May 15, 2025 • 47 mins
Ever found yourself in a hospital room Googling “all the medical mumbo jumbo that you just heard from five different people in white coats? Or maybe you’ve sat there silently, praying someone would just translate what's happening to your mom or spouse? You're not alone. Hospitals can be overwhelming AF.
When our loved ones get admitted, we’re handed forms, not answers. We're expected to trust the process, even when our gut says something’s off. And let’s be honest—half the time you don’t know who’s in charge, what your rights are, or how to get your questions answered without being labeled “that family member.”
That’s why I’m happy to have Dr. Julie Siemers—nurse, educator, and medical truth-teller with 40 years of experience on the Fit Girl Magic podcast to teach you Hospital Survival 101. She’s pulling back the curtain (and yep, throwing a little polite sass at the system).
You’ll learn how to advocate for your loved ones, speak the secret hospital language, and not be dismissed like a confused extra on Grey’s Anatomy.
Grab your notebook, open your Notes app, or just hit play and soak this in—because this episode might literally save a life.
Hit play now and let’s get into it.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:02):
Ah, magic makers. Great show on hand for you today.
Think about this. How many of you have ever been in the er,
a hospital, and you're googling. You know, why your kids won't take meds, why
your mom won't take meds, how long will it take for your dad to be
in rehab? What does rehab really mean? This episode is for
you. I have Dr. Julie Siemers here and
(00:24):
she has been a nurse for over 40 years. And we are going to spill
some gossip here about what it takes to advocate for
yourself and your loved ones when they are in the hospital. I know
personally, my mother in law was in the hospital and there was like 20 people
that came in the room and you're like, who do I listen to? Who should
I care about? And it's really hard to discern what's going on when they're throwing
all these terms at you. So buckle up ladies, you're going to get a crash
(00:46):
course in Hospital Survival 101. Julie,
welcome to the show. Thank you, thank you for having me.
You know, I love that, you know, here you are a medical professional
and you realize that us non medical professionals
were in, you know, most times you get that call
and you're already in a heightened state of like, holy crap.
(01:09):
And then you're, the doctors are just throwing all these terms and words at
you and you're just like trying to just process it all. You know, what
was it that made you say, you know what? I really need to start educating
people on how to like navigate, navigate this stuff.
You know, being as you said, in the healthcare system for a long time and
dealing with patients, families and patients themselves and really
(01:30):
seeing firsthand how complex it is,
how frustrating is, as you said, especially on those states of high
anxiety when you've maybe got a diagnosis you weren't
expecting or maybe you just came, you know, had a traumatic
accident and you're in the hospital. Nobody ever plans to be in the hospital.
But I think it went deeper than that for me when I started
(01:53):
my master's program in 2009.
And my thesis that I chose was patient
harm because when it came across my radar as
I was teaching students and sharing stories, because I think that's how
people learn is through other people's experiences and
stories and realized how many harm
(02:14):
incidents happened in a place where we
all expect to get healed and improve our health rather
than have harm occur. So that's kind of where the idea
expanded into, we need to do something about
this. Right? No. And, and it's interesting
how Once you kind of like peel back one layer, it becomes an
(02:37):
onion. And you like, you didn't realize how many layers were in that particular
onion. Oh yes, very true.
So let's just start like someone is in the hospital. Like, what
is the like, obvious mistake that, you know, most of us,
you know, make when people are admitted into the hospital?
I'll start with saying it is better to
(03:00):
become informed and educated before you find
yourself going to the hospital. And I know your show, your
audience and your guests you've had on here is how to stay
healthy. Right. Advocate for ourselves. And that is the best
thing that you can do. But if you find yourself in this situation,
because face it, we're all probably going to be a patient someday or
(03:23):
our family members are going to be a patient someday. So it really
is learn the fundamentals 101. So the first
thing I would say is, because healthcare acquired
infections kill so many
people or really impact their lives in
a harmful way, the first thing is to just make sure
(03:45):
everybody that comes in the room that is going to touch the patient, that they
must wash their hands. And so you'll have to find your
voice. Because we're a culture that aren't used to
speaking up or speaking out. Right. And so I
think understanding the consequences if you
don't say something like, please, Dr. Smith, would you wash
(04:07):
your hands before you examine my mother? Right. That should
be expected. We as nurses learn it, healthcare
professionals learn it in 101Fundamentals. And we
know it's in the literature that healthcare acquired infections still
are around and growing. So that would be, I guess, my
first tip or two. Right? I like that. You know, it's interesting
(04:30):
because I did notice that, you know, every
time, you know, a person comes in the room, there's an
immediate sanitation, you know, the. And it's visible.
Right. So it's not like this hidden thing that you, you don't see.
Like they, you know, wasn't, I don't think they made it as obvious, but
it was obvious that they're so and so or doctor so and so
(04:52):
was sanitizing before they actually
touched you. And what I also liked about what you said is being an
advocate because I feel that most times you see that person with the white
coat, the stethoscope, and you're like, Dr. So and
so knows and you just abdicate your power.
Yes, that is so dangerous.
(05:14):
And I'll say that because again, I'm not trying to throw any
profession or any person under the bus, so to speak, but
really, in this 15 years of
investigating this topic and learning, as you said, when I peel back the onion
and learn more and more, I'm like, oh, my goodness, I had no
idea. And so really, the
(05:35):
awareness is my main mission. Make
everybody aware and then inform and educate. And I
say that because you do have so much more power than
you think. And collectively, if
we as patients, family members, speak up,
then the healthcare profession is going to expect it and they
(05:58):
should. We should be working together as a team.
That was my TEDx talk that I gave, and it came out a couple, three
weeks ago, was on the. The
breakdown in communication is responsible
for 70% of patient harm events. And that's between
the health care team themselves or patients and their families
(06:21):
and the healthcare team. So it really is a
team approach, and we may have to socialize this
to the health care profession. Yeah, no, you're absolutely
right. And the other thing I, I know, I noticed was you
say it's a team, but it's really hard to understand the pecking order. Right.
Because it's like everyone comes in and they throw all these, like, literature. And I'm
(06:43):
like, I watch Grey's Anatomy for pleasure. I am not taking note
of the hierarchies. Yes.
And so it's really challenging when, like, they're like, oh, they'll talk, they'll say
team. And I'm like, okay. But at some point, someone's the captain. Who is the
captain? Who am I listening to? Because a lot of people will defer,
like, oh, yeah, yeah, you know, I'm just a nurse.
(07:06):
Or, you know, I'm just the, you know, intern. And you're like, well,
making decisions, Right?
That's a really good question. So when we're talking about, if you're
in the room and you're concerned about your mother, you're obviously going to go to
the nurse that's taking care of. Your mother because they come in all the time.
Right. If you don't get resolution there, then you
(07:28):
can escalate that to the charge nurse on the unit. And if you don't
get help or somebody to start intervening or taking
action, you need to ask for the house supervisor.
They're 24 7. And you can take it one step further.
If you don't get resolution from the house supervisor, is the
administrator on call? Okay. They're also supposed to be
(07:50):
24 7. Holidays, nights, weekends, it doesn't matter.
So finding your voice and using it to
escalate, you know, the help that you need or that your mom
needs is so important because.
And if you can bring someone with you or have your family with you
at all times because they're an extra set of ears,
(08:13):
eyes, the family knows the patient better than
anybody. And you can notice those subtle changes,
those nuances. Then a nurse and a doctor that bop in and out of
your room. Right. They're not going to notice. But those are early.
Can be early indications of the beginning of patient
deterioration. Right? Right. So neurological
(08:34):
changes, respiratory rate is escalating and staying
up there, the heart rate. A lot of these rooms have monitors in there.
Now those are clues that we can actually communicate and say, hey,
something's going on here, something needs to check. Right?
Yeah, you're right. Because it's like, you know, when someone's in the hospital, you're
just sitting there, you're, and you're, you're, you're, you might be noticing, you know,
(08:56):
you're, you know how your parent, your kid
normally is. So there might be a random thing that a nurse who
just comes in every 20 minutes might not notice. Right?
