It’s time for a special edition of my Germany vs the US series–a side by side comparison of how hospitals work. How do I know this information, you ask? Well, last week my appendix decided it wanted out stat and I wound up having emergency surgery. Many thanks to Amy for taking care of business while I was recovering!
As most of you know, I’m a RN with a master’s degree in nursing. Even though I’m not currently practicing, spending four days in the hospital brought it all back to me. So many things are the same from one country’s health care system to the other (the smells, especially!), but I thought you’d enjoy hearing about some of the differences.
I’ll Be Here All Week
This was a really big difference–in the States, insurance companies want you in and out quickly because hospital days are expensive. I had a laparoscopic appendectomy, which probably would have gotten me a single overnight at home, but here I was an inpatient for three nights, and they wanted to keep me for four. I managed to talk them into discharging me a little early because my husband was going away on an extended work trip and at least wanted to get me settled at home before he left. Even with that, I had to promise to come back the next morning for lab work and an examination.
Here in Germany, health care is single payor and provided by the government, so there isn’t as much incentive to control costs. One friend told me that Germans look at hospitalizations as mini-vacations, which horrified me since like all health care professionals, I absolutely loathe hospitals (ask my husband how long it took me to even admit I had a hot appendix and agree to go to the ER to get checked out!).
Walking, Walking Everywhere
This one was funny to me since I well remember wheeling patients through the hospital to the various departments and even to the front door when they were being discharged. We don’t let people simply walk around the hospital because they might somehow hurt themselves! That’s not the case here.
In the ER, after they’d gotten my pain under control and determined that I was going to need surgery, they told me they were going to admit me. The resident asked me if I felt good enough to walk; I was flying high at that point and said that I did. She handed me my coat and purse, along with my paperwork, and told me to take the elevator to the ninth floor where I would find my bed! Off I toddled at 4am, high as a kite and still really bad at German, and went looking for my room. I found it eventually but definitely broke a sweat looking for it!
The next day, prior to surgery, my nurse sent me to find the anesthesia department so I could consult with an anesthesiologist. Once again, off I went with just a sheaf of papers in hand. I filled out a four-page questionnaire about (I think) my previous surgeries and experiences with anesthesia, filled in (I think) my allergies and height and weight (in kg and cm, so math was involved and I was still on drugs, mind you), and spoke with (I think) an anesthesiologist about what to expect. We used to chart that the “patient is a poor historian” in situations where they can’t give you enough information to make good decisions; I was 100% a poor historian in this case!
Experienced Doctors Cost Extra
Another interesting twist before my surgery involved the nice ladies who came up from the admitting department to talk about my private insurance coverage, since I’m not part of the German system. They needed me to find out what kind of doctor my plan allowed–and this was very important because it determined whether a resident would be taking my appendix out, or if I could expect someone with slightly more experience. Imagine my relief when my husband got back to me with the news that Tricare would cover even the head of the department as my surgeon! (Although to be honest, I was willing to take my own appendix out with a rusty spoon at that point just to feel better again.)
I could also opt to pay out of pocket for a private room if I wanted. I kind of liked the sweet little Oma I was sharing a room with, even though we couldn’t communicate, so I stayed put, although I did reconsider that decision the day they brought her a bedside commode to use. Our room didn’t have a curtain divider and, well, you can imagine the rest.
Hospital Food is Always Meh
A really nice lady came by to take my food order every day, but I will be honest that it always sounded better than it tasted (some things are universal).
I was, however, impressed by the fact that they cared deeply about my morning coffee–I could have cream, cold milk, or hot milk to go with it–and I felt like finally I had found people who understand just how important coffee is to life.
They also brought by a lovely fourth meal every day that I was allowed to eat–kaffee und kuchen (coffee and cake). It was still hospital-food cake, but cake nonetheless.
