Chances are you or a loved one will at one time or another spend some time in a hospital. You may go in for something physical such as an operation or even tests such as a colonoscopy. A family member may need to go into a psychiatric hospital, perhaps just to evaluate the medications they are on.

Before going into a hospital remember: there are good hospitals and there are bad hospitals. It is up to you to make sure that the one you use is the best one.

There is a difference between regular hospitals and psychiatric wards. In the former an entry date is scheduled. You have time do your homework. In most cases going to a ward is done through an emergency room. The staff calls the different hospitals looking for a bed. They then expect you to be admitted that very moment. And you are taken there by ambulance; there are generally no walk-ins.

What do you do in this case? Be proactive and learn as much about the hospital as you can.

But how do you determine which are the good ones? These tips will help you make your decision. Some of them were suggested by Ron Nickerson. As a clinician he helped set up the children’s psychiatric ward at Tufts New England Medical Center in Boston Massachusetts. It is one of the best.

Ask for help. Don’t be railroaded into making spur of the moment decisions. Talk to other people. Talk to other parents. Find out who has used the hospital and get their comments on it. Don’t do it alone. Getting help can spell the difference between a good hospital and a bad one. If you have a time limit for bed space, get on the phone immediately. Do as much homework as you can before the ambulance arrives.

Make sure your Insurance will cover the hospital stay. Most hospitals will make the call for you but do it yourself also. There are many stories of people being told that their insurance will cover them in the hospital. Later on they discover when the bills start coming in that the insurance plan didn’t cover their specific case such as psychiatric care. Make sure your insurance will pay for other things besides the hospital. There are a number of items that may not be covered that will be billed later or separately. These include doctors, emergency room, emergency room doctors, and ambulances. Don’t rely on the hospital to check this out for you or even inform you of these extra charges.

Determine if hospitalization is needed. For regular procedures a second opinion is always necessary. If these opinions conflict get a third one, especially if we are talking about a major procedure. If a psychiatric hospital has been recommended perhaps only a medication change or a reevaluation is required. These can be taken care of a lot of times on an outpatient basis. Do your homework, there may be alternatives. In the case of a need for an immediate decision, call your psychiatrist and pediatrician/primary care physician to determine if the stay is essential.

Check out the cleanliness of the hospital. Have the floors at least been swept? Is there trash in the rooms? Are the windows washed? Are the rooms and desks cluttered? If there is a refrigerator, is it kept clean? Would you live in a house that is kept this way? Assume that however the hospital or ward is kept is the same way they will treat you or your loved one.

Observe the staff’s attitude. Do they grumble and complain? Do they mope around the floors? Are they bright and cheery? Do they enjoy working with children? Are they friendly? Don’t be afraid to ask them if they like working there. Their attitudes will affect the way you and or your loved ones are treated.

Find out the procedures used to handle out of control children. Are they restrained? Are they put in a quiet room? Are they ignored? How are the children calmed down? Be sure you understand the procedures. Better yet, try and observe them.

Make sure of the visiting hours and phone call procedures and find out if they are negotiable. Regular hospitals may have visiting hours from noon to 2 pm, then 4 pm to 6 pm, and 7 pm to 9 pm. Psychiatric hospitals are generally limited to the hours of 6 pm to 8 pm. It is tough on a child if they can only see their parents for a couple of hours in the evening. The main reason given is that with parents around a lot the staff cannot observe the child’s behaviors properly. However, will they allow you to visit more often?

Does your loved one have access to phones and what are the restrictions? How often will they be allowed to call you or you call them?

Does your child interact with older or younger children, adults, and geriatrics? A 6 year old child that is placed with older children can get quite an education. Not only that but their safety might be in jeopardy. Some psychiatric hospitals have been known to allow older children to supervise younger ones. The best procedure is to have all of these groups in separate wards.

Find out what the hospital offers for parent groups. Some will bring the parents together to discuss the problems each has with their children. There may be training sessions. There might be parent/child playgroups.

Get involved. Join the available groups; learn as much as you can. You can also learn a lot about how the hospital operates.

Get to know the human rights officer, director, and staff by name and number. Call and speak to them by name. Ask them a lot of questions and be in daily contact.

Check the nurse to counselor to child ratio. A good ratio would be 3 children per counselor and 3 counselors per nurse. If there is a larger ratio, for example, 10 children per counselor it probably means that less attention will be paid to your child.

Ask a lot of questions. There are some suggested questions listed above. Come up with your own. There are probably a lot you can think of that specifically concern you or your loved one.

You will notice that a lot of these tips are specific to psychiatric hospitals and to children. You may not need to use all of them if you are entering a regular hospital. But if you make small modifications, they can. For example, if this is about you wouldn’t you like to know the nurse to patient ratio (rather than counselor to child)? Will your nurse be supporting 10 or more patients? You could be waiting a long time to get your needs met.

It is tough enough having to spend time in a hospital. In the end following these tips can make your stay or that of your loved one more pleasant.

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