Yeah. And those are important things because again,
the literature tells us that before an
unplanned cardiac arrest, so a patient declining,
(09:18):
deteriorating, those physiological
changes happen 6 to 24 hours prior
to an unplanned cardiac arrest. So let's
just say dad had surgery. Two hours later,
he's got more pain. The pain medication
really isn't working. Now we're watching his heart rate go up over the next
(09:41):
couple of hours. And now we're watching his belly distend. If he had
a abdominal surgery, we're looking, he's looking pale now,
maybe now a little sweaty. You know, those are really
clues that something serious is going on. And
that's where we need to intervene and say, hey, somebody needs to do something. Something's
not right. Right. Because especially after like a surgery, you know, before
(10:03):
you have the surgery, they give you the list of all the possibilities. And
so as the patient, as someone who's had surgery, as patients, you're kind of like,
is this just from the surgery or is this something new?
So you're like, you are, you, you're like, you're so like, aware
of, like maybe this is a side effect that they didn't mention.
Yeah, yeah, you're right. I mean, one of the most common complications
(10:25):
after surgery is bleeding. And so that's something that we need to watch
for as nurses, of course. But family members too can
help. Blood clots are another really common
thing after surgery. And there is preventions that can
stop that. And then post operative pneumonia
is Pretty common, too. So there is. I write about those things in my
(10:47):
book, you know, for families. How can you help your family
member recover fast and healthy?
Just looking at those things that you wouldn't have known about until
you're specifically looking. Right, right. So let's just.
Let's just start. You know, your family member is in the hospital.
Do I have a right to know? And they're
(11:09):
an adult. So even an adult child or your parent.
Do I have a right to know what's going on with them? Yes, you
do. Yes, you do. So
there's sometimes. Well, it's only the spouse. You know,
I think that's the. The pecking order, as you called it earlier, you know,
and adult children, definitely. I would
(11:32):
absolutely do a durable power of attorney before I go into the
hospital, especially if it's planned like a surgery or something, like,
just so that your bases are covered. Okay, that's what I would recommend.
Yeah. And so that way legal. So, like, if we don't have
that, if, you know, my loved one is in the hospital and can I
say, Dr. Julie, what's wrong with dad? Yeah.
(11:54):
They should tell you. There should not be secrets about that because again,
we're supposed to be on the same team. Right, Right. So, you know, so there's
no HIPAA things that they can't say what's wrong with
him. There shouldn't be. Okay.
Again, it's. You might have different situations
with different hospital personnel at different hospitals. Right. But
(12:17):
I think that really is. If you can get
that sewn up or. Or dialed in before
you go. Yes. You say, I have the right to my. You
know, if your mom or dad is awake, they can give verbal
permission, but it's when they become maybe unconscious or, you know,
in the ICU or something might. Right. Positive problem.
(12:40):
So they have the right to tell you, you know, dad had a heart attack
or whatever. At what point does it become,
I, you know, I'm bound by this hippo, that I can't tell you
certain things. You know, it is
usually on the phone they say, I can't tell you that because obviously they
don't know who you are. But if you're there in person and you've
(13:01):
established that they're a family member, then there should
be no reason that there's a HIPAA problem.
Gotcha. But I'll give you. Even before you
go to the hospital, and this is in my book, too, because I think it's
such an important step. Choose the best
hospital in your area to go to. So there
(13:22):
is a website, it's called hospital
safetygrade.org and you
can go on there, put your zip code in and see the two or three
or five or ten hospitals in your area. They are rated A
through F, just like high school grades or
college grades. And it's based on 22
(13:43):
categories and subcategories of patient safety.
So if I personally would never go to a D
or F rated hospital, their safety is so bad that
your chances of harm or even dying are
about 91% higher than if you went to an A rated hospital.
So I would choose definitely an A or B. And then
(14:06):
I would go in and look specifically at the hospital that I'm choosing
and see those various categories and they're red,
yellow, green, for example, hospital acquired infections,
mrsa, Clostridium difficile. You can see
in there how if they're in the red zone, I'd be like, well, what are
you guys doing? Because you're doing really crummy, you know, in that
(14:28):
area. And then if I'm having surgery, I'm going
to ask the surgeon specifically. I see that the
hospital you want to do surgery on me doesn't do very
well with post operative blood clots. So what are you
going to do to help make sure my mom doesn't get a blood clot
after her abdominal surgery. Right, right. That's when
(14:51):
you become informed and educated. You can ask those really important
questions and be a team member to help keep them
safe. Gotcha. And at any point, you know,
is there like a, like an
overall patient bill of rights, like either
hospital or is it a federal thing, a state
(15:13):
thing? Every hospital has one.
And they're actually based off. It's not a federal
thing, although it should be, but it's based off the
Affordable Care act as well as some of the
guidelines with center for Medicaid and Medicare services,
etc. But overall, I've seen the
(15:34):
same ones written in many different places. So very
similar. But you have the right to information that you
understand. So as you were saying when we first started talking,
they come in the room and they speak this medical jargon that you have no
idea. What did they just say and what does it
mean? So I would stop that nurse or physician and say,
(15:56):
can you please explain what congestive heart failure is? Can you
explain what a diuretic is? Can you explain everything they just told
you? Can you explain, you know, what is the plan
of care here? What are we looking for to know that mom
is improving with this plan of care? Right.
And you're right. And again, you know, it's the questioning,
(16:18):
like, oh, you shouldn't question the person in the white suit. And we
are like, maybe you should, because, like, you know, Dr. Google can only take you.
But so far. Right. Well. And,
you know, the thing is, some of them may disagree with each other. Yeah.
So this is where I think one of the most important things as family
members, too, or even patients, is taking notes. Yes.
(16:41):
Yes. I, I stress that to my, My,
my clients all the time, especially going to a doctor. Like, you know, you have
five minutes with them before they're like, okay, see you next year. And I
was like, don't expect that you're going to remember. Like, if you have something weird
happening, start writing all of that stuff down so that you can. It
looks like you're. You're sitting there with a notepad and you're like, I'm not leaving
(17:03):
until these questions are answered. Yes. Yeah.
And in the hospital, sometimes you'll have a cardiologist and a
nephrologist and an internist. And again,
we talked about communication breakdowns many times. They miss
talking to each other and they may give conflicting. And
so then again, that's where you come in and say, but this doctor said
(17:25):
this. What do we really want to do here? What's the best thing for
mom? And the other thing, medicine changes. Medical
information changes. I think that it, it
doubles every three years. And that might not even be the latest
statistic, but in that case, if your doctor went to Medical
School 15 years ago, yes, he's got great experience now,
(17:47):
but is he or she up to date on.
Yeah, exactly. And you know what? Honestly, they
may not have time to go research. And so I
say you're in charge of your body. You get to
decide what is done to your body. And that's where you need
to be informed and educated. And I like that.
(18:09):
And, you know, as you said, maybe there is a doctor or a nurse that
you don't feel comfortable with. Can I be like, hey, you know, great
guy, but not for me. Can you request another doctor?
Yes. That is your right. Second
opinions are also your right. And if your physician gets
upset about that, that's the wrong physician. Yes.
(18:31):
Well, you know, and it's funny because I. It's not that
I'm. You're like, I have to make a decision,
and you, you give me something that, like, especially if it's hard news,
like, you've given me hard news. And I'm like, I'm already trying to
accept whatever it is that you said, maybe there's someone else who, like
you said, went to school 15 years later and knows a different path.
(18:54):
Right. I'll also. I'll give you an example of
why you should always get a second opinion. I wrote, I do a lot of
social media just to inform and to educate. And it
was probably about a month ago it came out a story in the news of
a man who had been getting chemotherapy for 11 years and found
out he never had cancer. Oh, good
(19:14):
Lord. I know. And then it blew up into this whole
thing. It was a doctor in Montana who had been
doing that to multiple patients. And so
you can't just take their word and on
trust. It's not where we're not assuming ill
intent, but we have to just cross our own T's and
(19:36):
dot our own eyes just to protect
ourselves. Because, yeah, he's one in a few
that really, truly intended harm.
But, you know, there's many other cases where they just
don't know or they just didn't understand
or I'll tell you, another one is to
(19:58):
make sure all of your results, your lab results,
your CAT scan results, your mammogram results that you
actually see the report. Yes. Get it. You
know, it's in your medical record. You need to look. If it's electronic, make sure
and look in there. You can't assume just because you don't hear
anything from the doctor. Oh, it must be fine. There's another
(20:21):
story in my book of a young. He was a
42, I believe, had a children,
had a brain tumor. But they told him and his wife after
surgery. Oh, don't worry, it looked benign. So when
they didn't hear anything, they assumed it
was. Yeah. Well, unfortunately, six months later, he's got
(20:43):
the headaches are back. They do another CAT scan, they find that the
tumor is now huge. And then they find
the misfiled pathology report
that said, yeah, he did have cancer six months ago.
