Navigating the Hospital System

Whether you have recently become a Carer or have been in a Caring role for some time, the experience of being a Carer of a person who has been admitted to hospital can, in many cases, be the cause of a lot of anxiety.  Alternately some people find it an opportunity to have some respite, recharge their batteries and catch up on other roles in their life.  We hope that the information on this page will assist you to have a positive experience in your caring role while your care recipient is in hospital.

Each hospital on the North Coast is unique and has evolved in response to local health needs, funding arrangements and a variety of different local and regional administrative structures.  Hereby, there exists differences in the systems to manage patients and visitors at each of the campuses.

As a “Consumer,” (the word used by the Health Service to describe a person using the service) your “Cared for” or “Care Recipient” (the person you care for) will be provided with information to inform them of their rights and what services they can expect while they are at hospital.  This information also applies to yourself.  The following link is to information by Carers Australia on Your Rights in the Hospital

Admission

Your Care Recipient will become a consumer of the hospital in one of two ways, an “emergency admission” or a “planned admission.”  On admission your Care Recipient becomes a “patient”

Emergency Admission

If it is an emergency admission, the staff at the hospital will conduct a “triage.”  The triage consists of the systematic gathering of information and the prioritising of which medical conditions require the most urgent response and where the patient is to receive the appropriate treatment.  People presenting with conditions that require an urgent response will be prioritised.

The first information that is taken is about the immediate concern regarding the patients health.  If the patient is unable to communicate for themselves then the Carer will be asked to provide this information.  This will include their medical history, current list of medications and recent test results eg. Xrays, CT scans.  Many people compile a personal health folder that contains details of their medical history and treatments that is helpful at this time.

If it is determined that it is a medical emergency, the patient will be moved to the most appropriate part of the hospital to stabilise their condition.  This may involve a transfer to another hospital with a more specialised capacity.

In a systematic order, the triage nurse will ask for the patient’s relevent personal details.  People who have presented to a NCAHS facility within the previous five years may already have a Medical Record which will contain information about previous treatments from the NCAHS.  Information about diagnoses and treatments provided by other services and health professionals will also be sought.

Planned Admission

A planned admission occurs when a health professional, usually the patient’s GP, makes a referral to the hospital for the patient to undertake a pre-determined course of assessments, treatments, operations, or observations, in a hospital setting that is determined to be the most appropriate place for this.  A planned admission allows for the gathering of information prior to admission, including a referral letter from the referee.  As the Carer, your observations and contact details should also be included in the referral.

Biopsychosociocultural Assessment

To ensure that the patient has the best experience possible, staff at the hospital may ask you for a range of information that assists to compile the “biopsychosociocultural assessment.”  This includes information about the patients pysical or biological health and development, psychological health and development, familial history and social experience including occupation, religeous and cultural backgrounds.  All of these issues (and more) can impact on a persons health and chance of recovery.  This information will assist the hospital staff to understand and show respect towards sensitive issues.

Importantly, if you have information that you believe is important and that you have not been asked for it then you can write a letter or ask to speak with a nurse or doctor.  In some instances the information that is requested may be challenging for you to provide and you may ask for a support person, a social worker, a cultural consultant, or an interpreter to assist.

Being a Partner in Care with Hospital Staff

When you visit your Care Recipient in hospital you may see some “obvious” deficits in the care being provided.  This may be partly explained by the limitations of the hospital setting, but it is often the case that it is because they do not have the same depth of understanding of the patient and their personal characteristics that you do.  Also, hospital staff may not be aware of your level of experience and depth of understanding.

A good approach to this issue is to ask for a suitable time to meet with the hospital staff because you have some information or questions to discuss regarding care related issues.  Because there is often several hospital staff involved in the care, it might be more appropriate to talk to the Nursing Unit Manager (NUM), who has an overseeing role and will be able to ensure that important information is communicated.

In some instances, staff may be concerned about the privacy of the patient and the confidential nature of some information.  Health service staff are bound by privacy legislation that prohibits the exchange of a patients information, except in extreme cases or where it it is within their “duty of care” to seek or provide information with third party’s including Carers.  The best approach to this situation is to develop a rapport with the staff and discuss the importance of the information you are seeking for the ongoing care and wellbeing of the patient.  You could also ask to speak to the Nursing Unit Manager (NUM).

Hospital Staff and their Roles

The following links are to information sheets published by Carers Australia

(including; Speech Therapists, Occupational Therapists, Physiotherapists, Psychologists and Social Workers).

For information specific to Aged Care Assessment in hospital please see this link to an information sheet developed by Carers Australia.

Discharge Planning (planning to leave the hospital)

Ideally, Discharge Planning should start when the patient is admitted to hospital.  However if the diagnosis and treatment plan is not clear on admission, or complications occur during the hospital stay, then the date of discharge may not be known.  Asside from the date of discharge you may need to know a range of information to assist to make a successfull transition from hospital to home for you and your Care Recipient.

The following checklist will be a good start:
  • What is the diagnosis, treatment and likely prognosis of the Care Recipients illness?
  • What medications do they need to take?
  • Are there any follow up appointments?
  • What ongoing care is required?
  • Who will be involved in the ongoing treatment and care?
  • What is the expected date of discharge from hospital and will transport be provided?
  • Are home modifications and equipment needed?
  • What support services are available in the community?
  • Who do I contact for follow up advice and support?