If there’s one thing I’ve learned in 2020, it’s that an awful lot of people don’t know what “hospitalization” actually means.
So I think it’s time to educate y’all!
There are many reasons why a person might be hospitalized. Here are a few reasons I’ve been “in house” (the hospital term for being in the hospital):
To receive IV antibiotics, and I basically felt fine.
To receive surgery and recover from it (or, to receive procedures and recover and go home—these are called “23 hour admits.”).
Because I’ve needed fluids and pain meds around the clock, and regular labs to verify how things are going in my body.
Because I felt like crap and needed lots of therapies and needed to be carefully watched.
My first admit for CF, in 1993, was one where I felt pretty good. I mean, I played in the playroom, I did wheelchair races in the hallway, I wasn’t lying in bed. But I needed IV therapies, I needed albuterol therapy, and we had to learn about CF. So I was in the hospital to get that intensive training and therapy. But I felt fine. (Well, as fine as I normally felt!)
Later on, I’d be in the hospital for a few days if I needed IV meds. We’d do them, make sure I was tolerating them OK, and then I’d be sent home—on the IV meds. I went to school with an IV in. I went to work with an IV in. I just did the meds when I needed to do them. (Now, apparently, this doesn’t happen as much, which I think is ridiculous, but….I digress.)
“23 hour admits” are basically admits where I might stay longer, but the plan is to get me out that day. This is how we used to do bronchs, or even things like pH probe tests (AWFULLLL). You’re in for a day or so, and then you go home. When I had my cardiac ablation, I was in for a few days, we did the ablation, and I went home soon after. Again, didn’t feel too crappy. On with life.
Sometimes yes, I do feel like crap, and I need to be admitted! But even then, this doesn’t equal DEATH. When I have pancreatitis, 99% of the time I will be admitted, because the “cure” for pancreatitis is pain meds and fluids, along with regular blood draws to check certain enzyme levels which show how the pancreas is doing. Now, being in pain isn’t fun and being hungry isn’t fun, so these aren’t the most fun admits, but generally, they’re not EMERGENCY LEVEL PANIC admits.
Then we get to the last category, which is, “Yes, Emily is very sick and needs to be in the hospital to make sure bad things don’t happen.” These are not fun. The upside is that you get to sleep a lot (or I did anyway.).
Being in the hospital does not mean “WOW SO SICK” just like being in the ICU doesn’t mean “DEATH!” It just means that you need a certain level of nursing care and medication. Whenever I needed cardiac cardioversion (aka the paddles), I was always admitted to the ICU, for monitoring. I felt OK once the pain meds were on board and I had stopped vomiting. :) But I was in the ICU because things could go south and then we’d need to work fast. But I was a pretty easy patient for the nurses on those nights!
Sometimes, yes, the “hospital census” (aka, in patient number) is high. Sometimes you have a lot of people in the hospital, like….during cold and flu season. Hospitalizations tend to go up then, because people get things like pneumonia (which I was hospitalized for a few years ago), or other things like that. Sometimes you might need to be in house but aren’t admitted like the one time my doctor had me deal with pancreatitis at home (which was….weird, but anyway). Sometimes, yes, I have waited in the ER while a room was made ready upstairs.
Some hospitals have observation rooms in or off the ER, and some don’t. These can also be used to “hold” patients until a room on the floor is ready. In January that’s where I stayed when my BGLs were wacky and endo finally….gave me insulin. (Sigh.)
That’s not to say that hospitals can’t be overwhelmed—they can be. (See, OSU ER trip in January where we waited for eight hours which has never happened in my life.)
But what I want you to take away from this is the idea that hospitalizations or ICU usage means a lot of people are at death’s door.
Also remember that people are in hospitals every day for a lot of things (see above), and are in the ICU for a lot of things every day. I’ve done three (four???) ICU stints now and I’d prefer to not to do it again because it’s sort of un-fun but I was in the “census” as an ICU patient, even though I wasn’t really at the level of an ICU person (see cardioversions above!)
All a census number really shows is how many people are in the beds at the moment. That can change based on a lot of factors. For example, NCH used to try to discharge a lot of people before the holidays. If you could go home, they wanted you to go home because who wants to spend Christmas in house? NO ONE, REALLY.
So I hope this gives you a slightly better insight into what a hospitalization can be, if you’ve never really experienced one yourself!