So now by the time they're treating it, it was too late and he didn't
survive. Yeah. You know, it's interesting because
(21:04):
it's really easy to fall through the cracks. And, you
know, it's through no malice. It just really, like you
said, a misfiling. Like his first name. Like someone wrote a P,
it looked like a B. So it could easily have been done.
Yeah. Or just, you know, pure. Like it
got stuck to something and landed in the wrong. Landed in the
(21:27):
wrong pile. Which, you know, it's unfortunate, but at the end of the day, we're
all human and so Right. You
know, but it is always like that, that follow up where you're right because like
sometimes you're like ah, I didn't hear anything so I guess I'm good. But yeah,
you know, now everything is electronic so it's really easy for you to do in
like a few keystrokes. Follow up and be like, hey, you
(21:48):
know, I don't know if I got the letter and look inside and see
what's. Yeah. What's going on now? Oops, sorry,
go first. I was just gonna say you made a really good point. Yes, it
is humans that make errors, but it's the
system that allows the errors and that's where we need to
close the gaps. Yeah. Because. And again that's why we need
(22:10):
transparency in healthcare. But unfortunately,
80% of lawsuits that are filed the hospitals
require an NDA, a non disclosure agreement. Which
means we're not going to learn. No. Oh, it's not going to be a.
CNN that the guy for 11 years was getting bad chemo
treatments. And you know, and I,
(22:32):
I understand it to some extent because also then it makes you afraid of everything.
But I also think that if I
have, if you know, this person has been out
there, you don't know how, how good his records were. So like
maybe there's someone who is still being treated out there that you
know, there they, they keep doing the scans and like, well
(22:54):
like there's still something weird here and not really knowing what, what's going
on. Yep, exactly. But
yeah, I, I think at some point, which will probably never change because you know,
you have to cover your own ass all the time.
One of the big things I see, especially with my, my clients
(23:14):
aging parents getting discharged from the hospital. So mom and
dad have been there and you know, I know personally
that when my mother in law was in the hospital was during
the winter and they're like she's 90 years old, you want her the
hell out of here because of, you know, Covid
pneumonia, any possible thing that you talked about, you know, hospital
(23:37):
borne illness. So you know, are they really pushing people
out the door before it's safe for them to leave?
Yes, they are in many places.
You know, that's the response I was expecting. I'm
sorry. Oh, I, I love it. I love the brutal honesty.
I love it. You know, long gone are the
(24:00):
days that physicians
could make those decisions. Now they're being
overridden by not just healthcare
insurance companies, but AI technology. Right.
I just wrote about that the other day because it came across my feed like
three different Times in the news lately of now there's
(24:21):
lawsuits because of patients dying because they left the hospital
too soon, despite the physician saying they needed longer
in a post acute care. But these insurance companies are denying
based on AI algorithm, which I love
AI. I mean, it's fantastic. There's a lot of great stuff with it, but we've
got to use it judicially and it should not override a
(24:43):
physician's medical training and experience. Right.
If, if Sharon can't stand up, then Sharon shouldn't leave.
Like, you know, there's a, you know, the couple
surgeries that I've had, there's been like three things that I had to be able
to do on my own in order to be able to leave the hospital. Like
AI is not going to know. It's going to say, oh, well, you know, she's
(25:03):
a X number age person, you know, these. No, no
comorbidities. She should be able to leave in 20 minutes.
But it's like if I can't stand up, I can't go to the bathroom on
my own. Like I should stay till that's all rectified.
Yes. Even something as simple
as there was a woman who was in the
(25:25):
hospital for heart dysrhythmias and they were trying to regulate her
medications. Well, she was discharged with a
heart rate of 127. Normal heart rate for
adult is 60 to 100, and usually it's
around 60 to 80. Well, when your
heart is beating that fast, the ventricle doesn't fill as properly
(25:46):
as it should, so the amount of oxygen getting to your brain,
getting to your vital organs has decreased. She fell
in her driveway on the way home or trying
to go home. Had to go back because now she had a
vertebrae fracture from falling in her driveway. There's
nobody that should be discharged with abnormal vital signs. So it's
(26:08):
even that simple. That could be that catastrophic.
Right, Right. Because you don't even know, like if, if your, your heart
rate is double what it should be. Is it a medication
issue? You know, is it some other complication that's starting to like,
rear its head and if, God forbid, she lives
alone. Right. Yeah. It's so scary. It
(26:30):
truly is. And that, that's why I say the more you can learn
about your body, how it functions and your family and know
what's normal and use that voice to say, no, I'm
sorry, Mom is not going home. Right.
Well, especially, you know, I, one of my good friends, her mom
broke her hip and so she's like, you know,
(26:52):
go and be down and out for a good eight weeks. And she's like, look,
she goes, I have stairs. I have this. I have this. She's like, we need
to work through options because she, you know, like you told me, she can't be
here by yourself. And so she's. He's like, she goes, what am I supposed to
do? And, you know,
for a lot of people, you're in a rock and hard place because, you know,
(27:12):
fortunately, she lives in the same state, but how many kids live
thousands of miles away from their. Their parents?
Yeah, it's tough. It's hard to be alone in healthcare these days. I don't
recommend it. No, it is very hard to be alone in health
care. And so as we're talking about that, you know, you, you kind
of hit on that. There should be some type of power
(27:35):
of attorney before, you know, anything happens.
At what age should you have this medical power
of attorney? I get it now. No matter what
age you are. Only because we just never know what's going to happen.
Gotcha. You know, and again, I'm not trying to be pessimistic. I'm a really
optimistic girl, but we just never know what's going to
(27:57):
happen. So just have it on file with your family, your
kid, your parents, so that everybody's covered
just in case. It's always better to be proactive rather
than, oh, dear, what do we do now? And so, so the
question I have with a power of attorney so that, you know, one of the
things that I've heard is that, you know, your kid goes off to
(28:19):
college, and so, you know, they're in another state,
you're in another state that, you know, just the whole medical treatment, pieces
of like, you know, if they're asleep, if they're, you know, they're unconscious,
you know, can you still make decisions without that
piece of paper? Yes, it would depend on the state,
the child's age. I mean, there's probably factors there,
(28:41):
but I think it really is your only
safeguard just to say that I have it and it's simple. You can
download it off the Internet on a free form, you know, website or
whatever, and just get it notarized. You'll be good. Well, you know, it's funny because
I think as a parent, you. You're like, Stevie, he's 18. Like,
what's the big thing? And you're just like, that's an adult. Yeah,
(29:03):
yeah. There was a young man a couple weeks
ago who, it was actually in December, but his parents filed a
lawsuit who takes an Asthma inhaler
every single day for most of his Life. He was 22.
His insurance coverage, he was paying
$66 out of pocket. It jumped in January
(29:25):
to $569 and he couldn't afford it.
And three days later he was dead. He had an asthma attack
that could not be reversed or saved quick
enough. So even as an adult child, you still
may be in that situation where you still need your parents
or you know, your family member to be
(29:49):
able to make decisions for you. Yeah,
whenever I hear those stories, I'm like, you know there's a human attached to that,
right? Yes, yes. That's every time something
happens like this, it's somebody's mother, father, sister,
brother, everyone, you know, and I just, when the
decisions are being made, like with these pharmacy benefit
(30:11):
managers to raise medication prices
like that, I'm like, do you understand the harm that you're
doing potentially? I mean, there's so many people
now that can't afford their medications. Right. And I shouldn't have to
choose. No, that's a travesty to me.
Yeah, it is a complete travesty. Especially because you're like, you know, I do a
(30:33):
lot of work with biomedical companies and I'm like, I get the first few
years it's caught, it takes millions. I, I understand that,
but at some point, why did it go from $66
to 500? Did you come up with some space age polymer that you put inside
of it now? Like, you know, give me a justification for why it's
new and improved, that it has to, you know, over quadruple
(30:55):
in price. Well, from all the
news that I've been reading on that they pharmacy benefit
managers made an excess of $7.4
billion in the last five years. That's crazy. It's just
greed. Greed and corruption. Complete, I'm sorry to say.
