In ‘To Err Is Human: Building a Safer Health System’ report, the Institute of Medicine’s (IOM) estimates 98,000 people die from preventable medical errors. The likelihood of experiencing a medical error is about six percent for each day in the hospital (IOM, 2000)
You are your own best advocate. If you can’t advocate for yourself, get your family members and friends to advocate for you by following these tips. These safety tips are summarized by Donna Crisp, author of Anatomy of Medical Errors: The Patient in Room 2. You will access the healthcare system at some point in your life, and need to be actively engaged in your care. It is your life after all.
Become Your Own Medical Consumer Advocate:
- Pay attention, even if you must detach from your emotions as a patient.
- Ask questions and take notes.
- Remain skeptical and alert.
- Identify your assumptions and validate them.
- Never assume you are being told what you most need to know, much less all you need to understand.
- Make sure you or someone with you knows what medication you are prescribed and given, and for what purpose. Remember that medication errors are common in hospitals. Realize that you may refuse medication for any reason.
- Whenever possible, have someone act as your advocate and witness.
- Learn as much as possible about your health issues so you can formulate relevant questions and concerns to share with your physician or other caregivers.
- Realize and remember that sickness and treatment are about much more than a physical problem, disease, or trauma: They are also about suffering, fear, anxiety, loneliness, support, and hope.
After You Receive Bad Health News:
- When you hear bad news, do not necessarily assume it is true. It might be, but become your personal devil’s advocate. Do not allow fear to be your driving force. It is not unusual for a second opinion to yield a different diagnosis. A second opinion may be essential to confirm a correct diagnosis and, as well, may give you more treatment options for consideration. Always get a second opinion.
- Ask other people—a neighbor, colleague, friend, family member, or someone from your religious community or groups of interests—if they know anything about your diagnosis. When I asked people about uterine cancer, several people told me there was a high success rate with surgery, assuming the cancer had not spread. This immediately gave me hope.
- Find out which doctor has the reputation for being the best person to help you, but remain skeptical—even bad doctors have fans. If you personally know people who work in healthcare, such as a nurse or physician, ask them who they would go to—and why—if they received your diagnosis.
- If you have more than one hospital to choose from, learn how various hospitals deal with your problem. For example, breast cancer treatments vary widely depending on where you live and which hospital you choose.
- The Internet provides comprehensive information about most anything; make sure you use only reliable sources—websites such as MedlinePlus from the U.S. National Library of Medicine, WebMD, Sharecare, or the Mayo Clinic. Unscientific blogs may confuse or alarm you as it’s difficult to verify their stories or claims.
- Finally, remember that knowledge is power. Learning about your health crisis may not only guide your choices, it may also empower you with a sense of control during a time when life feels scary.
Before You Go for Healthcare:
- If possible, have your affairs in order, especially your legal will and your advance directives—living will and healthcare power of attorney. Prepare for the worst scenario and hope for the best outcome. Take copies of your advance directives with you when you go for treatment. Also, tell your friends and family what they might need to know in case you do not come home on schedule, or worse.
- Make arrangements for your home, pets, mail, and other matters you will not be able to attend to while out of commission.
- Items you may need include personal telephone, watch or clock, pen and paper, contact information for people you might need to talk with, and reading material—preferably something that inspires you.
- Make sure you tell your loved ones ahead of time how you feel about visitors—which ones and how often. Since I planned to be home about 24 hours after entering the hospital, I expected to have no visitors, only the friend who was with me. Later, my family knew I would not want visitors while I was in a coma.
While You Are in the Hospital:
- Have someone with you as much as possible—someone who is not afraid to ask tough questions or speak up if something does not seem right, someone who can help make decisions (or call the right people) if something goes wrong. Choose a person who is brave enough to risk being seen as inappropriate or meddling. It is better to appear foolish than to risk saying nothing, in case something is not right. There is nothing more important than your physical and emotional well-being when you are under the control of a medical system.
- If your doctor or nurse (or someone else) is not giving you the right care or is not treating you with respect, ask to speak with someone in authority, such as the nursing unit manager, the nursing supervisor, the doctor’s supervisor, or the administrator in charge. If you do not know how to contact any of these people, pick up the telephone and dial the operator for assistance. I once knew a woman whose arms had been severely injured, leaving her unable to wipe herself in the bathroom. When I learned that a nurse was not helping her with that chore, I spoke to the unit manager to insist the nurses perform correctly.
- If you cannot get the nutrition you need, ask someone to bring you food you can eat.
- In general, do not be afraid to ask for anything that might help you, even if you think your request cannot be met. You never know. And, if you cannot speak for yourself, make sure you have a personal advocate who can look after your needs. Staffing shortages are common in hospitals.