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.

I was supposed to be discharged at 5pm, eventually left at 9am the following day, after being told at 10:30pm I couldn't go because the doctor got called out on an emergency.

Given that we always hear there is a shortage of beds in hospitals, you'd assume they would want to work quickly to free up the beds asap

Say a consultant and 2 juniors start a ward round at 9am - you tell a few patients they can go home but the ward round is still going on after that. Consultant goes to their afternoon clinic. 2 juniors have to do all the paperwork but also have to look after the already sick patients, suddenly more unwell patients, request and discuss scans, do bloods not able to be done by phlebs or nurses, chase the results of bloods/ scans already done and act on results and refer to specialties (if you’re on acute unit), update family members among other things.
Other posters have very eloquently summarised what nurses are doing.

MrsChandler, why didn't you know us nurses absolutely adore keeping fit and well patients in hospitals whilst we sit on our arses doing sweet fa and drinking tea.

It's very frustrating. I work in obstetrics and our discharge paperwork takes about 90 mins if you've been an inpatient for 2-3 days and have minimal TTOs.

So that's 90 mins - but I've got 8 or 9 women and up to 10/11 babies who all need care & obs doing. Oh and I've got to pick any admissions up from theatre/recovery too. And coordinate the ward. And I've got the buzzer going.

Agggggghhhhhh. I do feel for patients who want to go home & I have no issues with them self discharging & coming back later for paperwork etc.

MrsChandler, why didn't you know us nurses absolutely adore keeping fit and well patients in hospitals whilst we sit on our arses doing sweet fa and drinking tea. hmm

Not entirely sure what you mean by this. All I meant by my last sentence was there’s no point in me going through all the work that nurses are also doing all day when there have already been quite a few posts that have eloquently summarised all the hard work that they are doing.

Not entirely sure what you mean by this. All I meant by my last sentence was there’s no point in me going through all the work that nurses are also doing all day when there have already been quite a few posts that have eloquently summarised all the hard work that they are doing
Sorry I wasn't having a go at you. It was tongue in cheek.

Oh fair enough - sorry! a bit difficult to gauge sarcasm online 🤦🏾‍♀️

Anyway hoping radio silence from OP means she’s finally discharged!

To all the nurses (and any medical professionals),
Thanks for explaining this.
It completely makes sense. However, for someone who doesn't work in that field (and basically has no idea what's going on), it seems so strange to be told you're ok to go home and then for nothing to happen for hours.

And the food thing always annoyed me as I'd think I (or dd) was going home so wouldn't order food (or be allowed to) and then be starving.

It would be so helpful to have some 'cheat sheet' info that explains 'discharge today'.
Ie that it doesn't mean an immediate discharge.

The discharge lounge in our local hospital is open from 8am until 10pm. That sums up how long it can take imo.

It’s funny how the policies of patients own medication going in are so different. My DD can end up in one of three near hospitals if she has a bad fall (narcolepsy). One doesn’t allow patients to bring in their own meds under any circumstances. One allows it, but takes it from the patient to go in the drug trolley and then you have to remind them frequently that it’s her medication not theirs to dish out to other people (happened three times so far!). And the other one allows patients to bring theirs, and manage their own normal medication as normal and just account for it in their notes.

When DS 27 was 5, they put magic cream on him to take his line out before discharge, then disappeared for an hour, by which time the cream had worn off. Apparently, it was because it was a weekend, so not as many staff.

The second you hear "just waiting for pharmacy to send your medication up" add about 4 hours onto the expected wait at our local hospital. When we were in post-natal they were actually just sending you home with instructions for the fathers to come back 5 hours or so later to pick up the medication so they could get people out of the ward that century.

The system doesn't work for this at all.

My hospital is great but busy, I’ve waited 8 hours once. I understand, it’s frustrating but I get it.

When I had dd2 I requested discharge as soon as possible and they agreed at around 8pm. Finally got discharged about 6pm the next day

OTOH with Ds I arrived at hospital about 11.30pm, had him at 1am and by 4am was back home.

Difference was dd2 was under consultant care as she had a congenital condition, so we had to have a consultant to do everything. With Ds the midwives were much quicker.

For added fun the postnatal medication you are asked to wait for is often paracetmol and ibuprofen!

Waiting two hours definitely isn’t standard practice if all is well with the patient. I had day surgery under GA earlier this year and practically left at 2:30 on the dot - my Uber invoice for the journey home shows that the Uber started at 2:42pm so I guess my hospital was very efficient!

Maybe a lazy choice of words of mine as I know how hard the doctors and nurses work while faced with limited resources. Understanding the importance of freeing up beds as quickly as possible, are there any medical staff on here who are able to suggest what might be a better system of discharging patients, or is the system that is there now aleady the best possible one

Well, I can beat you all for speed of discharge.
Last year, DW was in hospital for a month (septic arthritis and hospital acquired pneumonia), she called me at 14:00 to say she was being discharged. Forty minutes later she rolled up at the door in an ambulance! Was a bit cross, actually!

My DM nearly missed the last admission of the week to the hospice where she died waiting for drugs from the pharmacy before she could be discharged from hospital. Had she missed the bed, she'd no doubt have jumped out of the window as she swore she would if she had to cope with the heat / noise / aggression from another patient for a whole weekend longer.

FamilyFeud, God I couldn't do your job.

It reminded me actually that we did leave with DM and without her drugs because the ambulance arrived. I had to settle her in the hospice then walk to the hospital and back to get them.

I spent 7 hours waiting to be discharged with my newborn. All the while listening to stressed out midwives over lack of beds while sat there desperate to go. It's bizarre.

Waiting for patient transport is horrific. We can't just take my grandad from hospital as he cant walk and never has his wheelchair at hospital and also needs hoists etc to move him so we have to wait for hospital transport to move him on a bed/trolley.

One of the times it was 'booked' at 12.30pm. It arrived at 9:18pm. I understand there's only so many of them and they cover the entire county and it's not exactly small but blimey it was irritating! It's not unusual for it to be a good 5-6 hours after being called.

Urgent care takes priority over discharge letters unfortunately.

But delayed discharges contribute to lack of beds so that acutely ill patients can't be admitted.

Seems to me that the system needs to change! It's so inefficient having people in beds in hospitals needing to be looked after just because they are there when the Dr has said they're ok to go home. When I had my last baby I had to sit in the delivery room from 7.30am until 4.30pm because there were no beds free for me to be moved to. It was so uncomfortable. Then suddenly there was a lot of flapping around because they ran out of delivery rooms, which is when I got moved. The next day (as I see on this thread is standard) I was told I could leave in the morning, but then had to wait until 4pm to actually be allowed to leave. At which point they started flapping around because they had run out of delivery rooms and needed to clear some beds...

Surely if there was a big push on getting people out quickly the nurses would have more time because they wouldn't be providing care for all the people sitting in beds for no good reason? Given that it seems it's like this everywhere it is clearly the system that needs to change.

No one is working slowly! They are just massively stretched. I have waited most of a day for discharge plenty of times and it’s not because any one could work quicker- it’s because there are 25 patients to look after and me getting home in time for Come Dine With Me is not their biggest priority.

I do get that they are massively stretched, but if the patients were discharged as a priority then they wouldn't be so stretched looking after so many of them.

@poodletip
Actually as soon as someone's discharged, another patient is in their bed space within an hour. I then have to do all the admission paperwork, all observations and ecg and bloods etc. As well as still needing to do all my notes on the patient who had been discharged, so it actually creates more work for us.