No, it is because especially when you look at other countries that, you know,
(31:17):
half the drugs that we pay oodles for, you
know, they're like, oh, you could get that at cvs. Like so it's really,
yeah. Crazy about that. So we have the power
attorney. But there are also times that there might be need
for a other people to be involved. So
like maybe it's you're a grandparent, so maybe.
(31:40):
And the parenting capacity, so there might be children
involved, you know, are there like other services that you
can kind of that or might be thrown upon
you? Yeah, I would just
consult an attorney, honestly, just to say, given
the wild and wacky world of what ifs, how can
(32:01):
we Best make sure that our family has the right
documentation so that we have the rights to help our family
member if they're incapacitated. Right. That's the
best way to go about it. Perfect, perfect. And so now, you
know, we're going back to the, the discharge, you know, how do I know that,
you know, they're like going back to my friend's mom,
(32:24):
you know, she had to be the pusher to get her into a
rehab facility. So how do you know if
it's a nursing home, a rehab facility, or they're just being pushed out
too soon? The caseworkers should be able to do that. The
case managers at the hospital, they have a specific
role that, that is what they're supposed to do is assess what
(32:47):
the functionality is of the patient and then determine
which facility is best suited for. You
know, most of it's probably rehab unless it's going to be super
long term care. But like, yes, a broken hip definitely would
be a rehab place. They should be taking
care of all that. Again, the family member may have to
(33:09):
say, you know, put their foot down. Say, I can't take her home, I've got
stairs. Right. You know, there's nowhere for her to be.
Understand the situation and then say, help me understand why
you think this is a good idea. Yeah, exactly.
And you're like, and if you think it's a good idea, what's your living situation
(33:29):
look like? Exactly.
So now if I know that I'm going to the
hospital, you know, is there anything that I should
prepare, you know, other than having make sure the power of attorney is there,
is there anything should I prepare to bring with me to the hospital just to
make sure that I have it other than my own pajamas?
(33:51):
They won't even let you wear those. Yeah. I do
have a free patient safety checklist that I can send you
and you can attach in the show notes for your listeners. But I would
say your list of medications, usually they won't let
you take your own medications there, but if they know what you're on
already is probably
(34:13):
about all you're going to be able to. I'd leave everything else at home. Your
watch, your rings, your jewelry, obviously bring your phone so you can communicate with your
family members. Yeah, right. So just basically bring
yourself
and is there
like, you know, for someone listening, like what's like, you know, one piece of
(34:36):
advice that like you would give. To everyone,
the two I like to share is the three Ps. So
be present, be polite
and be persistent. So be
present when the Nurses are making rounds or giving shift report, you
know, during change or when the doctors are making rounds, if you
(34:58):
can. But to me, it also means be present in your heart,
have good intentions, and assume that you're going to work
well together with the team. And then be polite, even though
it's hard sometimes when you're really frustrated.
I know most facilities are understaffed with nurses,
and so they're probably running around like crazy. And so just being
(35:20):
polite. Hey, you know, I've asked three times, my dad needs his
pain medication. How can we make that happen? I know you're
busy. And then be persistent. If you
are concerned about something and you're not getting intervention
or action or resolution like we talked about before.
But the cuss words, not what you think it is,
(35:43):
are words that you can use when you really need to
get someone's attention on the health care team. So
I'm concerned, I'm
uncomfortable, I'm scared, and this is a
safety issue. So if you use one of those terms
and then back it up with your evidence, I'm really uncomfortable
(36:05):
with the amount of pain my mother is in. This just
doesn't seem right. She had a pain pill an hour ago and she's writing
something's not right. You know, that kind of thing.
Yeah, those are kind of keywords. No, and
I like that because it's like, you know, you helped us kind of
like break through the, like, medical curtain
(36:27):
as far as. Yes. The words that, like, you, you know, you hear
concern and then you're like, oh, let me perk up a bit, you know, versus,
like, mom's in pain. And then you're kind of like, well, how much pain is
she in? Like, you know, so then it becomes this multiple questions that the nurse
has to ask. But if you start with concerned or she's uncomfortable, then
they're like, okay, what does that mean? You know, understand what that means.
(36:49):
Now, this is one thing I've heard, but maybe it's not true
anymore. You should avoid hospital stays on the
weekend. Typically, hospitals
are less staffing on the weekends.
Doctors aren't as available on the weekends. It seems there may
be somebody on call covering for your physician. So they may not
(37:11):
know your son, you know, your. The true story,
your family member. Exactly. And then you've got to catch them up
with, yes, but. And that's where your notes come in. Good.
Yeah. There are
studies that definitely say more harm happens on the weekends. So
if you can get your surgery done or whatever you're going to do at the
(37:34):
beginning of the week is probably a little bit better. Right. Then have it,
you know, because most people book things on Fridays because, like, oh, I have the
weekend to recover. But you know, just in case something goes
awry. Right. Just to know. Yeah, just to
know. But yeah, this has been really,
like, enlightening. And I think the biggest, my biggest takeaway is
(37:55):
this, the notepad and the question. So that when the doctor is talking
to you, he's, you're not, he's not saying. You're just relying on your memory. Like,
you're like, I physically wrote it down. So I like making
sure I know that. So I really think that is paramount.
And so I ask
every, I ask everyone, where can
(38:17):
we find you on the socials? And you've mentioned your book a couple times. So
I also want you to talk about your book and also your TED Talk, which
I will link in the show notes. Wonderful. Yes. My
website is Dr. Julie Seamers s I
e m e r s.com and most of my socials are Dr.
Julie Seamers as well. And then my book is on Amazon. It's called
Surviving youg Hospital Stay, A Nurse Educator's Guide to
(38:40):
Staying Safe and Living. To tell about it. It's
got 30 stories in there which I, as I said earlier, I think
people just really relate to. Oh my gosh, that happened to them.
Now I know better how I would maybe react in that
situation. Yeah. And then my TEDx
talk is, and I can send you that link too, is titled
(39:02):
how not to Die in the Hospital.
I know, Mike. I go like, that's, that's a great Google. Like, how do I,
like that's something someone's going to be thinking about when their next hospital
stays, like, how not to die. And you pop up.
Yeah. In that TEDx story too, I give. Or the TEDx talk, I
give three stories of patients that did not survive their hospital stay,
(39:26):
even though their families did try to speak up. And so I
think when we see that and hear those
stories and unfortunately they're way too common.
Yeah. Then it gives us the power and the
courage, I think, to speak up. Because if you don't,
what may be the consequences? Yeah. And that's, that's
(39:47):
what's scary. You know, I mean, the big thing you, you said was,
you know, speak up and that you're like, you know, be polite. Like, just be
like, hey, I don't understand. And you know, no one's going to, you know,
chastise you if you're like, being polite about it. But if you're like, hey, buddy,
like, cut the crap. You know, they're going to be like, oh, yeah,
it's going to be a note in your file. Here's kind of the last
(40:08):
thing I want to leave with you is over
250,000 patients die every year
from medical harm. If we compare that to the
airline industry, which. Yes. I mean, this midair collision in my
backyard. I live right outside of D.C. only
in the last two decades. Only. And I
(40:29):
say this in all reverence to the families that lost these people on
airline crashes, but it was only 269
in 20 years. We're talking about over
600 a day. Wow.
So with that in mind. And that's.
The harm is even bigger than that. That's just the deaths.
(40:51):
So that's why I think we need to break the silence. We need
to, as you said earlier, I love it. We've got to pull back the
curtain. I call it the wizard of Oz curtain of
healthcare has just got to be pulled back. And we have to have
transparency. Right, I agreed. I mean,
like you mentioned earlier about all of these lawsuits and the whole NDA, where it's
(41:13):
like, you know, if you were on CNN because, you know, you.
Whatever you did, more people would be like, oh, hang on.
You know, maybe I should ask more questions. Maybe I shouldn't just blindly
trust. So find the courage
and the confidence, people. I know it'll make a difference in your loved one's
life. I absolutely love it. And, Julie, I ask
(41:35):
everyone before I wrap up the show, what's one thing that makes you feel
magical? What makes me feel
magical is helping other people, sharing my knowledge, sharing
my experience, and just hoping
this doesn't happen to anybody else. Yeah, no, you're right. And I
think like you said, you know, listen to your TEDx talk or even reading a
(41:57):
book, it just helps you kind of bring awareness to all of the potentials
that are out there. That you're like, wow. And everyone considered that. Now it's considered
and right. And hopefully if it does, you know, it does cross
your path. You were more informed about hearing these
patients stories. Exactly. All right, matchmakers,
this is a must listen to if you are juggling aging parents, adult kids, your
(42:19):
own health, know how to take control of your hospital experience.