Pain is Relative
This part might only be interesting to those of you with a health care background, but their approach to pain control is different in a couple of ways. First, when I walked into the ER I was in serious pain and had been for hours. I thought it was significantly worse than childbirth, if that tells you anything! Well, they asked for my passport and a urine sample, and had me lie down on a gurney–in the middle of the hallway of course, because that’s how it works in the ER. Then, before anything else (and by anything I mean vital signs, an assessment of my abdomen, labs–anything), they put in an IV and gave me pain meds.
Now, as a patient in excruciating pain, I thought this was amazing, but as a nurse it was definitely different than what I was used to! By the time the surgical resident (I think) came to examine me and do an abdominal ultrasound, I was feeling absolutely fabulous. It all came out fine in the end, but it wasn’t the order I was used to.
As quickly as they put me on those pain meds, they wanted me off of them, which was a shame, really. I was allowed IV meds for about 12-18 hours after surgery, but then they pulled my IV and put me on something oral (I’m guessing like Percocet) for one day, and then it was nothing but paracetamol/Tylenol for me! It wasn’t unbearable, but it was more uncomfortable than I would have liked to wean down so quickly.
Take Your Things and Go!
When it was time to leave, they just handed me a copy of my labs and discharge summary and said goodbye. I picked up my bags, said goodbye to Oma, and walked outside by myself, just like I’d walked in.
The hospital is literally within walking distance of our apartment, but it’s all uphill, so I waited out front until my husband could drive down to get me. No sense dying immediately after leaving the hospital if you can help it.
The best part about the hospital is coming home!
So, while I wasn’t expecting the opportunity to experience the German hospital system, all’s well that ends well. The staff were all lovely and friendly, I’m healing well without any complications, and best of all, I didn’t die. I do have to wait until the end of the month before I can fly back to the States, though, so my daughter and I have shifted our plans.
The worst part of the whole experience was that I had to miss her high school graduation; to be honest I’m still really sad about that. But at least my husband was able to be there–he’s certainly had to miss a bunch of milestones over the years because of his work. Can you tell I’m trying to count my blessings instead of feeling disappointed?!
Now I’m off to rest–thanks for stopping by!
(See the other posts in this series here)
I love reading about the differences between Germany & the US. I’m so glad everything turned out to be ok with you. Sorry about the graduation, but you will have another one coming up in 4 years. Be well.
That is true–thanks for the perspective. And as my daughter tells me, it was FOUR HOURS LONG and I would have been miserable if I had been there. lol
Take care,
Christy
Hello,
Hope you are mending nicely. I was excited to hear from you.
Sorry you missed your daughter’s graduation. Glad your husband was able to be there.
Please update us.
Sincerely
Rebecca Purdie
Thanks so much, Rebecca. I appreciate the good wishes! I feel so much better; I’m almost completely recovered and have most of my strength back. Things like this make us so thankful for good health, don’t they? Take care,Christy
Oh my gosh, what an experience. You did good and
so did your husband and daughter. Better days ahead
while you stay healthy and all happy.
Thanks so much, MJ. I’m thankful to be on this side of things; healing well and feeling strong again. I appreciate the good wishes!
Christy
Oh, my goodness! So glad you’re okay!
I’ve been loving these “Germany vs. the US” posts. We moved to the UK when I was five (and stayed most of the way through elementary school), and then I lived in London for six months in college. So it’s been really fun to compare your experiences to my own. Ex pat life is very different for adults and kiddos.
Hope you heal quickly!
Hi, Corrie–
Thanks so much for the good wishes! I’m feeling almost 100% again.
My guess is that your experience as a kiddo was a little smoother, simply because most of my friends who have younger kids have watched them take like ducks to waters to their new host country. We old folks are a little more set in our ways! I’m so glad you enjoy reading the posts, though, because I have so much fun writing them and I always have so much to share.
Take care–
Christy
Thankful everything turned out great for you….I know you were so very sad when you were not able to attend sweet daughters graduation….but a great moment of pride for your husband. Take care of yourself and in no time at all you will be back in the USA!
