At Red Voice Media and The Stew Peters Show, we care about our viewers as more than just numbers and advertising dollars. Stew often refers to his viewers as a family, one that is full of doers, of activists, of people who step up to the plate to take care of fellow family members.

After watching medical situations play out around the nation, most recently and notably the Quiners in Minnesota, we wanted to find a tangible way to help our viewership family to avoid this type of situation happening to them.

So, we found a patient advocate who feels the same way- actually caring about people as people, not just numbers- and asked for her advice. God blessed us with an incredible resource- Melanie out of the Southwest Washington area- and she agreed to allow us to share some of her advice with you. For security purposes, and the safety of her medical license, we will only be using her first name. She explained to us, and now we are passing on to you, the importance of getting what’s called a medical power of attorney. In our state, and possibly in others, this is different than a regular POA. However, for the purpose of this article, I will refer to this as POA from here on.

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This may seem daunting and stressful, but if you read through the information carefully, you’ll see it’s not as difficult as you’re probably thinking it is (which is exactly the same boat I was in before speaking to Melanie!).

For credibility, Melanie is an RN, BSN. She first got her degree in psychology and became a case manager for sexually abused and institutionalized children. When she had children of her own, she went back to school and became a nurse, and has been so for the past seven years. She has worked in hospice, wound care, and ultimately landed in patient advocacy and case management as an independent contractor. Melanie has a father who is paraplegic and under her care, so she has experienced the medical system from both sides of the lens.

Melanie does do paid case management advocacy, but she has been working pro bono for Covid patient families, because she doesn’t want money to be a barrier for families to receive potentially life saving information. She agreed to share this information with Red Voice Media because she knows that there are so many people out there (this author included) who don’t know how to protect themselves and their family members from bureaucratic “guardianship” from hospitals who care more about their Covid bonuses than saving as many lives as possible.

“They have rights,” Melanie told me. “Covid doesn’t get to automatically hit the pause button on these rights.”

Before starting, it should be noted that not all hospital employees are cold and callous, and Red Voice Media doesn’t seek to claim they are, nor does Melanie. It also needs to be noted that what we are about to discuss is mostly based on Washington State law and code- you should check with your own state laws to make sure you’re protected.

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Melanie told me that officially assigning a POA to our loved ones is a proactive way to allow people to be their own advocate. She’s been getting a lot of calls recently from family members who have loved ones stuck in the hospital- alone, and without knowing exactly what their wishes would be.

“What I’m about to tell you are the legitimate steps that have worked so far, in this area anyway,” Melanie said. “They’re not fool proof, but they’re a good guideline for how to navigate these types of situations.”

Melanie uses an acronym to explain to people what they should do: PATIENT.

is for print. Each person should print out their state’s patient rights and responsibilities, as well as the hospital’s to where they would be taken in an emergency. While it varies with each state and hospital, most should have a disabled support person policy, and the keyword to search for is SUPPORT PERSON. The hospital’s patient rights policy will be modeled after the state’s policies, and they can’t argue their way out of their own policy, so having this handy will be helpful.

If you’re already in the hospital and haven’t had a chance to do this yet, the policy should be posted somewhere, or you can ask to see a copy.

According to Melanie, there has been a huge difference in knowing this information upfront when they walk into the hospital versus having to play catch up when someone is sick and family is locked out of hospital.

A is for advanced directives. There are many types of AD’s, such as living wills, trusts, etc., but for our purposes, we will focus on the durable power of attorney for health care (DPOA-HC) form. This can be accomplished without going to an attorney- for example, in Melanie’s area, she recommends www.honoringchoicespnw.org. Again, each state has their own laws about this, and in Washington State, you need only have two non-family member witnesses sign, or have it notarized for it to be legal.

On the DPOA-HC, you’ll select a person who you delegate to make your medical decisions, as well as an alternate person. Melanie suggested doing this as soon as a person turns 18, like she did for her son, especially if your state is like Washington. This is both because of what she’s seen and personally been through, and also because of WA State’s laws: In Washington, there is a hierarchy of who gets to make a medical decision in the absence of a POA. One would naturally think that would default to a spouse.