Grab Julie's book, surviving your hospital stay
and, you know, go through it. You know, we talked about that. Power,
power, medical power of attorney. Get that right now. Get that all in
order for your entire family so that we're not in a surprise when we get
that, like oh, my God. Phone call. All right, magic makers. I will talk to
(42:41):
you next week and enjoy the rest of your day.
Ah, magic makers. Great show on hand for you today.
Think about this. How many of you have ever been in the er,
a hospital, and you're googling. You know, why your kids won't take meds, why
your mom won't take meds, how long will it take for your dad to be
in rehab? What does rehab really mean? This episode is for
you. I have Dr. Julie Siemers here and
(00:24):
she has been a nurse for over 40 years. And we are going to spill
some gossip here about what it takes to advocate for
yourself and your loved ones when they are in the hospital. I know
personally, my mother in law was in the hospital and there was like 20 people
that came in the room and you're like, who do I listen to? Who should
I care about? And it's really hard to discern what's going on when they're throwing
all these terms at you. So buckle up ladies, you're going to get a crash
(00:46):
course in Hospital Survival 101. Julie,
welcome to the show. Thank you, thank you for having me.
You know, I love that, you know, here you are a medical professional
and you realize that us non medical professionals
were in, you know, most times you get that call
and you're already in a heightened state of like, holy crap.
(01:09):
And then you're, the doctors are just throwing all these terms and words at
you and you're just like trying to just process it all. You know, what
was it that made you say, you know what? I really need to start educating
people on how to like navigate, navigate this stuff.
You know, being as you said, in the healthcare system for a long time and
dealing with patients, families and patients themselves and really
(01:30):
seeing firsthand how complex it is,
how frustrating is, as you said, especially on those states of high
anxiety when you've maybe got a diagnosis you weren't
expecting or maybe you just came, you know, had a traumatic
accident and you're in the hospital. Nobody ever plans to be in the hospital.
But I think it went deeper than that for me when I started
(01:53):
my master's program in 2009.
And my thesis that I chose was patient
harm because when it came across my radar as
I was teaching students and sharing stories, because I think that's how
people learn is through other people's experiences and
stories and realized how many harm
(02:14):
incidents happened in a place where we
all expect to get healed and improve our health rather
than have harm occur. So that's kind of where the idea
expanded into, we need to do something about
this. Right? No. And, and it's interesting
how Once you kind of like peel back one layer, it becomes an
(02:37):
onion. And you like, you didn't realize how many layers were in that particular
onion. Oh yes, very true.
So let's just start like someone is in the hospital. Like, what
is the like, obvious mistake that, you know, most of us,
you know, make when people are admitted into the hospital?
I'll start with saying it is better to
(03:00):
become informed and educated before you find
yourself going to the hospital. And I know your show, your
audience and your guests you've had on here is how to stay
healthy. Right. Advocate for ourselves. And that is the best
thing that you can do. But if you find yourself in this situation,
because face it, we're all probably going to be a patient someday or
(03:23):
our family members are going to be a patient someday. So it really
is learn the fundamentals 101. So the first
thing I would say is, because healthcare acquired
infections kill so many
people or really impact their lives in
a harmful way, the first thing is to just make sure
(03:45):
everybody that comes in the room that is going to touch the patient, that they
must wash their hands. And so you'll have to find your
voice. Because we're a culture that aren't used to
speaking up or speaking out. Right. And so I
think understanding the consequences if you
don't say something like, please, Dr. Smith, would you wash
(04:07):
your hands before you examine my mother? Right. That should
be expected. We as nurses learn it, healthcare
professionals learn it in 101Fundamentals. And we
know it's in the literature that healthcare acquired infections still
are around and growing. So that would be, I guess, my
first tip or two. Right? I like that. You know, it's interesting
(04:30):
because I did notice that, you know, every
time, you know, a person comes in the room, there's an
immediate sanitation, you know, the. And it's visible.
Right. So it's not like this hidden thing that you, you don't see.
Like they, you know, wasn't, I don't think they made it as obvious, but
it was obvious that they're so and so or doctor so and so
(04:52):
was sanitizing before they actually
touched you. And what I also liked about what you said is being an
advocate because I feel that most times you see that person with the white
coat, the stethoscope, and you're like, Dr. So and
so knows and you just abdicate your power.
Yes, that is so dangerous.
(05:14):
And I'll say that because again, I'm not trying to throw any
profession or any person under the bus, so to speak, but
really, in this 15 years of
investigating this topic and learning, as you said, when I peel back the onion
and learn more and more, I'm like, oh, my goodness, I had no
idea. And so really, the
(05:35):
awareness is my main mission. Make
everybody aware and then inform and educate. And I
say that because you do have so much more power than
you think. And collectively, if
we as patients, family members, speak up,
then the healthcare profession is going to expect it and they
(05:58):
should. We should be working together as a team.
That was my TEDx talk that I gave, and it came out a couple, three
weeks ago, was on the. The
breakdown in communication is responsible
for 70% of patient harm events. And that's between
the health care team themselves or patients and their families
(06:21):
and the healthcare team. So it really is a
team approach, and we may have to socialize this
to the health care profession. Yeah, no, you're absolutely
right. And the other thing I, I know, I noticed was you
say it's a team, but it's really hard to understand the pecking order. Right.
Because it's like everyone comes in and they throw all these, like, literature. And I'm
(06:43):
like, I watch Grey's Anatomy for pleasure. I am not taking note
of the hierarchies. Yes.
And so it's really challenging when, like, they're like, oh, they'll talk, they'll say
team. And I'm like, okay. But at some point, someone's the captain. Who is the
captain? Who am I listening to? Because a lot of people will defer,
like, oh, yeah, yeah, you know, I'm just a nurse.
(07:06):
Or, you know, I'm just the, you know, intern. And you're like, well,
making decisions, Right?
That's a really good question. So when we're talking about, if you're
in the room and you're concerned about your mother, you're obviously going to go to
the nurse that's taking care of. Your mother because they come in all the time.
Right. If you don't get resolution there, then you
(07:28):
can escalate that to the charge nurse on the unit. And if you don't
get help or somebody to start intervening or taking
action, you need to ask for the house supervisor.
They're 24 7. And you can take it one step further.
If you don't get resolution from the house supervisor, is the
administrator on call? Okay. They're also supposed to be
(07:50):
24 7. Holidays, nights, weekends, it doesn't matter.
So finding your voice and using it to
escalate, you know, the help that you need or that your mom
needs is so important because.
And if you can bring someone with you or have your family with you
at all times because they're an extra set of ears,
(08:13):
eyes, the family knows the patient better than
anybody. And you can notice those subtle changes,
those nuances. Then a nurse and a doctor that bop in and out of
your room. Right. They're not going to notice. But those are early.
Can be early indications of the beginning of patient
deterioration. Right? Right. So neurological
(08:34):
changes, respiratory rate is escalating and staying
up there, the heart rate. A lot of these rooms have monitors in there.
Now those are clues that we can actually communicate and say, hey,
something's going on here, something needs to check. Right?
Yeah, you're right. Because it's like, you know, when someone's in the hospital, you're
just sitting there, you're, and you're, you're, you're, you might be noticing, you know,
(08:56):
you're, you know how your parent, your kid
normally is. So there might be a random thing that a nurse who
just comes in every 20 minutes might not notice. Right?
Yeah. And those are important things because again,
the literature tells us that before an
unplanned cardiac arrest, so a patient declining,
(09:18):
deteriorating, those physiological
changes happen 6 to 24 hours prior
to an unplanned cardiac arrest. So let's
just say dad had surgery. Two hours later,
he's got more pain. The pain medication
really isn't working. Now we're watching his heart rate go up over the next
(09:41):
couple of hours. And now we're watching his belly distend. If he had
a abdominal surgery, we're looking, he's looking pale now,
maybe now a little sweaty. You know, those are really
clues that something serious is going on. And
that's where we need to intervene and say, hey, somebody needs to do something. Something's
not right. Right. Because especially after like a surgery, you know, before
(10:03):
you have the surgery, they give you the list of all the possibilities. And
so as the patient, as someone who's had surgery, as patients, you're kind of like,
is this just from the surgery or is this something new?