Thanks so much, Marti. Yes, I was disappointed, but at least she didn’t think it was a big deal. We can’t wait to go home and see friends and family!
Take care,Christy
Thank you for sharing your experience. I really find these posts highlighting the differences to be fascinating! Sending you many healing thoughts!
Thanks so much, Kim. I’m so glad you enjoy these posts, because I really love writing them! I’m almost back to 100% and really appreciate the good wishes.
Take care,
Christy
Oh my gosh Christy! I’m so glad everything worked out. I’m happy you are on the mend. Try to take it easy. I’m sorry you had to miss your daughter’s grad. I hope your husband recorded it for you. I had my second born in a German hospital and I felt like I got the best care. You will be running around like your old self soon.
Heidi Colton
Thanks so much, Heidi. Yes, he recorded her walking to get her diploma, and they live-streamed it on YouTube, so I saw the important parts. I was disappointed but of course it could have been so much worse.
I agree, I believe I got good care, too. It was just different and some of the things that we get so uptight about in the States (like not walking around the hospital by ourselves) probably aren’t that big of a deal in the long run. And the cake and coffee in the afternoon is a huge winner!
Take care,Christy
Oh Christy! I’m so sorry you had to go through with this medical emergency but as you said all’s well that ends well. I think I would not like finding my way to my room while in the haze of the medications
However I do like being able to walk out of the hospital and longer hospital stays.
I’m so sorry you hand to miss the Graduation. I would be very sad too, bout loved how you dealt with it and counted your blessings.
Rest well Christy!! So happy you are on the way to recovery!
Shirley–So good to hear from you! I hope you’re doing well, too. I have been so out of the loop this past year (and I honestly think I was low-grade depressed during our very long, dark, cold, and locked-down winter). How is your new home? Never mind…I’ll head over to your blog and take a look. I know it’s beautiful.Take care and thanks so much for the good wishes.
Christy
I’m so sorry you missed the graduation, but so thankful your husband was there. As a military spouse, I know how often the military member has to miss so many occasions. I’m thankful you had good care and are home recovering nicely.
Thanks so much for the well wishes, Kathy. I am almost back to normal and thankful for a fast recovery. You are right that the important thing was for Chris to be there; it helps put it all in perspective.
Take care–
Christy
I hope you’re feeling much better now that you’re home and the appendix is out! Yes, sorry about the graduation but it couldn’t be helped. You are so funny….I laughed through some of this…No sense dying immediately after leaving the hospital if you can help it! I actually laughed out loud! Kuddos to your hubs for stepping in for graduation. Feel better soon!!
I’m glad you laughed–I meant for it to be funny! All the differences make me laugh now that I’m on this side of things and pretty much recovered. Thanks for the good wishes, Nita!
I sent this to my friend the risk manager- she will enjoy this. Glad you are ok and back at home. I am an ED RN who teaches now.
Thanks, PC! I was thinking of risk management when I wrote this–especially the walking around drugged up with a hot appendix! I hope she enjoys it…my guess is the difference in liability when health care is single payor is what accounts for their more relaxed approach.
Christy!! I had chronic appendicitis (undiagnosed at that time) throughout high school and college. Finally, when I was a college senior, I happened to hit the ER when the attending doc was a general surgeon. Apparently my WBC was never quite high enough for anyone to suspect appendicitis, but this guy had a hunch. . .and he was right. All that to say that I still remember the AGONY of appendicitis. So glad to hear that you had the surgery with no complications. But wow! The differences in hospital care are fascinating. I used to work in healthcare venture capital, where I had to study various nationalized health services, and found it so interesting. I’d love it if there were a way to reach a compromise between what we enjoy in the States and the universal coverage found elsewhere. No matter how you slice it, the way forward will be expensive! But as the mother of a naval officer, I am surely grateful for Tricare.
So sorry for you to miss your daughter’s graduation. I can well imagine the grief of that. Blessings as you continue to heal!
