Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.
It should be expected that you or your loved one be treated with the highest and safest level of care when you are in the hospital. But it is also part of your responsibility as a patient to understand your rights and to know what to expect if you are hospitalized for any reason. After all, you know your body best.
1. Be your own advocate
If you are unable to advocate for yourself, and if the situation allows for it, have an advocate with you at least some point during your stay. This can be a family member or close friend who you feel comfortable with. Ask when your physician or other members of your healthcare team make their rounds so your advocate is present with questions or concerns.
2. Carry a list of your current medications
Your medications may be changed while you are in the hospital, and it is important to ask which meds were added or deleted so you are clear what you are taking and why. This will also serve as a “double check” for your healthcare team at the hospital. Most medications given in the hospital are listed by generic name instead of brand or “trade” names. For example, brand-name Glucophage will be known as metformin in the hospital. If you have medication allergies, remind any new nurses or doctors of this fact. It should be in your chart, but in a busy hospital things can get overlooked.
3. Know your rights
Patients don’t realize they are legally allowed to view their chart. Some hospitals try to push back on this and may say you cannot see the chart until discharge, but you have rights as a patient. The HIPPA laws are in place to protect you; make sure you keep asking and know your rights.
4. Be prepared to monitor your blood sugar
When you know you’re going to be admitted to the hospital, it is crucial you are prepared to the best of your ability. A majority of individuals automatically get placed on a rapid-acting insulin, like Apidra, based on blood sugar levels and nutritional intake. This happens even if you were on an oral anti-diabetic medication such as glyburide at home. Depending on the length of stay, this may or may not be the best choice for you, but it is the most efficient means of keeping tight glucose control, especially during a time of illness or emotional stress, and it remains protocol at most hospitals. Don’t get frightened by this: insulin usually starts at a low dose and is very closely monitored while you are in the hospital.
With increased staff shortages and higher patient ratios at hospitals, low or high blood sugar side effects may not be immediately noticed in the hospital. If you feel sick or have a decrease in your level of consciousness due to other medical complications, advocates may pick up on this first, especially if they know your baseline behaviors. You need to be conscious and alert and inform the nurse right away if you feel the symptoms of low blood sugar such as dizziness, clammy cold skin, or weakness.
Nutritional services do their best to provide healthy, well-balanced meals and snacks. However, it is essentially your choice to utilize the best nutritional choices available. If you are given chocolate cake, for example, don’t just eat it because you assume it’s okay!
Illness, your environment, and emotional stressors can all negatively impact glucose levels, so it is important to be your own advocate of your own health and overall well-being. Today, more than ever, we control or own outcomes to a large extent. Your healthcare team will appreciate your involvement.
5. Know your doctor and discharge details
While in the hospital, make sure you know the name of the doctor in charge of your case in the event you need to contact him or her directly. Also, keep in mind that after a major medical event such as heart attack or surgery, you may need insulin upon discharge. If you were not previously on insulin, you may not have to stay on insulin. As you heal, you may be able to be maintained on your oral medications.
Remember: be sure to always count yourself as a member of your own healthcare team. Knowledge is power, my friends. Stay well.
What are your experiences on managing your diabetes in a hospital? Share your thoughts on this article in the comment section below and check out this related discussion thread.