So you're like, you are, you, you're like, you're so like, aware
of, like maybe this is a side effect that they didn't mention.
Yeah, yeah, you're right. I mean, one of the most common complications
(10:25):
after surgery is bleeding. And so that's something that we need to watch
for as nurses, of course. But family members too can
help. Blood clots are another really common
thing after surgery. And there is preventions that can
stop that. And then post operative pneumonia
is Pretty common, too. So there is. I write about those things in my
(10:47):
book, you know, for families. How can you help your family
member recover fast and healthy?
Just looking at those things that you wouldn't have known about until
you're specifically looking. Right, right. So let's just.
Let's just start. You know, your family member is in the hospital.
Do I have a right to know? And they're
(11:09):
an adult. So even an adult child or your parent.
Do I have a right to know what's going on with them? Yes, you
do. Yes, you do. So
there's sometimes. Well, it's only the spouse. You know,
I think that's the. The pecking order, as you called it earlier, you know,
and adult children, definitely. I would
(11:32):
absolutely do a durable power of attorney before I go into the
hospital, especially if it's planned like a surgery or something, like,
just so that your bases are covered. Okay, that's what I would recommend.
Yeah. And so that way legal. So, like, if we don't have
that, if, you know, my loved one is in the hospital and can I
say, Dr. Julie, what's wrong with dad? Yeah.
(11:54):
They should tell you. There should not be secrets about that because again,
we're supposed to be on the same team. Right, Right. So, you know, so there's
no HIPAA things that they can't say what's wrong with
him. There shouldn't be. Okay.
Again, it's. You might have different situations
with different hospital personnel at different hospitals. Right. But
(12:17):
I think that really is. If you can get
that sewn up or. Or dialed in before
you go. Yes. You say, I have the right to my. You
know, if your mom or dad is awake, they can give verbal
permission, but it's when they become maybe unconscious or, you know,
in the ICU or something might. Right. Positive problem.
(12:40):
So they have the right to tell you, you know, dad had a heart attack
or whatever. At what point does it become,
I, you know, I'm bound by this hippo, that I can't tell you
certain things. You know, it is
usually on the phone they say, I can't tell you that because obviously they
don't know who you are. But if you're there in person and you've
(13:01):
established that they're a family member, then there should
be no reason that there's a HIPAA problem.
Gotcha. But I'll give you. Even before you
go to the hospital, and this is in my book, too, because I think it's
such an important step. Choose the best
hospital in your area to go to. So there
(13:22):
is a website, it's called hospital
safetygrade.org and you
can go on there, put your zip code in and see the two or three
or five or ten hospitals in your area. They are rated A
through F, just like high school grades or
college grades. And it's based on 22
(13:43):
categories and subcategories of patient safety.
So if I personally would never go to a D
or F rated hospital, their safety is so bad that
your chances of harm or even dying are
about 91% higher than if you went to an A rated hospital.
So I would choose definitely an A or B. And then
(14:06):
I would go in and look specifically at the hospital that I'm choosing
and see those various categories and they're red,
yellow, green, for example, hospital acquired infections,
mrsa, Clostridium difficile. You can see
in there how if they're in the red zone, I'd be like, well, what are
you guys doing? Because you're doing really crummy, you know, in that
(14:28):
area. And then if I'm having surgery, I'm going
to ask the surgeon specifically. I see that the
hospital you want to do surgery on me doesn't do very
well with post operative blood clots. So what are you
going to do to help make sure my mom doesn't get a blood clot
after her abdominal surgery. Right, right. That's when
(14:51):
you become informed and educated. You can ask those really important
questions and be a team member to help keep them
safe. Gotcha. And at any point, you know,
is there like a, like an
overall patient bill of rights, like either
hospital or is it a federal thing, a state
(15:13):
thing? Every hospital has one.
And they're actually based off. It's not a federal
thing, although it should be, but it's based off the
Affordable Care act as well as some of the
guidelines with center for Medicaid and Medicare services,
etc. But overall, I've seen the
(15:34):
same ones written in many different places. So very
similar. But you have the right to information that you
understand. So as you were saying when we first started talking,
they come in the room and they speak this medical jargon that you have no
idea. What did they just say and what does it
mean? So I would stop that nurse or physician and say,
(15:56):
can you please explain what congestive heart failure is? Can you
explain what a diuretic is? Can you explain everything they just told
you? Can you explain, you know, what is the plan
of care here? What are we looking for to know that mom
is improving with this plan of care? Right.
And you're right. And again, you know, it's the questioning,
(16:18):
like, oh, you shouldn't question the person in the white suit. And we
are like, maybe you should, because, like, you know, Dr. Google can only take you.
But so far. Right. Well. And,
you know, the thing is, some of them may disagree with each other. Yeah.
So this is where I think one of the most important things as family
members, too, or even patients, is taking notes. Yes.
(16:41):
Yes. I, I stress that to my, My,
my clients all the time, especially going to a doctor. Like, you know, you have
five minutes with them before they're like, okay, see you next year. And I
was like, don't expect that you're going to remember. Like, if you have something weird
happening, start writing all of that stuff down so that you can. It
looks like you're. You're sitting there with a notepad and you're like, I'm not leaving
(17:03):
until these questions are answered. Yes. Yeah.
And in the hospital, sometimes you'll have a cardiologist and a
nephrologist and an internist. And again,
we talked about communication breakdowns many times. They miss
talking to each other and they may give conflicting. And
so then again, that's where you come in and say, but this doctor said
(17:25):
this. What do we really want to do here? What's the best thing for
mom? And the other thing, medicine changes. Medical
information changes. I think that it, it
doubles every three years. And that might not even be the latest
statistic, but in that case, if your doctor went to Medical
School 15 years ago, yes, he's got great experience now,
(17:47):
but is he or she up to date on.
Yeah, exactly. And you know what? Honestly, they
may not have time to go research. And so I
say you're in charge of your body. You get to
decide what is done to your body. And that's where you need
to be informed and educated. And I like that.
(18:09):
And, you know, as you said, maybe there is a doctor or a nurse that
you don't feel comfortable with. Can I be like, hey, you know, great
guy, but not for me. Can you request another doctor?
Yes. That is your right. Second
opinions are also your right. And if your physician gets
upset about that, that's the wrong physician. Yes.
(18:31):
Well, you know, and it's funny because I. It's not that
I'm. You're like, I have to make a decision,
and you, you give me something that, like, especially if it's hard news,
like, you've given me hard news. And I'm like, I'm already trying to
accept whatever it is that you said, maybe there's someone else who, like
you said, went to school 15 years later and knows a different path.
(18:54):
Right. I'll also. I'll give you an example of
why you should always get a second opinion. I wrote, I do a lot of
social media just to inform and to educate. And it
was probably about a month ago it came out a story in the news of
a man who had been getting chemotherapy for 11 years and found
out he never had cancer. Oh, good
(19:14):
Lord. I know. And then it blew up into this whole
thing. It was a doctor in Montana who had been
doing that to multiple patients. And so
you can't just take their word and on
trust. It's not where we're not assuming ill
intent, but we have to just cross our own T's and
(19:36):
dot our own eyes just to protect
ourselves. Because, yeah, he's one in a few
that really, truly intended harm.
But, you know, there's many other cases where they just
don't know or they just didn't understand
or I'll tell you, another one is to
(19:58):
make sure all of your results, your lab results,
your CAT scan results, your mammogram results that you
actually see the report. Yes. Get it. You
know, it's in your medical record. You need to look. If it's electronic, make sure
and look in there. You can't assume just because you don't hear
anything from the doctor. Oh, it must be fine. There's another
(20:21):
story in my book of a young. He was a
42, I believe, had a children,
had a brain tumor. But they told him and his wife after
surgery. Oh, don't worry, it looked benign. So when
they didn't hear anything, they assumed it
was. Yeah. Well, unfortunately, six months later, he's got
(20:43):
the headaches are back. They do another CAT scan, they find that the
tumor is now huge. And then they find
the misfiled pathology report
that said, yeah, he did have cancer six months ago.
So now by the time they're treating it, it was too late and he didn't
survive. Yeah. You know, it's interesting because
(21:04):
it's really easy to fall through the cracks. And, you
know, it's through no malice. It just really, like you
said, a misfiling. Like his first name. Like someone wrote a P,
it looked like a B. So it could easily have been done.