Thanks so much, Richella! I’m almost back to 100% and thankful to be home (did I mention that I hate hospitals?). I can’t imagine chronic appendicitis–18 hours was plenty for me, and 12 of those were spent highly medicated. I’m so glad you finally found relief but am sorry that it took that long to figure out!
Despite missing graduation, there’s still so much to be thankful for. God is good!
Take care,Christy
Christy! That was a great post about a less than ideal situation. Thank you for sharing the humorous side of things. Such a bummer about graduation though. Glad you survived the whole thing with flying colors, No more health issues!
Hey Lori–
So glad you enjoyed it! It was definitely an experience to remember and it does make for a funny story to share.
I hope you guys are doing well–so good to hear from you!
Christy
Wow, this really does sound quite different. So glad you are now home and on the mend. Quite the experience.
I keep telling myself that if nothing else, it makes for a good story! Thanks for the good wishes, Marty.
Christy
Wow! We don’t realize some of the blessings of living in the USA until we hear about life in other countries, especially the health care in other countries. I enjoyed this post and pray that you heal quickly with no complications and life progresses with normal activities quickly.
Thanks so much, Ann. I’m feeling so much better–pretty much back to 100% at this point.
I appreciate the good wishes!
Christy
I’ve loved reading your comparison posts but I’m so sorry you had to experience this situation to write this one!! It was just as interesting and you made me laugh.
As a mom who had a high school graduate this year, I was a little teary eyed that you missed your daughter’s graduation though. However, when I read your husband was able to go and you pointed out he had missed many important events over the years, it made me smile. I know he was so proud!!!
I hope you are feeling better and thank you for sharing so much of your life with us.
Hi, Liz–It made me laugh to write it, too. Humor is the best medicine, right?
Thanks for the virtual pat on the back about graduation. I know that it’s not the end of the world, but of course it makes me sad to miss any time with her when we have so few days left while she’s at home. Congratulations to your graduate, as well, and many thanks for the well wishes!
Christy
I just discovered you via the fall home tour and went to your site to read all your Germany/US comparison posts. I loved reading them as I lived in Germany from late 2001 to early 2005 as a DOD Civilian employee in Garmisch. In fact, I met my husband there. I’d forgotten about all the differences we encountered there. We’d planned to return to Garmisch on vacation in 2020 but obviously COVID put a stop to that. Hopefully by 2022, we’ll be able to safely travel there. Garmisch is very small compared to Stuttgart. In my years there, I only ever saw 2 elevators and one was in my husband’s (then boyfriend) apartment! When I broke my tail bone, my German co-worker went to a pharmacy and told them I needed a different RX and they gave it to her to give me — without a written RX! I miss so much about living there. Enjoy each day! Thanks for writing these posts. They brought back fond memories for me.
Hi there, Sue–
I’m so glad that you enjoyed those posts. It’s almost time to write another one! How nice that you were able to live in Garmisch–it’s absolutely beautiful. We weren’t able to get there last year, either (same reason–thanks, Covid!), but hopefully this winter.
That sounds about right with the prescription. Some things are more common-sense over here and you’re not the first person I’ve heard say that.
Thanks so much for writing–Christy
Thanks for sharing. The differences in healthcare are always interesting. I’m also an RN and had my appendix out in July. You are absolutely correct, I was discharged within 24 hours lol. Glad it all went well for you.
I hope you’re completely recovered! I couldn’t figure out why I was so tired going into the second month post op…my H&H were kind of low after surgery but not that low. Then I returned from the States and found my operative report in the mail waiting for me. I pulled up Google translate and–surprise!–turns out mine perforated and NO ONE MENTIONED IT TO ME. I guess that explains why it took me awhile to feel 100% again! I’m still laughing/shaking my head!
When will you post a Germany vs. US #6 blog?
Hi, Tammy–
I hope to write another one soon. I’ve been debating comparing the Covid rules (not an easy post to write) so that’s been holding me up. I’m glad you like them enough to wonder when the next one is coming out, though!
Take care,
Christy