Hospital discharge

[ILiveInAPineappleCoveredInSnow]

I am sat here absolutely raging. My husband was supposed to be discharged from hospital at lunchtime, (so the dr and ward sister told him) so I arranged to get out of work to get here for lunch. Sat here for two hours then they said there was a hold up - and now it would be nearer to 5. So it's now 6.45 and still we are waiting, the nurses keep fobbing me off and I've had to ring my parents to pick my son up - they managed to get him at 6.10 luckily I rang his after school club and they were happy to wait as they actually finish at 6. My son is now sat in my parents' car outside my house, 30 mins away from the hospital, and I still have no idea when they are actually going to pull their finger out and get him discharged!!!!!!

Have had to ring them and say to take him to their house now as they have been sat outside mine for 45 mins now and could potentially be at least another hour :-(

I'm really angry and my pregnancy hormones are not helping at all!!!!!

Do you think I would be unreasonable to write and complain?

[ILiveInAPineappleCoveredInSnow]

Pixie, because he's really quite ill, in agony and terrified.

[ILiveInAPineappleCoveredInSnow]

Thanks sashh and smells, will make sure he drinks plenty and keep an eye on whether he needs laxatives. He is in agony so he doesn't need the pain of being bunged up on top of that!

[materrules]

Hmm well a view from the other side- i work in a hospital pharmacy and every single day patients are told they are going home during the morning ward rounds so like you and your husband arrange transoprt etc but the doctors dont actually write the prescriptions until after lunch when they have finished their ward rounds. Then when there are problems with the prescribing- which there is on over half the prescriptions we have to sort them out waiting for doctors to get back to us which can take time. We have to make sure the prescription is safe! I too would question the meds prescribed- would you want to go home with unsafe meds? Although the difference being in what i do is i always tell the patient the problems and keep them informed which sounds like the problem in your case.

[MorrisZapp]

It's a daftness really. When my dad was in hospital, he had to wait for hours on end, dressed and ready to leave, because the consultant had to come and make sure he was ok to leave.

The consultant turned up eventually, said do you feel ok to leave, dad said yes, consultant signed something, and said ok then cheerio.

Hospitals are like that, unfortunately!

[Tenacity]

Hospitals should not be like that at all. They should change!

When things are much calmer, OP, it might be worth putting in a formal complaint so they can improve their standards. There is no reason to accept bad practice.

[Sirzy]

Morris - do you not think the consultant may have looked at his notes before coming in to ensure everything was ok clinically? It won't have just been a case of asking him how he felt then saying he could go!

[marriedinwhiteagain]

Agree with tenacity. If there is a post lunch log jam in the pharmacy and scripts are wrong then the pharmacy and the doctors need to start workinng.

All over our hospitals are signs telling the public to treat staff with respect; appointment letters demand one is not late, etc. Well in my opinion respect works both ways and needs to start working both ways as a matter of urgency.

We had this many years ago btw when DH was discharged ater an op and phoned me to collect yet when I got there 10am, we were advised the meds wouldn't be ready until 2 (which had nt been communicated to DH). DH wanted to get home so I said I would come back for the meds and that was a win win because it freed the bed. The response was aong the lines of "well if he stayed the next shift could deal with new admission, so no it doesn't help us". Absolutely disgusting immo and they didn't look rushed off their feet.

[marriedinwhiteagain]

The pharmacy and the doctors need to start working together to provde a better overall service (that funny little word at the end of national health which nedds a higher profile within the nHS.

[jellybelly18]

Pineapple YNBU at all. A little communication isn't a lot to ask for.

On another note (not you op) stop blaming pharmacy for delays! Ok sometimes delays happen due to staff shortages/extreme business like anywhere else but the majority of time othis is what happens - Dr sees pt at 8am for example then says right you can go home. Dr. writes TTO at 12. sends it to pharmacy. Ideally no concerns with it, dispensed and left dept. within 1 hour. If any concerns spend time chasing Dr and getting amendments which takes however long it takes if Dr is busy.

TTO's are time stamped when they come into pharmacy, when someone starts working on them, when they are checked and when they leave the dept. in everywhere I've worked this must be under 1 hour. any discrepancy must be documented on the TTO. targets are that 97% must be within 1 hour at last place I worked and they were. Discharge lounge had to be prioritised (sp) 30min.

