Advocacy

Recent events, which included me accompanying Kelly to the hospital for 45 hours, opened my eyes to certain truths about health care. Questions of coverage and access can wait for another day (and, perhaps, another blog). What struck me was the usefulness of a patient advocate.

In the typical hospital setting, a patient will be seen by doctors on a periodic basis throughout the day and night, with more frequent visits from nurses and nursing assistants. The cast of characters can become astonishingly large in a very short amount of time. In the time we spent at the Children's Hospital of Oakland, we were seen by at least six nurses, three lab personnel, four volunteers, three interns/residents and four doctors. As the patient, Kelly did whatever she was told, but much of what she was told had to do with treatments to come or outcomes to be assessed. I found myself to be the central repository of information received from these many sources. Many times in our relatively short stay I guided both the doctors and the nurses in the course of treatment, advising one or the other group of what someone else had said, or done, or neglected to do. I stopped one nurse from administering a medication that had made Kelly sick when the intern had told us half an hour earlier that they would no longer give it to her. I made sure treatments happened on time, results of tests were tracked down and nursing assistance was procured when needed. Kelly's recovery would have occurred had I not been there, but I am convinced that she would have spent another 12 hours in the hospital if I had not prodded the hospital staff to do all the things they said they intended to do.

I imagine a significant distinction between conventional hospitals and children's hospitals (or wards) is that unlike ordinary patients, most child patients come with a built-in, full-time advocate -- a parent or guardian. They keep the hospital staff on its toes in a way that an adult patient, confined to a bed and often addled on medication, cannot. Our little adventure showed how crucial an alert patient advocate can be to ensuring that the care the hospital intends to provide is actually doled out.