Photo by Paramount Pictures
'You can be my wingman anytime.'
Coming from Iceman (Val Kilmer) to Maverick (Tom Cruise) in “Top Gun,” that was a huge compliment. And if someone chooses you as his or her hospital “wingman,” consider it an honor. Although you’re not actually flying jets together in tight formation, as the wingman – or patient advocate – you have the patient’s back. According to the National Patient Safety Foundation, your mission includes helping the patient “navigate the confusing health care system.” You’re speaking up as needed, looking out for the patient’s best interests and acting on his or her behalf. If you’ve just been enlisted, these guidelines can help.
Acting as the main wingman – or wingwoman – for a family member or friend involves commitment. You need to have time to spend at the hospital – or be able to take time off work – and have access to reliable transportation, the Empowered Patient Coalition advises in its guide for patients and advocates. You could be learning about treatment options during medical rounds or keeping track of events in a patient journal. Bottom line: You can’t really look out for your loved one from a distance.
Keep a sharp eye on safety.
The core reason for being a hospital wingman is to help keep someone you care about safe. Don’t assume every health care provider has the right information, says Ilene Corina, president and founder of PULSE of New York, a nonprofit patient safety group. Before surgery, “make sure everyone who comes in and talks to the patient introduces themselves and explains why they’re there, and what they’re going to do,” she says. “You want to make sure that if it’s a gallbladder, they’re not telling you that you need your appendix out.”
Communicate with respect.
The ideal wingman is assertive and a good communicator. You’ll be talking to doctors and nurses, asking questions and speaking up when something’s wrong with the patient’s condition or care. Be tactful, if possible. “We call it ‘assertive but respectful,’” Corina says. For instance, she says, you should double-check the pre-surgical ID bracelet, but you don’t have to stand over the hospital worker who’s placing it – wait until you and the patient have a few minutes alone.
Respectful communication should be a two-way street, says Andrea Goldstein, of Seaford, New York. Unfortunately, she says, that was lacking – along with adequate care – in a recent ER experience involving her son, who went in for excruciating pain. Standing neglected in the corridor, Goldstein (an RN herself) spoke out – loudly. She drew the attention of another patient’s visitor (similarly frustrated), eventually followed by the charge nurse, ER doctor and the hospital’s patient representative. “I’m not necessarily advocating causing a scene, although it is fairly effective,” she says. But, she adds, “You’re just trying to get care for your loved one … not Mercedes care, just decent care.”
Hold out for hygiene.
One problem in the ER encounter, Goldstein says, was nobody washed their hands when entering her son’s room, as evidenced by the used, discarded IV bag and tubing (not his) left undisturbed in the dry sink. Corina says advocates can play a big role in infection prevention by “making sure people wash their hands when they come in and before they touch the patient.” They can check whether the patient’s hands and nails are clean as well, in case they inadvertently scratch a surgical site or wound while sleeping.
Give hands-on help — or find it.
Helping out with basic needs such as eating, bathing or walking may seem like a no-brainer for some patient advocates, but that depends. A non-health professional trying to help a bandaged, post-op patient out of bed could potentially cause more damage or even a fall, Corina says. “I don’t really want to take my father to the bathroom or give him help with his urinal,” she adds, out of consideration for his self-respect and their relationship. Instead, she says, the advocate’s role is to use the call button and make sure a nurse or nurse’s aide appears.
Navigate the paper trail.
As an anxious, distracted patient, it’s hard to concentrate on the piles of paper you get in the hospital – from instructions on how to turn on the TV, to critical documents like surgical consent forms. “The patient’s going to be given a lot of information to read and sign,” Corina says. “Before they even go for surgery, you might want to ask if they could get [the consent form] ahead of time, so they can read it at their leisure.” As wingman, you can read along and explain, if needed. You should also ask if the patient has a living will, and if so, find out how you can access a copy if need be.
Keep it private.
What’s revealed in the hospital stays in the hospital. “You never discuss what you hear outside of there,” Corina says. “So if I’m going with my very dear friend and I find out she has a drug problem, she has to know that I will never talk about it and never bring it up again.” Whatever medical information you learn, show discretion. “It’s really an honor to be at that patient’s bedside when they’re in that vulnerable state,” Corina says. “So at Thanksgiving dinner, you’re not going to even bring up their blood pressure medicine. Forget you ever heard it.”
Bill Swartz, 49, president of video game publisher Mastiff in San Francisco, has taken on the patient wingman role several times. When a loved one has looming health issues, he keeps a copy of his or her medical record, printing it out and bringing it to the hospital, in case the ER or inpatient staff lacks immediate access. After a surgery, he advises, don’t just ask if the patient is OK, but ask if the patient is OK and if there were unusual incidents of any kind. That, he says, “requires a more precise and useful answer.” Before talking to health care providers, Swartz does basic Internet searches to become informed about medical conditions and procedures, and demonstrate to doctors, nurses and technicians that “we’re the case to get right.”
We’re all human.
“Remember that people in medical facilities are human” is the other main advice from Swartz. Seems obvious, but he tries to make providers feel good about themselves, and he’s been known to deliver a batch of brownies to a “wonderful” post-op nursing staff as a thank you. In the past few years, Swartz has been patient wingman to several ill family members. His motivation: “They’re in the worst shape of their lives, they’re in pain and they have the right to be scared.” But he shrugs off the idea that his actions are particularly praiseworthy – “I don’t think I do anything special.”
Join the crew.
Maybe you’re not the assertive type, or you can’t commit blocks of time – but you can still offer some kind of support. It might be driving the patient to the hospital, managing his or her personal belongings or picking the children up from school. You can coordinate hospital visits, or be the discharge-minded friend who reaches out to the hospital social worker and looks up outpatient care providers online. Even “knowing the dog will be walked will help the patient relax,” Corina says. “You know, there’s always somebody who needs to make the tuna casserole and get the housekeeping done.”