Many times i have been on the ward and heard patients saying they have been waiting for 3 hours when are they going home and the nurses reply that we are still waiting for pharmacy. meanwhile im standing in corner with a just written tto for them that has just been given to me!

If you're ever annoyed at the length of time you've waited ask to see the time stamps on pharmacy's copy. when you want to go home you want to go immediately but i don't think 1 hour is unreasonable.

[Sirzy]

I will continue to blame pharmacy. When I have seen the doctor write the script straight away, he has given it to a HCA who takes it straight down to them and we are still waiting 5 hours later for medicine then yes it is down to their crap system!

[wannabestressfree]

Having tramodol and oramorph together is quite unusual. It is always flagged when I go into hospital and a nurse wrote on my bottle 'patients own!!!!!' This is regardless of the fact I see the crohnic pain team and have a serious illness.

For future reference whenever they tell you they are discharging I would wander up about teatime. It's what we do as we know what's going to happen :)

[jellybelly18]

Maybe the doctor wrote a crap script? I'm not saying we are perfect I'm just trying to say that sometimes there's something going on behind the scenes that doesn't get communicated. I think pharmacy are a convenient scapegoat sometimes, because they aren't there to communicate.

Waiting 5 hours is very bad. I wouldn't want that for anyone.

[Sirzy]

I don't know but the problem is the same every time DS is admitted although normally nearer to 3 hours waiting. The pharmacy have recently had massive changes though and we haven't been inpatients since so hopefully that has improved things.

[Sirzy]

Im not saying that it is always the pharmacy just that it seems that way in our local hospital.

[jellybelly18]

Hope it improves for you!

[MamaMumra]

Sirzy - writing TTOs. The day of discharge is happy due to poor discharge planning. At my hospital pharmacist end up making amendments / having issues with about 20% of TTOs. Also a surprisingly large number come to the pharmacy when the patient is ready to go.

Our nurses now make sure TTOs are written up in good time, but obviously this needs everyone to be organised and communicate properly.

It's short sighted to lay the blame at the pharmacy.

[MamaMumra]

Aargh auto correct fail.

TTOs on day of discharge is bad discharge planning

[Sirzy]

My dad worked at the same hospital. In this case it was down to the pharmacy and their crap systems. As I said they have recently had massive changes to try to reduce the waiting time.

[Pobblewhohasnotoes]

MamaMumra Sat 11-May-13 10:59:53

TTOs on day of discharge is bad discharge planning

It is, however getting the Doctors to write them the day before can be impossible. It drives us mad! They don't realise we need to get patients home and have more coming in so need the beds.

[Smellslikecatspee]

Do you mind me asking and of course you can ignore but what did your husband have done?
Just sounds like he's in a lot of pain still.
Wondering if its a chronic thing maybe he needs to see a specialist in pain management.

Or if a different med might be better. Opioids are rubbish with some types of pain.

Sorry of I'm been over nosey I just hate to think of anyone in pain.

[clam]

I had nothing but praise for the NHS when I was in for a week following my broken leg, until the day of discharge. I was ready to leave at 9.30am (as told by the nurses) and just had to wait for a wound check. Finally made it out of there just before 9pm that night. When I was eventually seen by a doctor he told me I was bed-blocking! I think he might have been joking, so I told him I'd have been more than happy to have unblocked the bed 11 hours earlier, had his team got their act together.
Waited an hour and a half for a porter to bring a wheelchair - in the end, a sweet ward assistant went and found one in the corridor and wheeled me down to reception herself.

[alcibiades]

I wonder how many planned operations get cancelled because there's no bed available - but there would have been if the discharge system worked faster.

The local hospital has a Discharge Ward, with comfortable chairs and a couple of beds. The ward is only open during the day, so I'd imagine that if there are still patients waiting for all the paperwork to be done beyond 5 o'clock or so, the nurses would be chivvying people up.

[Pobblewhohasnotoes]

I don't know of any ops cancelled due to late discharges. We juggle beds. I work in paediatrics, things maybe different on the adult side.

[MamaMumra]

I know - its taken a huge effort to get TTOs down in advance - and it doesn't always happen - we did a huge audit last year and we found that the majority of TTOs that were late were needed before or near the time they got sent to the pharmacy.

I remember the days when bed managers were coming t pharmacy to chase up meds...