When you enter the doors of an emergency department, what you are entering is the realm of the unknown. Needles, blood, blaring alarms and all-nighters with nurses are about to become your new norm. For your whole life, you thought good food, sleep, and TV reruns could fix anything. But those are in short supply in a place you need it the most. Oh, and when else in your adult life had you had to ask to use the bathroom?

Safe to say, your life is about to be flipped upside down. Here are the ten things you should know before going.

1. Hospitals are in it to make money. Yep, that’s right. Everyone jokes about it, but it’s true. The vast majority of hospitals are in it to make money. Now to make money, they need to take care of people and make sure the hospital doesn’t have a bad reputation. But that doesn’t mean they have to provide state-of-the-art care or have the best outcomes. Sad, right? Who goes into a hospital wanting anything but the best? The truth is that isn’t always (or even usually) the goal of organizations. Sure, everyone wants to do a good job, but that’s not what’s driving most of the decisions.

We would be doing hospitals a disservice if we stopped there. People aren’t inherently evil. It’s just that people who treat people do not usually run hospitals. Business folks run them. Dollars-and-cents folks. They don’t know what excellent patient care looks like (usually). Which brings me to my next point.

2. No one will fight harder for you than health care workers. Believe it or not, it’s true. Nurses, doctors and hospital staff are usually very passionate about their work. They are the ones saying, “We need to do this better,” or “We need this equipment so that patients get better care.” By and large, they care. The problem is they aren’t usually represented well enough in hospital committees. And they surely aren’t making significant decisions.

Many nurses and doctors leave hospitals at the end of their shift upset that they couldn’t take care of patients well enough for one reason or another. They were too busy because they don’t have enough help. Or they don’t have the equipment they need. They are afraid to speak up because the hospital culture is toxic. Hospitals are full of caring people who wish they could do more.

3. Nurses are worth their weight in gold. Nurses are consistently ranked as the most trusted profession, and there is a reason. They spend the most time with patients and typically have the deepest bond. A good nurse will make sure that you are getting everything you need to get better. They will go to bat with administration, doctors and even your family at times for you. Now, the opposite is also true. A lousy nurse can ruin your stay in many ways.

4. A good doctor will take care of you in every way. A good doctor does a lot more than provide medical care. They make sure that you have good nurses. They make sure that all of your testing, labs, and studies are done in a timely fashion and done correctly. They follow up on things so that you don’t have to stress so much. No one has more respect in a hospital than doctors, and when they make it clear they want excellent care for their patients — people listen.

5. Your bill is going to be as much as a used car. This varies depending on your stay and insurance. But go ahead and prepare for it. Be ready to gasp when you see that your Tylenol costs $35. Or when you see that one night costs $1500. Nope, you didn’t even get Egyptian cotton sheets.

There is hope. It is possible to dispute a hospital bill successfully. It’s not going to be easy or quick, but it can be done.

6. The worst infections come from the hospital. Yes, it makes no sense at all. The places where the most vulnerable people reside have the most super-bugs. And you better believe they are everywhere. On doorknobs, cafeteria salad utensils, and sometimes on health care workers hands! Make certain that everyone entering your room washes their hands to keep these uglies at bay.

The good news? If you aren’t sick or vulnerable, it’s pretty unlikely you’ll get infected.

7. Hospital food is the furthest thing from nurturing. I’m pretty sure someone famous said: “Let thy food be thy medicine and thy medicine be thy food.” Oh yeah, that was Hippocrates. The father of modern medicine. But something went awry between 461 BC and now.

So what’s a person to do? Well, it’s a great time to cash in on any favors from friends and family. Never has Chipotle tasted so good. If you are less lucky, it’s good to know there are more options. Often the public cafeteria has better food if you can make it down. Ask the food service what they can do, they make custom meals that are better than your standard fare!

8. You won’t be 100 percent on discharge day. Maybe if you were a patient 50 years ago, but today the emphasis is on getting folks out quicker. Of course, some people push the limits, but by and large, it is just a change in practice. I have to say it’s usually a negative thing though. If you can feasibly go home and resume your recovery, wouldn’t you want to?

When should you worry? Lots of hospitals have devised “goals” for the length of stay and can determine whether or not a person gets a bonus or other incentive. See the problem here? Though not common, don’t be afraid to ask if there is an arbitrary discharge goal for you.

9. You’re not going to remember half of what you were told about your illness. In the heat of the moment, we tend to shut down. It’s not the best time to educate someone on diabetes or heart failure, but you have to start somewhere. Don’t be embarrassed to ask for clarification. Don’t be ashamed to ask for more information or even the same information if you didn’t get it the first time.

It’s a good idea to take notes and look stuff up on reputable sources at another time. Or talk to your doctor at your next visit.

10. Hospital experiences are like playing the lottery. No two stays are the same, and it’s likely that even your neighbor had a much different experience than you. One person may come into a hospital and get great nurses and doctors and be out in three days. Hell, maybe the food was even decent. But the next week when you come the scanner is down, and everyone’s in a bad mood. You have to stay an extra day — now your bill is higher!

David Slone is a nurse practitioner who blogs at the Savvy Patient.

Image credit: Shutterstock.com