How to Prepare for an Emergency: Lessons of a Broken Hip, Part 2

To see part one, look here: It is a familiar story for families:  one of your senior members falls and breaks their hip.

My 84-year-old mother fell while visiting us. Her hip was broken, and our introduction to emergency care in the United States was chaotic, at best. While the EMTs and Emergency Room staff were trying to help us, the system was clearly full of cracks, and we fell through several.

My family is filled with medical professionals. We are comfortable with the health system, so we believed we knew how to handle events like my mother’s emergency. However, even insiders can get confused. And we learned preparation is key.

Once she was settled in her room, out of the natural chaos of ambulance and Emergency Room, it seemed things would settle down. Surgery and recovery awaited, but we were comforted by the promise of routine care, not Emergency Room franticness.

She was wheeled to the operating room and we all waited in the surgery waiting area. It was a weekend and there was no hospital personnel in the waiting area.  No one ever notified us of our mother’s progress. We were told nothing.

We never did meet the surgeon and never had the procedure explained to us. The surgeon never returned to see our mother after surgery. We went back to her room and waited.

Once she was brought back to her room from the recovery room, we stayed with her for the rest of the day. When it became clear she was ok, and we were not going to meet with the surgeon, most of us left to get some rest and my sister stayed to watch Mom.

At which point Mom started having a bad reaction to something. My sister tried to call a nurse, and eventually left Mom’s room to track one down. It turned out Mom was reacting badly to a medication. Again.

It took four days to get this reaction under control. Once it eventually stabilized, Mom was taken to a rehabilitation facility. Here, however, there was additional medication confusion. The dosage and timing were incorrect, leading to skyrocketing blood pressure. Mom was taken back in the ER by ambulance spending another 6 hours there until she was stabilized.

Eventually, the ER Physician went through our entire list of Mom’s medications, making sure to indicate the dosage and timing. With our newly-detailed list in hand, and her blood pressure under control, she returned to rehab.

Thankfully, that was the last of the serious complications. Now she’s out of the rehabilitation facility and doing very well.

However, we are still frustrated. Everyone wants the medical system to support them and their family in times of vulnerability, not the opposite.

Weeks later, I spoke with a physician friend describing the chain of events.   He knew what I was talking about; he was all too familiar with our frustration. Medical professionals know stories like ours well.

Physicians and nurses are extremely busy, and many hospitals are struggling with the balance of budget and personnel.

Because of the hectic pace and staffing complications, medical teams (from ambulance EMTs, to emergency room crews, to hospital teams, and even primary care offices) struggle to share critical information. The lack of a centralized system makes it difficult to help the patients. This is why my mother’s medication information was repeatedly muddled or lost.

There isn’t an easy system in place.

So what can we do?

Be prepared and know your rights.

The last article had a helpful list of things to prepare in advance. Be sure you have this ready for all family members, not just the elderly.

In addition, the list below details your rights as a patient and ways to help the system work. It can help make your hospital stay less chaotic than ours.

  • Know your rights. The American Hospital Association has a Patient Bill of Rights. Know what you have a right to insist upon. Unless your loved one is in emergency surgery, you have the right to meet the doctor to discuss treatment before any procedure. Insist upon it. You have the right to know the risks/benefits of treatments, what to expect from it, and what will happen afterward. Even with emergency surgery, insist on meeting the doctor afterward to discuss this.
  • Get to know the nurses; they are your best resource on a hospital floor. Figure out where their station is on your floor. Be friendly, and make sure they know who you are. Understand they are often understaffed, so be patient, but insist on attention when your loved one needs it. Knowing where they are located will help.
  • Find an advocate in the hospital. Often hospitals have Patient Representatives. Find them and get to know them, they are there to be your voice.
    • This could also be your primary doctor. If you do not have a regular doctor, you should find one. They are important advocates and understand your health history.
  • If you are over 18 yrs. old, get legal documents prepared, including the Health Power of Attorney, CPR Instructions, and a Living Will – they are free and available in English (click here) or Spanish (click here).
  • If an elderly family member is going on vacation, help pack their medications, and have a written, laminated and easily accessible list of medications. Be sure to include timing and dosage, not just the name. Keep a copy of the list with their medication, and send one to those they are visiting.
    • On this list, include allergies or negative reactions to any medication or substance (include latex allergies, food allergies, etc.)

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