Yeah. Or just, you know, pure. Like it
got stuck to something and landed in the wrong. Landed in the
(21:27):
wrong pile. Which, you know, it's unfortunate, but at the end of the day, we're
all human and so Right. You
know, but it is always like that, that follow up where you're right because like
sometimes you're like ah, I didn't hear anything so I guess I'm good. But yeah,
you know, now everything is electronic so it's really easy for you to do in
like a few keystrokes. Follow up and be like, hey, you
(21:48):
know, I don't know if I got the letter and look inside and see
what's. Yeah. What's going on now? Oops, sorry,
go first. I was just gonna say you made a really good point. Yes, it
is humans that make errors, but it's the
system that allows the errors and that's where we need to
close the gaps. Yeah. Because. And again that's why we need
(22:10):
transparency in healthcare. But unfortunately,
80% of lawsuits that are filed the hospitals
require an NDA, a non disclosure agreement. Which
means we're not going to learn. No. Oh, it's not going to be a.
CNN that the guy for 11 years was getting bad chemo
treatments. And you know, and I,
(22:32):
I understand it to some extent because also then it makes you afraid of everything.
But I also think that if I
have, if you know, this person has been out
there, you don't know how, how good his records were. So like
maybe there's someone who is still being treated out there that you
know, there they, they keep doing the scans and like, well
(22:54):
like there's still something weird here and not really knowing what, what's going
on. Yep, exactly. But
yeah, I, I think at some point, which will probably never change because you know,
you have to cover your own ass all the time.
One of the big things I see, especially with my, my clients
(23:14):
aging parents getting discharged from the hospital. So mom and
dad have been there and you know, I know personally
that when my mother in law was in the hospital was during
the winter and they're like she's 90 years old, you want her the
hell out of here because of, you know, Covid
pneumonia, any possible thing that you talked about, you know, hospital
(23:37):
borne illness. So you know, are they really pushing people
out the door before it's safe for them to leave?
Yes, they are in many places.
You know, that's the response I was expecting. I'm
sorry. Oh, I, I love it. I love the brutal honesty.
I love it. You know, long gone are the
(24:00):
days that physicians
could make those decisions. Now they're being
overridden by not just healthcare
insurance companies, but AI technology. Right.
I just wrote about that the other day because it came across my feed like
three different Times in the news lately of now there's
(24:21):
lawsuits because of patients dying because they left the hospital
too soon, despite the physician saying they needed longer
in a post acute care. But these insurance companies are denying
based on AI algorithm, which I love
AI. I mean, it's fantastic. There's a lot of great stuff with it, but we've
got to use it judicially and it should not override a
(24:43):
physician's medical training and experience. Right.
If, if Sharon can't stand up, then Sharon shouldn't leave.
Like, you know, there's a, you know, the couple
surgeries that I've had, there's been like three things that I had to be able
to do on my own in order to be able to leave the hospital. Like
AI is not going to know. It's going to say, oh, well, you know, she's
(25:03):
a X number age person, you know, these. No, no
comorbidities. She should be able to leave in 20 minutes.
But it's like if I can't stand up, I can't go to the bathroom on
my own. Like I should stay till that's all rectified.
Yes. Even something as simple
as there was a woman who was in the
(25:25):
hospital for heart dysrhythmias and they were trying to regulate her
medications. Well, she was discharged with a
heart rate of 127. Normal heart rate for
adult is 60 to 100, and usually it's
around 60 to 80. Well, when your
heart is beating that fast, the ventricle doesn't fill as properly
(25:46):
as it should, so the amount of oxygen getting to your brain,
getting to your vital organs has decreased. She fell
in her driveway on the way home or trying
to go home. Had to go back because now she had a
vertebrae fracture from falling in her driveway. There's
nobody that should be discharged with abnormal vital signs. So it's
(26:08):
even that simple. That could be that catastrophic.
Right, Right. Because you don't even know, like if, if your, your heart
rate is double what it should be. Is it a medication
issue? You know, is it some other complication that's starting to like,
rear its head and if, God forbid, she lives
alone. Right. Yeah. It's so scary. It
(26:30):
truly is. And that, that's why I say the more you can learn
about your body, how it functions and your family and know
what's normal and use that voice to say, no, I'm
sorry, Mom is not going home. Right.
Well, especially, you know, I, one of my good friends, her mom
broke her hip and so she's like, you know,
(26:52):
go and be down and out for a good eight weeks. And she's like, look,
she goes, I have stairs. I have this. I have this. She's like, we need
to work through options because she, you know, like you told me, she can't be
here by yourself. And so she's. He's like, she goes, what am I supposed to
do? And, you know,
for a lot of people, you're in a rock and hard place because, you know,
(27:12):
fortunately, she lives in the same state, but how many kids live
thousands of miles away from their. Their parents?
Yeah, it's tough. It's hard to be alone in healthcare these days. I don't
recommend it. No, it is very hard to be alone in health
care. And so as we're talking about that, you know, you, you kind
of hit on that. There should be some type of power
(27:35):
of attorney before, you know, anything happens.
At what age should you have this medical power
of attorney? I get it now. No matter what
age you are. Only because we just never know what's going to happen.
Gotcha. You know, and again, I'm not trying to be pessimistic. I'm a really
optimistic girl, but we just never know what's going to
(27:57):
happen. So just have it on file with your family, your
kid, your parents, so that everybody's covered
just in case. It's always better to be proactive rather
than, oh, dear, what do we do now? And so, so the
question I have with a power of attorney so that, you know, one of the
things that I've heard is that, you know, your kid goes off to
(28:19):
college, and so, you know, they're in another state,
you're in another state that, you know, just the whole medical treatment, pieces
of like, you know, if they're asleep, if they're, you know, they're unconscious,
you know, can you still make decisions without that
piece of paper? Yes, it would depend on the state,
the child's age. I mean, there's probably factors there,
(28:41):
but I think it really is your only
safeguard just to say that I have it and it's simple. You can
download it off the Internet on a free form, you know, website or
whatever, and just get it notarized. You'll be good. Well, you know, it's funny because
I think as a parent, you. You're like, Stevie, he's 18. Like,
what's the big thing? And you're just like, that's an adult. Yeah,
(29:03):
yeah. There was a young man a couple weeks
ago who, it was actually in December, but his parents filed a
lawsuit who takes an Asthma inhaler
every single day for most of his Life. He was 22.
His insurance coverage, he was paying
$66 out of pocket. It jumped in January
(29:25):
to $569 and he couldn't afford it.
And three days later he was dead. He had an asthma attack
that could not be reversed or saved quick
enough. So even as an adult child, you still
may be in that situation where you still need your parents
or you know, your family member to be
(29:49):
able to make decisions for you. Yeah,
whenever I hear those stories, I'm like, you know there's a human attached to that,
right? Yes, yes. That's every time something
happens like this, it's somebody's mother, father, sister,
brother, everyone, you know, and I just, when the
decisions are being made, like with these pharmacy benefit
(30:11):
managers to raise medication prices
like that, I'm like, do you understand the harm that you're
doing potentially? I mean, there's so many people
now that can't afford their medications. Right. And I shouldn't have to
choose. No, that's a travesty to me.
Yeah, it is a complete travesty. Especially because you're like, you know, I do a
(30:33):
lot of work with biomedical companies and I'm like, I get the first few
years it's caught, it takes millions. I, I understand that,
but at some point, why did it go from $66
to 500? Did you come up with some space age polymer that you put inside
of it now? Like, you know, give me a justification for why it's
new and improved, that it has to, you know, over quadruple
(30:55):
in price. Well, from all the
news that I've been reading on that they pharmacy benefit
managers made an excess of $7.4
billion in the last five years. That's crazy. It's just
greed. Greed and corruption. Complete, I'm sorry to say.
No, it is because especially when you look at other countries that, you know,
(31:17):
half the drugs that we pay oodles for, you
know, they're like, oh, you could get that at cvs. Like so it's really,
yeah. Crazy about that. So we have the power
attorney. But there are also times that there might be need
for a other people to be involved. So
like maybe it's you're a grandparent, so maybe.
