's always good
to be willing to talk about quality of life because
every single one of us will face some of these
issues someday, either not prepared at all. or
very well prepared indeed, from joining us right
here on the Light Keepers podcast each and every
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