Hospital pharmacy delaying patient discharge

[Rillington]

I have recently had various relatives in hospital. Every time they are discharged they have to wait hours for their medication. This means they are taking up a hospital bed they don't really need.

The last relative was told at 8a.m. they could go home that day. The medication eventually arrived at 9.45p.m.

Is this normal or just a problem at our hospital?

@Poppynit

Fantastic post, I hope you have recovered from the weekend stress.

Every new starter I have ever trained in pharmacy has always said the same thing 'I honestly didn't realise working here involved so much'. It involves much more knowledge, skill, training, patience and effort than many realise. It's not for the faint hearted.

I do like your idea of 'drug roulette' though, it would make our lives much easier 😂

It involves much more knowledge, skill, training, patience and effort than many realise.

This is very true. Someone asked me once why I decided to do a Masters in Pharmacy - would I not rather get a job as Pharmacist? They had no idea it a was pre-requisite of becoming a Pharmacist. They were surprised again when I finished my masters but still wasn’t yet pharmacist!

Flora? Eh?
No, it was a standard pain relief pill, not unusual.

It was just the operating hospital doesn't have its own dispensing. So all prescriptions get sent to sister hospital.

@TrufflyPig thank you! I’ve had a glass (or three) of wine and I’m off for three days now so I’ve calmed down 😂 I like to imagine a drug roulette would operate similarly to Oprah Winfrey... “you get a drug, you get a drug, EVERYBODY gets a drug!”

Sorry to the person I replied to if I came across as a little rude, it’s just becoming far too common that pharmacy teams are getting blamed for things that are totally beyond our control. Whether you’re in retail/community pharmacy, hospital pharmacy, prison pharmacy, the job is aaaaalways seen as “just sticking a label on a box”. The attitude towards us is getting seriously disheartening.

Don’t get a job in pharmacy, kids! 😂

@HildegardNightingale I do not profess, I am. Fact. I am sorry if you have experienced poor HR standards and I do not work for the NHS (I have always refused). Had my department been responsible for poor service I'd have investigated it and dealt with it and those who had suffered poor service would have received an apology and procedures would have been reviewed.

@EverdeRose actually I don't think it's appropriate for any stakeholder to use the first name of a nurse when expecting to be addressed by title themselves. In the name of equality I believe it should be formal titles for everybody or first names for everybody. I am sorry if Drs instruct nurses to address them by title; it is wrong. I have had them, more or less instruct me to do so, and have been crystal clear that if they wish me to address them with a title they may address me with mine. I am not subordinate to a Dr and will not be addressed as such and neither should any Dr have the power to treat any fellow human being as their subordinate. The outmoded paternalism and misogyny within the NHS needs to cease, its hierarchical nature is ill judged and unprofessional. I do not wish to be on chummy terms with medical advisers of any genre - I expect to be on professional terms with them.

I can't remember who asked if I'd object to my hairdresser keeping me waiting for 10 minutes. Firstly my hairdresser has rarely run late in more than 20 years and on the rare occasion she has she has apologised and is clear about the length of the delay. The NHS on the other hand regularly keeps people waiting, sometimes for hours, and it is so ingrained within the culture there is very very rarely an apology.

I don't for a minute think the delays re discharge are due to pharmacists themselves but I do think the communication and organisation needs sharpening up throughout the entire organisation which appears to have forgotten that its principle purpose is to serve the public.

I was reading an article about Sir Simon Stevens this morning (that chap who was markedly absent when things were going badly but who came to the fore as things started to go well). It was incredible to read that such a leftie's mantra is patient and taxpayer first. It never extrapolates into practice sadly.

@PinkSparklyPussyCat

I understand that the pharmacists have a difficult job and my issue is not with them. When you're told that you can't drive to the other hospital to pick up meds that are apparently needed urgently but can go back to the ward at 10pm at night then it's frustrating, especially when the person needing the meds just wants to go to bed but can't. In my case we're talking about an 84 year old and his 90 year old partner - they didn't want to be waiting up until midnight for me to appear with the meds!

Was it out of hours?

Personally I find in hospitals the vast majority of patients either use ‘nurse’ (in uniform) or ‘doctor’ (not in a uniform). I personally don’t care as long as it’s not anything rude or sexist (which actually on a fairly regular basis it is). I always use title surname and then ask preference or just ask depending on circumstances and I don’t think I’ve ever had someone ask for anything other than given name. Some people also object to the title surname so can’t win really!
Scotland and Wales have had standardised uniforms for some time, there was a recent consultation about doing the same in England, might have closed now though.

I like to imagine a drug roulette would operate similarly to Oprah Winfrey... “you get a drug, you get a drug, EVERYBODY gets a drug!

😂 Can you imagine if we actually did this? People would be begging for us to go back to 'just sticking a label on a box'.

I love the idea of drug roulette. Just think how many steps you could miss out. And we can save a bomb by using the cheapest drugs first.

Or perhaps the robot has a ‘random’ setting.

@BungleandGeorge no, it wasn't out of hours, my Uncle was discharged at lunchtime (I remember as he was upset he didn't get any lunch!). DH took him home and was told to tell me to go back at 10pm for the meds.

The really annoying thing was that when he opened his bag of goodies it contained codeine which he wasn't taking and lactulose that I could have bought in the chemist!

@jellyfishinatent

The problem is doctors have to be nagged and chased by the ward pharmacist to actually write the prescription for discharge meds. So they may come round to the patient at 8am, and say they can go home. But the prescription won't be written until much later in the day.

I can assure you its generally not a pharmacy problem, but a doctor problem

But of course it is much easier to blame the pharmacy

Oh FFS. This makes me mad on the behalf of patients

It is possible to be an organised junior doctor. This behaviour would drive me mad. 15 years ago I would not DARE to leave until I had done my discharge prescriptions for the next day

@mrbob I agree, and we do have some great ones! Although 90% of them still need at least 1 reminder to prescribe ttos for routine admissions at least 24 hours before discharge.