(31:40):
And the parenting capacity, so there might be children
involved, you know, are there like other services that you
can kind of that or might be thrown upon
you? Yeah, I would just
consult an attorney, honestly, just to say, given
the wild and wacky world of what ifs, how can
(32:01):
we Best make sure that our family has the right
documentation so that we have the rights to help our family
member if they're incapacitated. Right. That's the
best way to go about it. Perfect, perfect. And so now, you
know, we're going back to the, the discharge, you know, how do I know that,
you know, they're like going back to my friend's mom,
(32:24):
you know, she had to be the pusher to get her into a
rehab facility. So how do you know if
it's a nursing home, a rehab facility, or they're just being pushed out
too soon? The caseworkers should be able to do that. The
case managers at the hospital, they have a specific
role that, that is what they're supposed to do is assess what
(32:47):
the functionality is of the patient and then determine
which facility is best suited for. You
know, most of it's probably rehab unless it's going to be super
long term care. But like, yes, a broken hip definitely would
be a rehab place. They should be taking
care of all that. Again, the family member may have to
(33:09):
say, you know, put their foot down. Say, I can't take her home, I've got
stairs. Right. You know, there's nowhere for her to be.
Understand the situation and then say, help me understand why
you think this is a good idea. Yeah, exactly.
And you're like, and if you think it's a good idea, what's your living situation
(33:29):
look like? Exactly.
So now if I know that I'm going to the
hospital, you know, is there anything that I should
prepare, you know, other than having make sure the power of attorney is there,
is there anything should I prepare to bring with me to the hospital just to
make sure that I have it other than my own pajamas?
(33:51):
They won't even let you wear those. Yeah. I do
have a free patient safety checklist that I can send you
and you can attach in the show notes for your listeners. But I would
say your list of medications, usually they won't let
you take your own medications there, but if they know what you're on
already is probably
(34:13):
about all you're going to be able to. I'd leave everything else at home. Your
watch, your rings, your jewelry, obviously bring your phone so you can communicate with your
family members. Yeah, right. So just basically bring
yourself
and is there
like, you know, for someone listening, like what's like, you know, one piece of
(34:36):
advice that like you would give. To everyone,
the two I like to share is the three Ps. So
be present, be polite
and be persistent. So be
present when the Nurses are making rounds or giving shift report, you
know, during change or when the doctors are making rounds, if you
(34:58):
can. But to me, it also means be present in your heart,
have good intentions, and assume that you're going to work
well together with the team. And then be polite, even though
it's hard sometimes when you're really frustrated.
I know most facilities are understaffed with nurses,
and so they're probably running around like crazy. And so just being
(35:20):
polite. Hey, you know, I've asked three times, my dad needs his
pain medication. How can we make that happen? I know you're
busy. And then be persistent. If you
are concerned about something and you're not getting intervention
or action or resolution like we talked about before.
But the cuss words, not what you think it is,
(35:43):
are words that you can use when you really need to
get someone's attention on the health care team. So
I'm concerned, I'm
uncomfortable, I'm scared, and this is a
safety issue. So if you use one of those terms
and then back it up with your evidence, I'm really uncomfortable
(36:05):
with the amount of pain my mother is in. This just
doesn't seem right. She had a pain pill an hour ago and she's writing
something's not right. You know, that kind of thing.
Yeah, those are kind of keywords. No, and
I like that because it's like, you know, you helped us kind of
like break through the, like, medical curtain
(36:27):
as far as. Yes. The words that, like, you, you know, you hear
concern and then you're like, oh, let me perk up a bit, you know, versus,
like, mom's in pain. And then you're kind of like, well, how much pain is
she in? Like, you know, so then it becomes this multiple questions that the nurse
has to ask. But if you start with concerned or she's uncomfortable, then
they're like, okay, what does that mean? You know, understand what that means.
(36:49):
Now, this is one thing I've heard, but maybe it's not true
anymore. You should avoid hospital stays on the
weekend. Typically, hospitals
are less staffing on the weekends.
Doctors aren't as available on the weekends. It seems there may
be somebody on call covering for your physician. So they may not
(37:11):
know your son, you know, your. The true story,
your family member. Exactly. And then you've got to catch them up
with, yes, but. And that's where your notes come in. Good.
Yeah. There are
studies that definitely say more harm happens on the weekends. So
if you can get your surgery done or whatever you're going to do at the
(37:34):
beginning of the week is probably a little bit better. Right. Then have it,
you know, because most people book things on Fridays because, like, oh, I have the
weekend to recover. But you know, just in case something goes
awry. Right. Just to know. Yeah, just to
know. But yeah, this has been really,
like, enlightening. And I think the biggest, my biggest takeaway is
(37:55):
this, the notepad and the question. So that when the doctor is talking
to you, he's, you're not, he's not saying. You're just relying on your memory. Like,
you're like, I physically wrote it down. So I like making
sure I know that. So I really think that is paramount.
And so I ask
every, I ask everyone, where can
(38:17):
we find you on the socials? And you've mentioned your book a couple times. So
I also want you to talk about your book and also your TED Talk, which
I will link in the show notes. Wonderful. Yes. My
website is Dr. Julie Seamers s I
e m e r s.com and most of my socials are Dr.
Julie Seamers as well. And then my book is on Amazon. It's called
Surviving youg Hospital Stay, A Nurse Educator's Guide to
(38:40):
Staying Safe and Living. To tell about it. It's
got 30 stories in there which I, as I said earlier, I think
people just really relate to. Oh my gosh, that happened to them.
Now I know better how I would maybe react in that
situation. Yeah. And then my TEDx
talk is, and I can send you that link too, is titled
(39:02):
how not to Die in the Hospital.
I know, Mike. I go like, that's, that's a great Google. Like, how do I,
like that's something someone's going to be thinking about when their next hospital
stays, like, how not to die. And you pop up.
Yeah. In that TEDx story too, I give. Or the TEDx talk, I
give three stories of patients that did not survive their hospital stay,
(39:26):
even though their families did try to speak up. And so I
think when we see that and hear those
stories and unfortunately they're way too common.
Yeah. Then it gives us the power and the
courage, I think, to speak up. Because if you don't,
what may be the consequences? Yeah. And that's, that's
(39:47):
what's scary. You know, I mean, the big thing you, you said was,
you know, speak up and that you're like, you know, be polite. Like, just be
like, hey, I don't understand. And you know, no one's going to, you know,
chastise you if you're like, being polite about it. But if you're like, hey, buddy,
like, cut the crap. You know, they're going to be like, oh, yeah,
it's going to be a note in your file. Here's kind of the last
(40:08):
thing I want to leave with you is over
250,000 patients die every year
from medical harm. If we compare that to the
airline industry, which. Yes. I mean, this midair collision in my
backyard. I live right outside of D.C. only
in the last two decades. Only. And I
(40:29):
say this in all reverence to the families that lost these people on
airline crashes, but it was only 269
in 20 years. We're talking about over
600 a day. Wow.
So with that in mind. And that's.
The harm is even bigger than that. That's just the deaths.
(40:51):
So that's why I think we need to break the silence. We need
to, as you said earlier, I love it. We've got to pull back the
curtain. I call it the wizard of Oz curtain of
healthcare has just got to be pulled back. And we have to have
transparency. Right, I agreed. I mean,
like you mentioned earlier about all of these lawsuits and the whole NDA, where it's
(41:13):
like, you know, if you were on CNN because, you know, you.
Whatever you did, more people would be like, oh, hang on.
You know, maybe I should ask more questions. Maybe I shouldn't just blindly
trust. So find the courage
and the confidence, people. I know it'll make a difference in your loved one's
life. I absolutely love it. And, Julie, I ask
(41:35):
everyone before I wrap up the show, what's one thing that makes you feel
magical? What makes me feel
magical is helping other people, sharing my knowledge, sharing
my experience, and just hoping
this doesn't happen to anybody else. Yeah, no, you're right. And I
think like you said, you know, listen to your TEDx talk or even reading a
(41:57):
book, it just helps you kind of bring awareness to all of the potentials
that are out there. That you're like, wow. And everyone considered that. Now it's considered
and right. And hopefully if it does, you know, it does cross
your path. You were more informed about hearing these
patients stories. Exactly. All right, matchmakers,
this is a must listen to if you are juggling aging parents, adult kids, your
(42:19):
own health, know how to take control of your hospital experience.
Grab Julie's book, surviving your hospital stay
and, you know, go through it. You know, we talked about that. Power,
power, medical power of attorney. Get that right now. Get that all in
order for your entire family so that we're not in a surprise when we get
that, like oh, my God. Phone call. All right, magic makers. I will talk to
(42:41):
you next week and enjoy the rest of your day.
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