Hospital-y dr and weekend question

[PullingMySocksUp]

I’ve worked in hospitals a little, but only in big teaching hospitals and only during the week.
DH has had a few relatives in hospital recently, in smaller district hospitals and been on medical wards post stroke, post heart attack, post digit amputation etc. They’ve all said the drs don’t work at the weekend. So they don’t get discharged or get results back etc.

I’m really surprised by this and wondering if the drs still do a ward round but just in scrubs so DHs relatives didn’t realise they are drs. Or is this actually the case that there are no drs? No judgement on the hospital or drs if that is the case, it just seems odd. (I realise there would be on call doctors.)

There's a skeleton staff over holidays and the weekend.

Discharges tend to have to be rubber stamped by the patients' consultants and if they are not on call, the instruction is not to contact them.

So if the consultant is on call, the juniors can discuss discharging a patient, but if not, then the patients are discharged after the first Monday ward round.

There is no admin staff over the weekend, few pharmacy staff, patient transport doesn't run and social services can't set up or reinstate care packages.

It's best to wait until everyone's back at work.

When I was a junior doctor and on call for the weekend we would be 'firefighting'- dealing only with patients who had taken a turn for the worse/ who the nurses were worried about, who had just been admitted or who the regular weekday teams were worried about and wanted us to review. There wouldn't be a ward round for the every patient, and we wouldn't have dealt with routine stuff that could wait til Monday. For a stable patient it is entirely feasible that they wont see a doctor over the weekend, though there probably is an on call team there.

Doctors are there all the time including weekends in all the hospitals I have worked in.
The rota is different however, so things can take time to complete. Ward rounds in my hospital didn’t change whether it was weekend or weekday.

We used to have issues with discharges on weekends because other services wouldn’t be open and you can’t discharge without having a plan in place with other teams such as social care, GP or district nursing staff as patients would be left with using the out of hours services or being unable to access any help if they had problems post discharge. This may be different depending on the area or hospital I suppose

It takes more than a doctor to discharge so the issue is all the admin staff/local GP/community follow up isn’t around at weekends often

I have recently had a close relative in hospital. Agreed: zilch happens at weekends. No consultants are around so it's just the nurses keeping the ship sailing till business resumes on Monday. I found it quite odd to be honest. Prior to this I tended to think the NHS would be 7days a week.

I got discharged by a breast surgeon when I was seriously unwell one festive period with acute gallbladder issues. She wasn’t specialised enough to really make decisions but was the on call surgeon for the day so I got sent home. Perhaps if they had operated then I wouldn’t have ended up with a drain and countless stays in hospital where I became seriously ill. I was told a week later, by the right specialised surgeon, that the window for operating on me had passed and I had to wait 6 weeks.
Her job was basically to discharge people shoved in the day car surgery ward as they had run out of regular ward beds.

My husband having had a number of hospital stays this year, the longest being 6 weeks, I can confirm that on his ward at least he had rounds every single day, and we had his consultant sit and spend an hour painstakingly explaining his medication to him one Sunday when he'd become very confused.

He was discharged twice on Saturdays, and admitted once on a Saturday.

The only noticeable difference was when he was in a private room there were fewer nurses covering on weekends and he had to wait longer for drip changes etc. And parking was easier for me!

That’s really interesting. Thanks everyone

My baby was discharged from a large hospital on Christmas Day. She was there 10 days and stayed in PICU, HDU and on a ward. Picu and hdu were separate rooms but same staff covered both. On the weekend one consultant was in all weekend (amazing man, worked so hard!) on picu/hdu. He said when we asked he did a morning round and then was on call and his registrars ran the show.... but realistically we saw him in and out constantly throughout both days. We'd also seen him on the weekdays we were there he was def on from Friday lunchtime when we were in picu until Sunday evening when we left hdu!

A consultant saw us late Sunday night when we arrived on the ward. I expect it was run the same way

This is nonsense. Our senior Registrars do ward rounds everyday. On a weekend there is an on call Consultant who attends the wards. They don’t see every patient, more oversee that the medical priority’s are taken care of. We also discharge on a weekend. Medications are ordered beforehand. Results are available for most tests as standard.

I work in a psychiatric hospital so can only speak about this type of facility but there aren't always doctors on site during the weekend/nights to deal with the medical needs of the ward. Rather there is one junior doctor covering the three psych hospitals in the area and he/she travels between the 3 if needed. The nurses run the wards and are capable of dealing with most stuff, if they need any medical input then they will contact either the advanced nurse practitioner on call or the duty doctor on call. Both do pretty much the same job. The consultants do one ward round per week and a smaller meeting weekly to discuss any patients of particular concern.

Doctors are on site, but consultants tend to be on call.

Some sleep in, a lot don't and are available on the phone.

Our drs are on the ward every day, less at nights/weekend/ph though. Our patients are discharged every day we don’t need other services to discharge we just let anyone who needs to know the next working day.
discharged 5 patients today and got 5 in to replaced them. Only the ortho/surgical drs wear scrubs at our district gen.

Anyway glad to be home put my feet up and have a New Years drink

I am a hospital consultant. I work 1:8 weekends for the whole weekend (48 hours) on top of a standard 48 hour week.
I see and review ALL in-patients in my specialty (usually 15-20 new patients both days and 60 existing patients) on Saturday and Sunday. I discharge many patients.
I also am present for/do all major operations. I get approximately 8-10 hours broken rest the whole weekend. The junior doctors now work a shift of 14 hours maximum.
If that's your view of a Consultant being "on call" so be it- it's not like I'm on the golf course!

Junior Drs are on duty all weekend at our hospital, but not consultants. So no ward round done, but if a patient needed to see a dr there would be one in the hospital. No physios, OT or pharmacy work weekends. There can be planned discharges for the weekend, but the work would have been done on Friday for them. I would imagine it depends on the size of the hospital- ours has around 80 beds, no ICU only HDU and a ward only for paediatrics, no paediatric HDU or ICU. The consultants are on call and the paediatric consultant always comes in if he has any patients.

@Fridaysgirl hats off to you, you sound like the consultant we had in picu/hdu. He was incredible. I don't know how he kept going. As I say I'd seen him in the days previously to his weekend "on call" (basically working constantly). I do hope the rota then gave him a good amount of time to recover.

I think it varies. I ended up in hospital over a weekend because i was too ill to dicharge but not ill enough to be an emergency and call in radiologist/radiographer etc. I did see a couple of doctors but again not ill enough for the consultant to be paged.

My husband is a consultant surgeon. If he has a patient who has had a big op in the week he will usually pop in Saturday and Sunday even though he isn't ' on call' to chat with his patient and the junior docs. Sometimes me and the kids sit in the hospital car park on the way to or from an outing so he can check all is ok! He definitely won't look like a doctor on these pop ins. He'll just look like a bloke!

If your relative is in a community hospital then yes there will be no Drs on site over weekend or overnight, instead the nurses have to call for an out of hours GP to attend their poorly patients x

There are definitely doctors working at weekends. DS1 spends a lot of time in hospital.

I think what this thread proves is that there is a great disparity in the coverage based on geography,type of hospital etc etc.

It depends on the speciality, the level of acuity, trust policy and Royal a College guidance. There is no simple answer.
Many specialities run an on call system with consultants being within 30 minutes and senior registrars providing on site senior cover.
Some specialities have on site consultants (anaesthesia, critical care, emergency medicine, often paediatric and maternity services). Some offer a mainly five day service ( rheumatology, specialist palliative medicine, dermatology).
It just depends on lots of factors. All hospitals have doctors of varying levels on site 24 hours a day.