Hospitalization - Admission Procedures

Admission Procedures

You will most probably be admitted into a short-term hospital, which is a hospital that seldom has patients for longer than a month, and usually for 3 to 10 days. Long-term hospitals treat patients with psychiatric problems or long-lasting physical illnesses.

The hospital will probably be a general hospital, that is, one that deals with a complete range of treatment. However, some patients require care in a special hospital, for example, a pediatric hospital, if the patient is a child, or a maternity hospital, if a woman is having a baby. Your physician will recommend the most appropriate kind of hospital for your particular condition.

Elective Admission is admission to a hospital after at least one day of planning before the actual date of entry. Many such admissions are for surgery. Others are for tests that cannot be performed on an outpatient basis. Medical conditions that require an elective admission are less common, but if a hospital is full and the condition is not an emergency, a patient may remain at home for a day or two until a bed becomes available.

The admissions office is usually located in the main lobby near the information desk. When you arrive at the desk, there are a number of questions that the admissions office clerk will ask. Your name, address, and date of birth are required, and you will probably be asked to give your employer's telephone number as well as your home number. The clerk will also need to know the name and address of your next of kin or another responsible party in case an emergency develops during your stay in the hospital. Many hospitals want to know your religion because some religious groups place restrictions on what procedures may be done, and it is important that the hospital knows this in advance. For example, some sects do not allow the use of blood transfusions, and the hospital would be liable if one were given without the patient's consent.

The clerk must know the details of your insurance coverage, and you should take any necessary identifying information with you. Your Social Security number will be required.

During the interview, the clerk may or may not ask for your family physician's name. If you are being admitted under his or her care, the question is unnecessary because your physician will have already been identified when the admissions office was notified of your arrival. If, however, your physician has referred you to another physician or surgeon for inpatient care, then make sure that your physician's name is also on your chart.

Once the clerical part of the work is complete, you will have some tests done. In some hospitals, a technician waits close to the admissions office, and in others you are escorted to the laboratory for the tests. If you have been admitted for surgery, the operation will usually be done the following day. It is important that preoperative test results be available as soon as possible, because they may affect the decision to operate. If you are found to be anemic, you may need a transfusion before surgery. Your blood group must be identified before any operation, so that blood can be standing by for transfusion if any is needed during surgery. Your blood is cross-matched to make sure that it reacts favorably with blood of the same group, and its clotting ability is also tested. Most surgeons like the patient to have a routine electrocardiogram and chest X ray done before surgery, and these are also carried out before you reach your hospital room.

You are usually escorted to your room by a hospital patient escort, often a volunteer. Before leaving the main lobby, you may be asked to hand over any valuables or money you brought in with you for storage in the hospital safe. It is advisable to have only a few dollars in your room.

Shortly after your arrival in your room, a member of the nursing staff greets you, explains the facilities, and shows you how to use the nurse call system. You are then asked to change out of your street clothes into pajamas or a nightgown, or the hospital may provide a hospital gown.

If you still have valuables and money in your possession, you can hand them to the nurse, who will place them in an envelope and give them to a security guard for storage in the hospital safe. A receipt for the valuables will be attached to your chart.

Once you are in bed, a nurse will take your temperature, check your pulse and blood pressure, and record your weight. The wristband will be checked to make sure that the name is correct. It is fixed with a permanent clasp, and you must not cut the band off until you leave the hospital.

The ward clerk will check your signature on the admitting forms and see what tests and treatments have been ordered by looking at your chart. The clerk will give you the hospital information booklet and personal toilet kit. If you have any questions, do ask.

A nurse will then ask you a number of questions about your health and the reasons for coming into the hospital. He or she will want to know general health points, such as how regular your bowel movements are. He or she will also need to know if you are taking any other kind of medicines. If you have these with you, the nurse will take them and place them in a locked closet to make sure that all the medicines you take during your stay in the hospital come from one source and are carefully recorded.

If you have been taking contraceptive pills, you may need to stop dosage before surgery. The contraceptive pill can increase the chance of postoperative blood clotting in the veins of the legs, but many women do not regard the pills as drugs, possibly because they are not treating an illness. If you are taking contraceptive pills, always inform your doctor and the hospital staff. You may be advised that for your condition the birth control pills are not contraindicated, and you may then continue to take them while in the hospital.

You must also tell the nurse if you are allergic to any sort of medication or adhesive dressing. If you are, it should be recorded not only on the nursing notes, but also on the front of your chart and on your treatment card. The medications for all the patients on the floor are kept on a medicine cart with treatment cards for each patient. The nurse will take the cart around the floor regularly and record each medication and dosage.

The process of elective admission is now complete. On a busy day it may take several hours from the time you arrive at the hospital door to the time when you are finally settled down in your hospital bed.

Emergency Admission. Although the majority of hospital admissions are elective, you may be admitted to a hospital following an accident or for some other serious emergency. When you arrive at the emergency room, the clerk on duty needs information similar to that of the admissions clerk. He or she must know your name, address, insurance details, and major injury or complaint. The clerk is trained to recognize potentially dangerous symptoms.

Once the clerk has seen you, a registered nurse (RN) examines you to see if you need urgent treatment. If the nature of your injury is not life-threatening, you may have to wait for some time in an emergency room because the staff is dealing with other patients. However distressing the wait may be, a patient's health is in far less danger if he or she is in the emergency room. Should something life-threatening happen, such as a cardiac arrest, then the patient is only seconds away from a team of experienced physicians and nurses and specialized equipment.

If you are brought to the emergency room following an accident and are subsequently admitted to the hospital, remember to ask a friend or relative to bring in a clean set of clothing before you are discharged. You must remember that the hospital cannot clean the clothes you wore on admission.