By JUDD MATSUNAGA, Esq.
I recently had an overnight stay at St. John’s Hospital in Santa Monica, keeping watch over my 97-year-old dad in the Post Critical Care Unit (PCCU). Observing the doctors, nurses, nurse’s aides, and other hospital staff coming in and out of my dad’s room throughout the night reminded me of an article I wrote for The Rafu Shimpo titled “Surviving a Hospital Stay” (Aug. 9, 2017).
It’s been close to seven years since I last wrote about how hospitals can be dangerous places to visit — referred to as “Superbug Central.” Superbugs include bacteria, viruses, parasites, and fungi that develop the ability to resist drugs designed to kill them. This resistance means that the germs are not eliminated and continue to grow, making infections difficult, and sometimes impossible, to treat.
In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year, leading to over 35,000 deaths, according to the CDC’s 2019 Antibiotic Resistance (AR) Threats Report. When Clostridioides difficile — a bacterium that is not typically resistant but can cause deadly diarrhea and is associated with antimicrobial use — is included in these statistics, the toll of all the threats in the report exceeds 3 million infections and 48,000 deaths in the U.S. (Source: www.cdc.gov/drugresistance/about.html)
A recent CDC study found that antibiotic-resistant superbugs are easily transmitted within hospital environments, often via nurses’ clothing and patients’ bed rails. Testing revealed that the sleeves and pockets of the nurses’ scrubs were the most likely areas to be contaminated. It’s easy to see how a nurse could lean over an infected patient, thus contaminating their sleeves or scrubs.
Subsequently, they may move to the next room, leaning over the bed rails to perform various tasks, which could lead to the contamination of either the patient or the bed rails.
During my recent visit to the PCCU at St. John’s, I noticed a “fall risk” sign on all the rooms. This indicates that patients were often unable to walk to the bathroom, resulting in the use of a portable bedside commode or bedpan. One can imagine some mishaps. In the early morning hours, a janitor entered Dad’s room, disposed of the trash, mopped the floors, and left. However, not before touching doorknobs, the privacy curtain, and possibly other surfaces with his gloved hands.
Needless to say, I washed my hands frequently that night. Unfortunately, most hospital visitors have no clue and take very few precautionary measures to protect themselves — or you. They enter your room after touching elevator buttons, door handles, pens, and your bed rail — all of which may have been contaminated. Then, they come into your room, hugging, kissing, and holding your hand without first washing their hands.
Therefore, especially since COVID, I thought it was time to once again warn Rafu Shimpo readers about hospital visits. So, if you’re visiting a friend or loved one in the hospital, don’t bother bringing candy and flowers. Instead, bring a canister of bleach wipes. Wiping down the surfaces around the bed, including the bed rails, call button, and television controls, will remove dangerous bacteria that could cause an infection.
So, if you plan on visiting a friend or family member in a hospital anytime soon, I found a very helpful online article titled “Do’s and Don’ts for Visiting Patients in the Hospital” (Source: www.verywellhealth.com, Oct. 4, 2023). Hopefully, the guidelines will help keep you and your family safe from COVID/superbug contamination during your next hospital visit.
Do’s for Hospital Visitors:
(1) Do ask for the patient’s permission to visit before you arrive. Encourage them to be honest about their preferences. If they’re not up for a visit, inquire if another day would be better or if they’d prefer a visit once they are back home. Many patients love visitors, but some just don’t feel up to it. Do the patient the courtesy of asking permission.
(2) Do wash or sanitize your hands. Ensure this is done before touching the patient or handing them anything. After touching any item in the room, wash or sanitize your hands again. Infections come from almost any source and the pathogens can survive on surfaces for days. Don’t risk being the cause of further illness for your favorite patient.
(3) Do wear a mask. Regardless of current hospital rules, wearing a face mask can help protect both the patient and visitor from airborne viruses. If you do not have a mask, the hospital should be able to provide you with one.
(4) Do check before bringing balloons or flowers. If your patient shares a hospital room, avoid bringing balloons or flowers, as the roommate might have allergies. Most solid color balloons are latex rubber, and some people are allergic to latex. When in doubt, opt for Mylar balloons or refrain from bringing any.
