Be an Advocate

I can’t begin to count how often I say, “At some point every single person will need an advocate.” This is especially true in medical situations—people are very surprised at how quickly they can be put out of commission through injury or unexpected illness.

I had the opportunity to be that advocate for a co-worker this past week when she arrived at our office disoriented, vacant, and apparently having some kind of neurological issue or event. It didn’t take long to determine that *Jackie was not in charge of herself and not capable of making good decisions on her own behalf.

At that point advocacy started. I helped Jackie to a comfortable chair, kept a reassuring hand on her shoulder and quietly asked another co-worker to call 911. When the first responders arrived we quietly and very calmly shared relevant information, as I reassured Jackie that these people were here to help her. As long as I kept my hand on her she was able to calmly deal with their talk and procedures.

It wasn’t long before the ambulance arrived and decisions were made about transport and the chosen hospital. I informed co-workers that I would be going along with Jackie and I left before the ambulance was ready to go. The benefit of arriving at the Emergency Department first was that I was able to establish contact with the registrar so everyone would be aware that this patient was not alone and it would give me access to her right away.

Based on this day-long experience I thought it would be a good idea to write some tips for being an advocate in medical situation. These points are primarily for adults, but would work for children as well.

  • Be ready to help kindly, calmly, and quickly.
  • If you are the designated Health Care Representative for the patient make sure to have a copy of the document with you. (I keep mine in the glove compartment of my car.)
  • Introduce yourself to medical personnel, making sure to state your relationship to the patient.
  • When you offer information about the patient and what brought them to the hospital try to be factual and efficient with your words. The idea is to be a liaison between the patient and the medical professionals.
  • If questions are posed to the patient give them time and opportunity to answer. Many times the nurses and doctors are asking questions more to determine how able and aware a person is rather than for simply gathering information.
  • The medical person will likely look to you for confirmation of information the patient offers, and I do mean look, so be waiting for them to catch your eye. Do not interrupt until you are engaged for confirmation. If the patient’s answer is clearly off base you can stand back, out of the patient’s line of sight and shake your head, indicating that there is a problem with the answer.
  • You are there on the patient’s behalf. In sharing information about them do not belittle, criticize, embarrass or judge them. It is also unwise to correct them if their answers are off. There are quiet ways to share accurate information.
  • Be willing to sit quietly for long periods of time. Take your cue from the patient. Do not ask too many questions. If they are confused, sick, frightened, or in pain they likely do not have the capacity to engage in small talk or questioning.
  • When doctors come in feel free to ask questions calmly and respectfully. If the patient isn’t grasping what the doctor says offer a reassuring touch and explain it in another way.
  • Keep an eye on the patient and try to anticipate what they might want; they may not be aware of their needs or may be unable to articulate them. Does their skin feel cool to the touch—ask for a blanket. Are they thirsty or showing signs of a dry mouth—ask if they can have liquids. Do they need to go to the bathroom—notify the nurse so the nurse can decide how to handle it.
  • If pain, discomfort, bleeding, agitation, confusion, or hallucinations seem to be increasing ask for help. You are in the perfect place to notice these changes, and to act on them.
  • Do not assume the patient is safe to get up out of bed even if they think they’re perfectly capable. Ask for help.
  • If you are aware of the patient’s medication allergies make sure the nurses and doctors are made aware of them, too. When medications are ordered, and when they arrive do not hesitate to ask what they’re giving and why.
  • Be a calm and comforting presence—be an asset to everyone.
  • Remember that confidentiality is critically important. Share details only with people who have a need to know, both during and after the event.
  • If you will need to share information with family members take notes if necessary. Remember to report facts only, and be careful to not engage in criticism of the patient.
  • Be glad that you were able to help. If you need to talk with someone to help you process your experience find a trusted individual who will hold your conversation in confidence.

Our long day ended well in that I was excused after family members arrived, six hours after we arrived at the hospital. The patient was discharged later the same day and will be returning to work in another week. I was never given details about the final outcome and that’s perfectly alright. I did my part while I was needed. Mission accomplished.

I hope the list above will be helpful to you, and that it will encourage you to be an advocate for someone when they really need it.

*Name and details changed

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