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Hospital care

For many reasons, meedical and nursing care may require a stay in hospital.

Hospital care
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Outpatient or day care treatment is the preferred option for many procedures, but complicated treatments and severe illness may require hospital admission. Hospitals provide specialized medical and nursing care as well as expertise, treatments, and technology not available elsewhere. A stay in hospital is always necessary for major surgery. You may also need to be kept in hospital after minor surgery if you have a long-term disorder, such as a heart or lung disease, that increases the risk of complications.

You may need to be treated in hospital if you develop a serious illness or sustain a severe injury, or if you have a flare-up of an existing disorder, such as asthma. An elderly person may need time in hospital if his or her general health is poor. Children may be admitted to hospital for all of these reasons or in particular circumstances, for example if a non-accidental injury is suspected. If a doctor is unsure about the cause of a child's symptoms, such as a high temperature or abdominal pain, the child may be need to be admitted to hospital for observation and investigations.

You may need to be cared for in hospital if you are living alone and become too ill to look after yourself adequately.

What are the types of care?

Most routine operations and procedures can be arranged in a hospital near your home, but some conditions may need treatment in a specialist centre. For example, end-stage kidney failure, some types of cancer, and rare metabolic disorders are sometimes treated in hospitals that have particular expertise in these disorders. In addition, there are specialist hospitals for people who have long-standing mental health problems, although, whenever possible, care is arranged in the community using NHS and Social Services support services.

Routine admissions are to a general medical ward, but, if you are severely ill, you may need to be treated in an intensive care unit. Usually, children are cared for on children's wards in general hospitals, although there are some hospitals specifically for children.

General medical wards

Most people are admitted to a general medical ward, which provides a wide range of routine care, or to a general surgical ward if they are to have surgery. There are also wards that are designated for a particular branch of medicine or type of disease, such as oncology wards for cancer and coronary wards for heart disease.

You are usually allocated to a team of nurses who will be responsible for your care. Any medication that is needed will be given on a regular schedule, although drugs such as painkillers will be given as and when they are needed. Your temperature, pulse, and blood pressure will be measured at regular intervals and recorded on charts so that your doctor can monitor your progress.

A particular consultant, with a team of doctors, is in charge of your treatment in hospital. Decisions about your care are made on medical rounds, when this team of professionals will examine you and discuss your condition. This is usually the best opportunity for you to ask questions about the results of tests, your treatments, and progress.

Most wards allow visiting for most of the day, but visitors may be advised to avoid early morning visits when staff are busiest. Visiting may be restricted immediately after a general anaesthetic.

Intensive care units

People who are critically ill are usually admitted to an intensive care unit. These units differ from general wards in that they have a higher ratio of nurses to patients. They are also fully equipped with specialized equipment for treating and monitoring people who are seriously ill.

Admission to an intensive care unit is often necessary for monitoring after major surgery, such as transplant surgery or heart surgery, or during a serious acute illness, such as a severe attack of asthma or septicaemia. Intensive care may also be required after a person sustains a head injury or other major injury.

Some intensive care units specialize in treating particular conditions. For example, if you have had a heart attack (see Myocardial infarction), you will be treated in a coronary care unit where your treatment can be monitored continuously. Some hospitals have separate intensive care units for people who have serious kidney, liver, or nervous system disorders. Newborn babies who are premature or seriously ill are usually monitored and treated in a special care baby unit, also called a neonatal unit (see Special care baby unit).

Children's wards

Children are almost always admitted to children's wards, staffed by doctors and nurses who specialize in the treatment of children. There is often a playroom attached to the unit to allow sick children the stimulation and company of other children. Play therapists and teachers may visit to provide educational support. Usually, a child's main concern is being separated from the family, and parents are encouraged to spend as much time as possible with their child. There are usually facilities for parents to stay overnight.

Leaving hospital

The decision to discharge you from hospital will be made by your consultant after discussion with other members of the medical team and with you and your family. Ideally, your discharge will be planned in advance to allow time for any drugs that are needed to be prescribed and issued and any necessary follow-up care to be arranged.

After discharge from hospital, most people need no further care apart from follow-up appointments at an outpatient clinic or in a GP's surgery to check on their recovery. However, if you have a long-term disease or a disability as a result of illness, you may need rehabilitation, such as physiotherapy or occupational therapy, at an outpatient clinic or in your own home.

Posted 09.09.2010

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