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Advice on patient being discharged from hospital, when I don't think they should be!

46 replies

Orangeinmybluelightcup · 27/07/2021 15:12

Hello, after some quick ish advice if anyone has experience of this. My mums husband who is 71 was admitted to hospital on Sat with severe diverticulitis. Stomach cramps started on the Wednesday, on Thursday the doctor diagnosed and prescribed oral antibiotics and wait. By Sat he was in severe pain and vomiting blood hourly. He is also a diabetic so not eating messed up his blood sugars and led to heart irregularities. 111 advised they'd send a paramedic, 10hrs later they ended up taking him to hospital by ambulance. He spent the weekend in A&E majors. He was taken to a ward Monday and put on IV anti-biotics, insulin drip, anti-sickness meds, and tramadol. CT scans flagged a second issue of a mass on his kidney. The consultant urologist hasn't yet looked at the scans. The ward he is on are now saying that they have treated the diverticulitis for now and are discharging him in the next few hours with oral anti-biotics. He hasn't eaten or kept water down since Weds. The longest he's gone without vomiting is a few hours. He is still in severe pain and not fully lucid. They say he'll be more comfortable at home and they won't take further action until the consultant urologist advises on the kidney scan. Luckily my mum is 10yrs younger and can advocate for him and care for him at home, she's insisted she wants a discharge papers and a plan before she will take him. Are we doing everything we should be here? I can't see how he won't end up back in hospital in a few days, in a worse state than now!

OP posts:
Maxiedog123 · 27/07/2021 15:21

If he is continuing to vomit he is not yet fit to go home. I would decline to pick him up. I would politely ask the medical team of they were aware that he was unable to keep fluids down yet.

Nextchapterofmybook · 27/07/2021 15:27

Speak to PALS for the hospital- they will advocate for you

Orangeinmybluelightcup · 27/07/2021 15:35

My mum has said : They've removed the drips and he can't stop being sick. Not putting drip in again but trying meds orally which isnt working. Worried about insulin as he has pump on not sliding scale.

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Orangeinmybluelightcup · 27/07/2021 15:39

Pals just have a message that they're dealing with high volumes and to leave a message

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Tibtab · 27/07/2021 15:41

If your Mum says she can look after him then they are going to push for discharge.

Mindymomo · 27/07/2021 15:45

Just because the ward says he will be discharged, he will have to be seen by a doctor first, so this may not happen yet. We’ve found with various family members in hospital, things change all the time. At least your Mum is onboard with everything going on.

DogsSausages · 27/07/2021 15:47

Can mum call the ward, speak to the nurse and say she cannot take him home, he is vomiting, unable to eat or drink and has insulin, he is very high risk of being readmitted, she can also ring the consultants secretary. I hope he recovers soon but I am shocked if he is discharged.

Orangeinmybluelightcup · 27/07/2021 15:48

She has spoken to doctor in person and he is being discharged.

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Orangeinmybluelightcup · 27/07/2021 15:51

The ward don't answer the phone so she rocked up. They wanted her to take him there and then. She's refused until she's got discharge papers and care notes. Just don't see how he can be sent home. He can't eat or drink, so can't control blood sugar.

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Orangeinmybluelightcup · 27/07/2021 15:51

I think the hospital is in a right state. Some of the other patients actually clapped her...

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Purplewithred · 27/07/2021 15:51

Thresholds to stay in hospital are pretty high at the moment. To help your argument - what exactly do you think is likely to happen if he is sent home? What's the risk? What would they do in hospital that can't be done at home? Who will be responsible for his health care when he is home (GP, hospital etc?)

This is one of the decisionmaking tools they are using, might be something useful in here

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/999443/hospital-discharge-and-community-support-policy-and-operating-model.pdf look through this at P41 - Appendix A - Criteria to Reside.

Orangeinmybluelightcup · 27/07/2021 15:53

Cheers @Purplewithred

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Zilla1 · 27/07/2021 16:02

Is he an outpatient at that's hospital's diabetes clinic or under the care of a GP?

Orangeinmybluelightcup · 27/07/2021 16:12

@Zilla1 not sure, he definitely goes to hospital for some appointments because his diabetes is poorly controlled, he has a sensor and a pump. Are you thinking to get them involved?

OP posts:
Zilla1 · 27/07/2021 16:19

Yes, OP, based on your point of poorly controlled diabetes and being unable to keep food down then I'd insist on a meeting with the HCP recommending discharge and to be confident they discharge plan seemed to be informed by the management of their diabetes.

Good luck.

Orangeinmybluelightcup · 27/07/2021 16:26

Right, update, they are keeping him in. Basically they took him off all the ivs etc this morning, mum said not taking him until paper work, they've just rung saying he's too ill to be discharged.

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Zilla1 · 27/07/2021 16:28

Good news, OP.

Bagelsandbrie · 27/07/2021 16:28

I’m glad they’re keeping him in. Your Mum needs to say she can’t care for him if she doesn’t feel he’s safe to come home otherwise they will push for discharge.

DogsSausages · 27/07/2021 16:31

That's good he is staying in but I hope that he gets better soon, good on mum for going to the ward,

Orangeinmybluelightcup · 28/07/2021 15:45

He's been discharged! He's at home. Instructions to go back in 2 days if no better. My mum says he seems no better than when he was taken in by ambulance. First thing he did when he got in the door was vomit. He can't keep food down but has to try to because of his antibiotics and insulin. Really crap.

OP posts:
DogsSausages · 28/07/2021 15:51

Oh dear, is there a gp or district nurse who can visit him. Does he record his bm at home, did they offer any suggestions of what he should try to eat or drink if he is being sick.

Orangeinmybluelightcup · 28/07/2021 15:53

No offer for help or suggestions what he can eat. I've suggested to mum she speaks to the diabetic team to see if they can help.

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DogsSausages · 28/07/2021 15:58

Thats a good idea, maybe he needs carbs not just sugary or milky drinks. Did they ever find out why he keeps vomiting. Does he have a bm machine at home.

DPotter · 28/07/2021 16:00

Phone 111 again and ask advice now - mentioned failed discharge.

A failed discharge is a re-admission, I think with 48 hrs, and it gets the hospital's attention as I believed they're fined. He'll have to go through A&E again but he sounds far too ill to be at home.

Phone now

Orangeinmybluelightcup · 28/07/2021 16:14

They gave him an energy drink in hospital, which seems crackers! He threw it up anyway.

What's a bm machine, sorry?

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