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.

Well Poodletip you’ll be glad to know our hospital agrees with you and has a discharge lounge for patients in your position. So once fit for discharge you vacate your bed and are moved to the lounge where you can spend the day sat on a hard plastic chair waiting for your meds and paperwork. Much better than bed blocking don’t you agree?

Sorry, didn’t mean for that to sound so sarcastic!

The whole system is shit, I agree. I feel sorry for the patients, the nurses, etc.

Told we would need to stay 24hrs after ds was born early hours of the morning Was clear to leave at 8am next day, actually left hospital at 4.50 pm I was so desperate to leave!

I've been both sides of this. I was discharged home on the ward round after dc 2 in the morning, about 10 am. We left about 7.30 pm. I was climbing the walls a bit as my anxiety levels were rising as my parents and sister were sitting outside my house with dc 1 who was only one after driving an hour and not able to get in as they had no key at the time. My sister texting me all the time asking where were etc. It was a cold wet October evening. Frustrating yes. However I have been on many many occasions been the nurse chasing up the doctors to write TTO/ discharge letters, chasing pharmacy as well as care for patients. I know which I'd rather be!

A friend of mine worked in a hospital discharge lounge for a short (very short!) time after returning to work after major surgery.
Her view was that discharge lounges were, in fact, an accident waiting to happen.
While they do enable the ward beds to be physically vacated by the patients ready for the next admission, the staff working in the discharge lounges, don't have any experience of caring for that particular patient and therefore they can find themselves running round like headless chickens trying to co-ordinate someone's discharge and attempting to liaise between multiple medical teams.
As with everything in the NHS, the parameters get stretched in order to squash everyone in who is trying to use the service - or, in this case, escape from it.
Patients were supposedly, only to arrive at the DL when everything else was done/ready, ie, they were simply waiting for drugs or transport only.
In reality, patients would arrive who had not had a wash, been given breakfast and no-one had managed to get hold of next of kin to let them know discharge was happening.
Often it would transpire that transport hadn't been booked so poor patient was waiting for something that was never going to come.
Ward staff were pressurised into sending patients to the DL before staff were ready to send them in order to free up the bed.
My friend retired early to save her sanity.

A friend of mine was recently feeling quite poorly following an operation. Was told she could go home. She said she couldn’t walk. And was breezily to,d by the nurse “that’s ok we can wheelchair you to the discharge lounge” and she was discharged being unable to walk! Shocking.

She was also readmitted the following day semi conscious with over a litre of blood swishing around her chest cavity!

Doctor wanted to discharge me 2am Boxing Day with no way of getting home 2 hours a way from the hospital. I was not best pleased!

As a pharmacist in a hospital we are always blamed on delayed discharges and being asked where the medicines are when quite often the doctor hasnt even written the prescription.

E.g.
Dr sees you at 8am on ward round and says you can go home. They then have to see 25 other patients to finish ward round. Depending how complex and ill they are, that could take until 11ish. Then the consultant tells the juniors you can go home once everything is ok. Juniors then have to take bloods for any patients who need them because they'll need the results that day, that's another hour or so, so midday. They then need to speak to relatives about patients conditions, perhaps give bad news. Might take another hour.
Then they'll sit down and write the however many prescriptions they need. Not as simple as writing a few medicines, they need to put a full description of why you were in, what they've done, what changes they made to medicines, why they've done it etc. Then the pharmacist gets the prescription, and 90% of the time there is a mistake so it needs redoing. So by the time pharmacy have the correct prescription it could easily be 3pm. Then the department has to do all the discharges for the whole hospital, so if there's a lot it can quickly back up. Especially if there's not many staff or a lot of new people, which there does tend to be at this time of year (new doctors start in August so more likely to be slow and make mistakes, new pharmacists start in august so more likely to be slow and double check things instead of trusting themselves, new dispensers start who don't know the systems and are more likely to make mistakes that means the prescription needs redoing etc). basically don't get ill in august haha
It's a lot easier to tell a patient you are waiting for medicine than tell them the doctor needs to write a prescription. If you say you are waiting for the doctor every patient who wants to go home will be asking for the doctor which will slow them down further.