Throughout the day, various people go round the unit to check on the progress of the patients. The head nurse or the deputy head nurse usually make a round early in the morning (between 7:30 a.m. and 8:30 a.m.). The head nurse's comments are important to the physician in charge, and it is the nurse's responsibility to pass on all the information to the physician or the resident.
The head nurse also draws up a list of problems on which to base the plan for the day and assigns jobs to various members of the team in the nursing unit.
During the morning, one or more of the resident physicians will visit you to see how you are, correlate your progress with the information collected by the nursing staff, and discuss any changes in your condition. The resident is also there to answer any questions you may have, although you should remember that the ultimate authority rests with the physician in charge of your case.
The physicians are not encouraged to discuss the case in front of the patient. For somebody with no medical background, it is alarming to hear a group of physicians discussing possibilities, because, even if the patient does not understand the terms the physicians use, some of the words may sound threatening. If, however, you are worried by a remark made between physicians, you should promptly ask for clarification.
The physician in charge of your case may make his or her own visit at any time of the day depending on his or her schedule. It is a good idea to ask for an estimate of when the visit might be, so that you do not become unnecessarily anxious. Your physician's visit is the most important one for you because all of the important decisions are made by him or her. Try to organize your questions beforehand so that the time may be used with maximum efficiency.
The nurse assigned to each patient has the job of dispensing all the medications. It is also the nurse's job to provide all the primary care necessary for the patient assigned to him or her. When the medication is ordered by your physician, the information is transferred to a card which is kept on the medication chart. This means that the nurse has a record about which drug he or she should administer to the patient, how often it should be given, and in what circumstances it should be given. Each dose administered will be noted on the chart by the nurse. The nursing staff carries out numerous safety checks to make sure that there are no mistakes. You can participate by learning what each tablet or capsule is, so that if you are given a new pill you can ask when it was ordered.
Dispensing medication is a very responsible job, and the nurse must concentrate on what he or she is doing.
At some time during the morning a member of the housekeeping department cleans your room thoroughly. This may be done while you are out of your room having tests or X-ray photographs. During the morning your bed is changed and tidied. You can ask for this to be done again if a restless day has made the bed untidy by the evening.
The Order Sheet. The staff on the unit gets all of the information about your daily routine and care from the order sheet. The physician writes his or her instructions on the sheet, and the nurses consult it whenever they need information.
Instructions about your activity around the ward are written on the order sheet. "Up ad lib" or "unrestricted" means that you are free to get up and walk around the room, go to the dayroom, and use the corridor. You should not leave the unit without permission because, if you were suddenly taken ill, there would be a delay in getting help to you. "Up ad lib in room" means you may walk about the room, but not leave it. "Bathroom privileges," as previously mentioned, means that you may use the bathroom when you want to. If you do not understand the reason for a certain restriction, ask the resident physician to explain it to you.
Hospitalization - Admission Procedures
The procedures you follow on admission to a hospital vary from one hospital to another, but basically the process is the same in most institutions in the United States.
Care of the Dying - Reaction of Children
A child's reaction to death depends on many factors. A child's first experience with death is often the death of a pet. A child under the age of eight cannot understand that death is irreversible and may expect the mother or father to bring the pet back to life. After the age of eight or nine, the child's understanding is usually as rational as an adult's understanding.
Care of the Dying - Moment of Death
Do not be alarmed if the patient's breathing makes a groaning or croaking sound. It does not mean that he or she is in pain. When a dying patient slips into a coma, the position of the neck and body produces the noise, which can be reduced by gently turning the patient's shoulders or body.
