Über die Autorin bzw. den Autor

Johnilynn Wunderlich, RN, CLNC, has been a Registered Nurse for thirteen years. She has work experience in Neurological-Trauma Intensive Care, Special Needs Pediatrics, Pediatric Hematology-Oncology, and Medical-Surgical Intensive Care. She became a Certified Legal Nurse Consultant in 2004. She currently resides in Arkansas with her family.

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Patient Empowerment Guide and Journal

iUniverse, Inc.

Contents

MY HOSPITAL JOURNAL.........................................................1MY INSURANCE INFORMATION....................................................2MAKING DECISIONS............................................................3PRIVACY CODE................................................................4MEDICATION LIST.............................................................5MEDICATION LIST.............................................................6LIST OF SURGERIES AND PROCEDURES............................................7LIST OF PHYSICIANS AND THEIR SPECIALTY......................................8ITEMIZED BILLING............................................................10OBTAINING MEDICAL RECORDS...................................................11KEEP YOUR EYES OPEN.........................................................12NOSOCOMIAL INFECTIONS.......................................................14INFORMATION REGARDING ADMINISTERING BLOOD PRODUCTS..........................16RECORD OF BLOOD PRODUCTS....................................................17MEDICAL IMAGING.............................................................18INFORMATION REGARDING CONTRAST MEDIA........................................20ROUTES OF OXYGENATION.......................................................21FACTS REGARDING MECHANICAL VENTILATION......................................22MY VENTILATOR SETTINGS......................................................24REHABILITATION THERAPIES....................................................25THERAPY SCHEDULE CONTINUED FROM _______ TO ________.........................26DIALYSIS....................................................................28MY DIALYSIS SCHEDULE........................................................30TYPES OF NUTRITION..........................................................32MY NUTRITION SCHEDULE.......................................................35BASIC UNDERSTANDING OF COMMON LAB TESTS.....................................45IT'S ALL GREEK TO ME ... UNDERSTANDING MEDICAL LANGUAGE.....................50ENTERING THE EMERGENCY ROOM.................................................79MY CANCER JOURNAL...........................................................351SPECIAL DELIVERY............................................................368MEDICAL SUPPLY LIST FOR ___ DATES ___ TO _______............................372Index.......................................................................377

Chapter One

This journal belongs to: ________________________

I stayed at ________________________ hospital.

Dates of my stay: _____________________

My reason for coming to hospital: ___________________ _____________________________________________________

My diagnosis: _______________________________________ _____________________________________________________

My physician's names: _______________________________ _____________________________________________________

My day shift nurses names: __________________________ _____________________________________________________

My night shift nurses names: ________________________ _____________________________________________________

My patient care technician's names: _________________ _____________________________________________________

Names of charge nurses: _____________________________ _____________________________________________________

Name of case manager: _______________________________

Name of social worker: ______________________________

Name of nurse manager: ______________________________

Names of nursing supervisors: _______________________

Name of inpatient service director: _________________

Name of chief nursing officer: ______________________

Name of CEO at hospital: ____________________________

This hospital is owned by ______________ Corporation.

Is this a for profit hospital: _____ yes, _____ no.

MY INSURANCE INFORMATION

My primary insurance company is: ______________________________

My policy number is: _______________ Group number: ____________

My ID number is: ___________ Insurance phone number: _________

Mailing address of insurance company: _________________________ _______________________________________________________________

I am the primary/secondary (circle) policy holder.

If secondary policy holder, name of primary: __________________

My co-pays are: _______________________________________________

Do all my physicians take my insurance that see me during my

hospital stay: _____ yes, ____ no. This is important to ask.

My secondary insurance company is: ____________________________

My policy number is: _______________ Group number: ____________

My ID number is: ___________ Insurance phone number: __________

Mailing address of insurance company: _________________________ _______________________________________________________________

I am the primary/secondary (circle) policy holder.

If secondary policy holder, name of primary: __________________

My co-pays are: _______________________________________________

Notes: ________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________

MAKING DECISIONS

There are times when we need to make our decisions known in advance. Spending time in the hospital setting is one of those times. I have witnessed all too often patients suffer needlessly due to not having made these important wishes clarified in writing.

If you do not currently have these in place, I strongly urge you to complete them before you come into the hospital. If this is not possible, the hospital can assist you with them. Do not hesitate to ask!

I have a Living Will: ____ yes, ____ no.

Copy given to the hospital: _____ yes, _____ no.

Is a copy on the chart (ask)! ____ yes, _____ no.

I would like information regarding a Living Will: _____ yes, _____ no.

I have a Healthcare Surrogate: ________ yes, ______ no.

If yes, name of person: _____________________________

If no, I wish to initiate __________________________ as my Healthcare Surrogate if I am unable to become unable to make my own decisions.

Copy given to hospital: _____ yes, _____ no.

Is a copy on the chart (ask)! _____ yes, _____ no.

I would like information regarding the responsibilities of my Healthcare Surrogate: ____ yes, _____ no.

If yes, ask for the form from the hospital and have your healthcare provider explain it to you.

I have a Medical Power Of Attorney: _____ yes, _____ no.

My medical power of attorney is: ____________________________________

Their contact information is: _______________________________________ _____________________________________________________________________

Copy given to the hospital: _____ yes, _____ no.

Is a copy on the chart (ask)! _____ yes, _____ no.

I would like information regarding the responsibilities of my Power Of Attorney: _____ yes, _____ no.

If yes, ask for the form from the hospital and have your healthcare provider explain it to you.

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