(5) Do consider alternative gifts. Consider options like a card, something handmade by a child for the patient, a book, a crossword puzzle book, or even a new nightgown or pair of slippers. The goal isn’t to spend a lot of money but to make the patient feel cared for without causing potential problems or triggering allergic reactions.
(6) Do turn off or silence your cell phone. Different hospitals have different rules about where and when cell phones can be used. In some cases, they may interfere with patient-care devices, so your patient can be at risk if you don’t follow the rules. In other cases, it’s simply a consideration for those who are trying to sleep and heal and don’t want to be annoyed by ringtones.
(7) Do stay for a short time. It’s the fact that you have taken the time to visit, and not the length of time you stay, that uplifts your patient. Staying too long may tire them out. Better to visit more frequently but for no more than a half hour or so each time.
(8) Do leave the room if the doctor or provider arrives to examine or talk to the patient. The conversation or treatment they provide is private. Unless you are a proxy, parent, spouse, or an official advocate for the patient, that conversation is not your business. You can return once the provider leaves.
(9) Do follow all hospital policies and staff instructions. Most hospitals have set visiting hours, limits on the number of visitors in the room, and other rules you are expected to adhere to. Check the hospital’s visiting hours and other policies before your visit.
Don’ts for Hospital Visitors:
(1) Don’t enter the hospital if you have any symptoms that could be contagious. Neither the patient nor other hospital workers can afford to catch whatever you have. If you have symptoms like a cough, runny nose, rash or even diarrhea, don’t visit. Instead, make a phone call or send a card.
(2) Don’t take young children to visit unless it’s absolutely necessary. Check with the hospital before you take a child with you, as many hospitals have restrictions on when children may visit.
(3) Don’t take food to your patient unless you know they can tolerate it. Many patients are put on special diets while in the hospital. This is especially true for those with certain diseases or even those who have recently had anesthesia for surgery. Your treats could cause significant problems.
(4) Don’t visit if your presence will cause stress or anxiety. If there is a problem in the relationship, wait until after the patient is well enough to go home before you potentially stress them by trying to mend that relationship.
(5) Don’t expect the patient to entertain you. They are there to heal, not to talk or keep you occupied. It might be better for them to sleep or simply rest rather than engage in conversation. If you ask them before you visit, gauge their tone of voice as well as the words they use. They may try to be polite but may prefer solitude at this time instead of a visit.
(6) Don’t stay home because you assume your friend or loved one prefers you not visit. You won’t know until you ask, and your friend or loved one will appreciate the fact that you are trying to help by asking the question.
(7) Don’t smoke before visiting or during a visit, even if you excuse yourself to go outdoors. The odor from smoke is nauseating to many people, and some patients have a heightened sense of smell while taking certain drugs or in the sterile hospital environment. At most, it will make them feel sicker, and if your friend is a smoker, you may cause them to crave a cigarette.
There’s just one more item I’d like to discuss that didn’t get mentioned in the above article — your shoes! In the COVID-19 era, even if you sanitize the bed rails, wash your hands, practice social distancing, and wear masks in public, there’s still a chance you could track bacteria or the virus on the bottom of your shoes. According to one study, 50% of an ICU’s staff’s shoes tested positive for coronavirus, and the floor of the hospital pharmacy where staff had walked had a 100% positivity rate.
Another study conducted by “Good Morning America” and the University of Arizona found that shoes are “dirtier than a toilet seat” – toilets typically contain 1,000 bacteria or less, compared to the 66 million found on one of the test subject’s shoes. The test also revealed nine different species of bacteria living on the bottom of people’s shoes, which can cause infections in the eyes, stomach, and lungs.
I forgot about this one. But think about it — the doctor makes his “rounds” at the hospital. He visits rooms, some infectious disease rooms, contaminating his shoes, then walks into your room. If you’re lucky, he washes his hands, but his shoes contaminate your floor.
During the night, if Dad called out wanting the nurse, I walked from the couch to the nurse call button by his bed in my socks. In the future, when I get back to my car, I’ll have some disinfectant spray and disinfect the bottom of my shoes.
In conclusion, the good news is that individuals can do a lot to protect themselves and their loved ones when visiting the hospital. And remember, one of the most important rules is to take antibiotics only when absolutely necessary. Don’t ask your doctor for them for minor infections, and don’t try to use them to fight the flu or colds – antibiotics don’t work on viruses.
——————–
Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.