But one would be wrong: There is above the spouse a state-appointed guardian that jumps ahead of the spouse without a DPOA-HC (Washington State snuck this little ditty into legislation in 2019, and amended it, but not for the better, just this January). Every state has it’s own hierarchy- know what yours is.

No matter what state you’re in, the best thing to do ahead of time is bring in the POA to your hospital or doctor of choice and have them scan it into the person’s records. Then it’s always on hand and ready. But if it’s too late for that, bring a copy of the POA with you to the hospital or ER as soon as possible, so they can scan and confirm it then.

T is for typing up a medication list. This piece is big right now, Melanie said, because of the supplement piece. The hospital will not give you any medications brought from home, and they won’t give you anything not on a medication list unless they’re prescribing it. If you show them what you’re already taking, such as, for example, a high level of vitamin D, they’re pretty much obligated to give it to you.

As we are seeing so many hospitals elect to not give proper vitamins to patients, it is a good idea to have this handy to be able to show all those good vitamins you dose yourself with daily to keep you healthy.

I is for initiating the chain of command. Every type of medical center (hospital, long term care unit, nursing home, etc.) will have some type of chain of command. An example would be bedside nurse, charge nurse, patient relations, nurse unit manager, hospital administration or chief nursing officer.

Of course, as Melanie pointed out, a lot of advocating has to do with attitude and approach. You want to be assertive but not aggressive, persistent but not panicked. You want to be a problem to be able to get what you want for the patient, but you also want to be understanding- acknowledge that they’re overworked and understaffed. Empathize with their situation so they’ll empathize with yours. Compassion goes a long way, and your approach makes a huge difference.

But, if time goes on and you’re not being heard, it can escalate through the chain of command. Sometimes just asking, “What’s the chain of command at this hospital?” when a problem starts to arise is enough to accomplish the goal because then they know that you know you’re stuff.

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E is for enroll, and this is a job to do before a loved one is in the hospital. Enrolling in electronic medical records (MyChart, MyHealth, what have you) is important beforehand because you can authorize proxy access granting viewing permission and still be HIPPA compliant. Everyone should know everyone’s password for medical records, Melanie said, because then you can see in almost real time what the person is being tested for, what medications they’re being given, etc. This is also a good way to be able to send the information to another doctor or get a second opinion easily.

If you haven’t accomplished this beforehand, you can still ask for an access code. If the person is not lucid and you don’t have POA, however, the access code is difficult to get. It definitely pays to be proactive for this. If it gets to this point, you can’t sue without medical records- you’ll have no information to go on, so make sure to get this done.

N is for notebook. Document everything! The who, what, where, when, and why. Focus should be on who you talked to (last name if they’ll give it, but at least a first name spelled correctly, ask them if you have to, and their title and email if possible) and when (date and time), and what you talked about. Was it in person or on zoom?

While documenting is important, you don’t necessarily need to keep the phone out and recording at all times. In fact, it’s important to know your state’s laws on this. For example, Washington State is a two-party consent state, meaning that both the recorder and the person being recorded need to give permission to be on camera. Know your state’s laws before you bust out the recording device.

T is for transfer. If things aren’t going the way you want, your loved one could be transferred to a different hospital. Or if you want them home, they could be transferred onto hospice. You can take them out with an Against Medical Advice (AMA). An alternate “t” word is threaten. If it becomes necessary, you can threaten to sue using a medical malpractice attorney. You can threaten to write complaints against their medical license with state boards. Those complaints actually have a lot of clout and are something the medical staff would like to avoid.

S is for scripture. Melanie made sure to point out that while it’s the last letter in the acronym, it doesn’t belong at the bottom. “Put on the armor of God,” she said, “and pray throughout the whole process.”

Melanie said that medical errors are third leading cause of death in the US after cancer and heart disease. Having family members present gives the patient hope, something to work towards and not give up on, avoiding social isolation. Families do catch things when they’re in the room with the patient, they know patients’ base lines and when something is abnormal. They’re also there focusing on just one patient instead of having to split attention between patients- probably too many patients since there is such a staffing shortage.

These are important steps to take to make sure that yourself and your loved ones are taken care of properly.

Graciously, Melanie has even made herself available for follow up by email. Her email address is: [email protected]. Remember, Washington State laws may differ from other states, so do your research!

Thank you so much to Melanie for sharing this valuable and possibly lifesaving information with us.

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