With the exception of giving birth, people seldom enter hospital unless they are unwell. Therefore, patients will have pain or other symptoms plus the worry of wondering whether their health will improve or deteriorate. This would apply whether the patient were at home or in hospital. However, hospitalization involves additional stress, especially for someone who does not speak the language very well.

When a person is at home, they have control over their own environment and their lifestyle. They can decide their own daily schedule, and generally choose what they want to do. When someone enters hospital, they lose this control. They must accept the environment of the hospital, and allow their daily schedule to be dictated by others. Of course, to a large degree this is necessary for the efficient operation of the hospital, and for the benefit of the patient. Nonetheless, this loss of control is quite stressful.

For someone from another country, the stress may be compounded. They may be unfamiliar with the health care system in Japan, and they may have additional difficulties with communication because of the language barrier. It is impossible to generalize about health care in other countries. In some ways, each country will have its good and bad points. There is much to admire in the Japanese system. However, just because it is different from a patient`s home country, there may be stress.

The language barrier is also an important problem. The overseas patient may be unable to communicate even simple wants and needs. They may not be able to understand explanations about hospital rules and procedures. More importantly, they may not be able to communicate or understand important information which is necessary for proper diagnosis and treatment. Even if the hospital staff are providing the most appropriate care, the language barrier may create doubts in the patient`s mind about the quality of care which they are receiving.

Hospital staff need to be very sensitive to these concerns. It may be a natural human tendency to avoid people with whom we can`t communicate well. However, it is actually necessary for staff to spend extra time to make sure that communication problems are solved. These challenges remind us that good health care is more than just science and technology. Human relations are an essential part of our work.

Situation 1: A patient has just entered the hospital for elective surgery and is being visited in her room by a nurse.

Mrs. Thompson: What am I supposed to do with my valuables?

Nurse: Actually, we prefer that you don`t bring any valuables into the hospital. However, you can lock things in the cupboard next to the bed. If you have anything really valuable, it would be better to have one of your family take it home.

Mrs. Thompson: Well, I have some money in my purse and a little bit of jewelry. I suppose I could have my son take my jewelry home tomorrow, but I prefer to keep a little money with me.

Nurse: Sure, I understand. I am just supposed to warn you about these things in case something gets lost. The hospital would rather not be held responsible.

Mrs. Thompson: Okay. Now, what should I do with my clothes? I`d rather not get into pajamas unless I have to.

Nurse: I think the surgeon is supposed to come around and see you this afternoon, so you had better get into your pajamas. You should put your clothes in the cupboard over there.

Mrs. Thompson: It`s still early. I`d rather keep my normal clothes on for now, if that`s all right.

Nurse: I suppose there`s no harm in that, but you had better change after you have had your lunch.

Mrs. Thompson: I have this prescription from my doctor. Should I keep taking it?

Nurse: You had better ask the surgeon about that when you see him. When are you supposed to take your next pill?

Mrs. Thompson: I`m supposed to take one with every meal.

Nurse: Well, you`d better take one with lunch as usual. Then we should check with the surgeon.

Mrs. Thompson: I suppose I`m a nuisance with all of these questions.

Nurse: Not at all. We want you to feel comfortable here.

Patterns:

*I suppose
...I could have my son take my jewelry home tomorrow
... there is no harm in that
... I'm a nuisance

* I am just supposed to
... warn you about these things
* I am supposed to
... take one with every meal
* The surgeon is supposed to
... come around and see you

* When are you supposed to
... take your next pill
* What am I supposed to
... do with my valuables

* You should
... put your clothes in the cupboard over there
* We should
... check with the surgeon

* Should I
... keep taking it

* What should I do
... with my clothes

* I prefer
... to keep a little money with me
* We prefer
... that you don't bring any valuables into the hospital

* I'd rather
... keep my normal clothes on for now
... not get into pajamas
* The hospital would rather
... not be held responsible

* You had better
... get into your pajamas

... change after you have had our lunch

... ask the surgeon about that
* You'd better
... take one with lunch as usual
* It would be better
... to have one of your family take it home

Discussion:

1. What are some of the things that a patient may worry about when they enter hospital?

2. Do you think that hospitalization is more or less stressful for older people? Why?

3. What are some of the special worries that you might have as a patient if you could not speak the same language as your doctors and nurses?

4. In the first situation, the nurse says that the patient should not bring valuables, such as jewelry into the hospital. Why is the hospital concerned about this?

5. In the first situation, the patient is reluctant to change into pajamas. Why do you think she feels this way?