Who's job is it to discharge from hospital

[Toughtips]

And why does it take all day? Been waiting since 2:30. Meeting required was done ages ago. Now gonna be released into rush hour traffic. Just wanna go home.

What happens if you just go? Why do you need discharging, presumably they can't make you stay? Just wondering, not saying you should leave BTW, just wondering why the whole discharging thing takes so long. When DS1 was born I ended up staying in a whole extra night because no-one turned up to discharge me. That can't be good for anyone.

Are you waiting on drugs?

you can sign yourself out.. its not a prison. They do get a bit cross because it messes with their paperwork.. but if you really cant handle it then just leave.
I signed myself out after both births. Ask if you can return the following morning to complete paperwork etc

If the decision has already been made that you can go (not waiting for any test results etc) then you could be waiting for either a discharge letter or medications. If it’s a letter then just ask them to post it, if it’s medications then unfortunately it depends on how busy the pharmacy is 🤷🏾‍♀️ If you don’t need the new medication until a certain time or until tomorrow you can ask to pick up then if that’s easier.

We discharged dd1 once, as pp said, they were a bit disgruntled about the paperwork but that's it. If you're waiting on meds there's not much you can do though.

The discharge summary and medication is usually what takes a while,

Whose job is it? Depends what you were in for...
Doctor
Nurse
Pharmacist
Physiotherapist
Occupational Therapist
Etc

2 hours 9 minutes is speedy to me!

Speaking as a nurse.
Typical exampl:
Consultant come round in morning and says to patient “You can go!”
Two hours later, nurse gets a chance to read notes that say “Remove drain, Check Bloods, Discharge if ok”
Nurse removes drain asap.
Nurse checks computer for discharge letter and if medications are prescribed. They’re not.
Nurse rings doctor “No sorry haven’t had a chance to do that yet”
Lunch and midday medication round.
Patient gets inpatient.
Nurse rings doctor again “Yes I’ve done that”
Nurse prints discharge letter and calls pharmacist to ask for medications (often called TTOs).
Medications are delivered from pharmacy between 5 and 6.30 ish.
Nurse must double check all is correct before giving to pissed off patient who can then leave.

A couple of hours is nothing. My consultant told me I could go home during morning rounds about 0830. I finally got discharged at 1330

Red glitter Impressive!

When ds is in if we are told at morning rounds we can go home I still order him dinner and tea! It’s waiting for pharmacy that causes the delay for us, before now matron has gone down to collect them herself because the wait was so daft!

I’ve had to wait hours to be discharged every time I’ve been in hospital. I have self-discharged twice because I got so sick and tired of waiting around. It’s the consultants job but there’s lots of red tape to get through before you can actually go.

DD's had quite a few hospitalisations over the last year, and it's always the drugs that cause the hold up for us. We were told we could go at 9am once, but were still waiting for drugs at 5pm! As we only live 10 mins from the hospital i told them we'd go home, then pop back to pick up the medicine. They didn't mind at all. We do that every time now.

I think 2 hours would be some kind of world record. DD was admitted a week after birth for a night, consultant saw us at 8.30am and we finally left at 4.45. Think of it this way, if you're waiting to be discharged then you're right at the bottom of the list of priorities which is where you want to be. Frustrating though

If you’re able to pick up medication yourself from pharmacy ask your nurse to let you know when they’re ready - another delay can be waiting for porters to deliver them from pharmacy to the ward

Theycallme, you are spot on. Everyone is so stretched that they have to prioritise, and keeping people alive is number one.

Speaking as a recent inpatient-

Exactly as Bunchofdaffodils said! Luckily I ordered lunch just in case or I would have been hungry too!

Typically it’s a junior doctor’s job to write a discharge letter, then the nurse sends the request to pharmacy for the drugs. Don’t forget we got new junior doctors last week who will be overwhelmed by the amount of tasks they have to do. Urgent care takes priority over discharge letters unfortunately. When I was finally discharged after having DD, we were in 5 days for feeding issues, I was told at 9am we could leave. We finally left at 5.30! Didn’t even need drugs. It was just busy.

Because doctors have a habit of telling patients they can go home. What they don’t say is that this doesn’t mean now as there is often a load of paperwork that needs writing and TTOs that need ordering. Patients may also need to be seen by the physios or OTs first too or wait for blood results. And sometimes we have to bleep the doctors to remind them to do the paperwork and TTOs. Then you have to wait for pharmacy to process them, which is something we can’t do much about.

There are all sorts of reasons why patients might be waiting and it’s because behind the scenes there is often 101 things that need sorting first. Plus we’re still looking after everyone else.

Bunchofdaffodils that's a very good explanation, thank you. It ties in with my own recent experience.

As a nurse it's frustrating when a consultant comes round in the morning and says who can go home that day without telling them it won't be until the afternoon. I always warn my patients it will be in the afternoon unless they don't want to wait for their discharge letter or medications.
For someone who's on my ward, I then have to review their cardiac monitor and make sure they're aren't any arrtymias I'm not happy with, take cannulas out, review blood test results if the dr hasnt, and anything else required for them to go home.
Discharge letters are normally on the bottom of the drs list. They have to do a whole ward round first before even thinking about them, and if you're the first person to be seen that day, you could be waiting a while.
I then have to order the medications if they havent already been done. Usually the patient's been in a few days and has the right medications, however our drs are notorious at changing the medications on the day of discharge and we're not allowed to keep an extra stock to give to patients, so these have to then be ordered.
Depending on how busy pharmacy is depends on how long it takes to dispense the medications, I then have to double check them with another nurse against the discharge letter and drug chart.
And I also have 7 other patients to look after. On a day like yesterday, when the medications finally arrived, I had three IV medications due, three sets of relatives waiting to talk to me, a distressed end of life patient who needs JIC meds, two annoyed patients who are waiting to go home and a dementia patient trying to escape the ward!! And we were short staffed!
Oh and remember new drs started last week fresh out of medical school and they're still trying to get to grips with everything!
But you aren't under any obligation to stay in hospital, they can post you the discharge letter and you can collect medications later if necessary.

@Bunchofdaffodils that is spot on! Drs should be banned from saying that patients can go. Because we get it in the neck when they have to wait!

What's frustrated me is that my food has been canceled or given to someone else, I'm always in a single room. The walk to the shop in the Hospital was too much for me, so I've sat, hungry, waiting for Meds.

I can't deal with it. I had a minor procedure at 12:00 and they still had me there at 17:00, without anyone telling me anything except I was not allowed anything to eat or drink.

I took the drip out of my arm and walked out without telling them in the end. A bit of an overreaction in hindsight but I was sat there with nothing to do except wind myself up over still being there.

It won't be any consolation to know that what Bunch said is absolutely the norm.