Discharging yourself from hospital

suki1964

Guest101 wrote: »

There isn't a hospital in the country which would willingly keep someone in like this - there will be other reasons

Sorry but that's not quite true

I've been discharged at early morning bed rounds, but haven't received discharge meds, dressings, follow up appt, doctors letter until 6pm

It's not uncommon to be sat all day waiting for these things

My mother too waited 5 hours between discharge and finally getting to leave

MonkeyDr

I completely agree that waiting around for hours for discharge paperwork / medications etc is common. I blame the lack of resources (i.e. staff), and it is very frustrating both for those waiting to get home and for those waiting to get into a bed.
(One might go on to think that taking any actions that use up more staff time unnecessarily, such as walking out unannounced and prompting a search party, could be considered as adding to the problems for other patients...)

I also completely agree that no-one would keep a patient in hospital for days and days just to get a simple wound sutured. I would do this in 5 mins on a ward, or it could be done by a nurse practitioner in A&E and certainly wouldn't warrant admission in the first place.

Given that they are calling it an op, it must be a bit more complicated than that, requiring a surgeon & formal theatre +/- anaesthetic. Your OH has my sympathy in that being the least urgent patient on the 'urgent' theatre list is rubbish - always lower priority than a trauma case or emergency appendix etc, and yet not 'routine' enough to be booked as an outpatient.

However, the team will be recommending the op as they think that it is in his best interests. They will make their decisions based on evidence, guidelines and experience, whilst acknowledging that what is best for _most_ patients isn't best for _every_ patient. Maybe it's the sort of wound that usually won't heal without intervention, and commonly leads to amputation if untreated? I don't know. This is not an appropriate forum for medical advice anyway.

I am curious: what motive do you think the medics have for keeping him there when he doesn't want to be, other than the general motive of wanting to get him as well as they can?

onomatopoeia99

juliethemuse wrote: »

As soon as he starts asking for the form to sign to get out they all do a disappearing act.

One thing that has come out of this topic, and is confirmed by reading around NHS trust policies on self-discharge, is that the hospital can ask him to sign a form if he wants to self discharge. He can refuse, they cannot require him to sign a form or prevent him from leaving (other than in MHA and lack of capacity cases already noted).

sacha28

rpc wrote: »

The staff need to do more than just request that the patient return - section 136 only applied to specific cases where mental illness is a problem.

This isn't true. I have made many requests over the past 15 years for a patient to be returned to the department and have always specified that, should they refuse, a 136 is the only remaining option (under the instruction of the consultant). If there were no issues then you wouldn't be requesting their return so it wouldn't apply. There are many forms that need completing, hoops to jump through, red tape to run through.....which is why a patient self discharging, when not a simple case, is an absolute PITA.

Guest101

suki1964 wrote: »

Sorry but that's not quite true

I've been discharged at early morning bed rounds, but haven't received discharge meds, dressings, follow up appt, doctors letter until 6pm

It's not uncommon to be sat all day waiting for these things

My mother too waited 5 hours between discharge and finally getting to leave

It is true, you're just missing the point I'm making


Once you are in the discharge process, your bed is allocated, and the next steps begin.


Yes hours of waiting, of course, it's a hospital not a mcdonalds, but not days or weeks.

Guest101

sacha28 wrote: »

This isn't true. I have made many requests over the past 15 years for a patient to be returned to the department and have always specified that, should they refuse, a 136 is the only remaining option (under the instruction of the consultant). If there were no issues then you wouldn't be requesting their return so it wouldn't apply. There are many forms that need completing, hoops to jump through, red tape to run through.....which is why a patient self discharging, when not a simple case, is an absolute PITA (which of course we don't know in this case because the OP has given no details).

Yes but the point is s.136 only applies to those situations covered by the MHA, not general medicine, surgery, whatever.


So why not be clear about it?

Pop_Up_Pirate

Guest101 wrote: »

There isn't a hospital in the country which would willingly keep someone in like this - there will be other reasons

That isn't true.

Hospitals quite often keep patients in who are waiting for operations or treatments when the initial op is cancelled. They do this thinking its 'easier' to keep them in a couple more days rather than send them home then have to come back a few days later and have to fill out all the paper work again.

Saves time but takes up bed space.

Doctors sometimes keep patients in longer than really necessary to cover their own behinds too. Rather safe than sorry. Again, takes up bed space.
As the docs don't always visit the same ward each day, a patient often has to wait for the next visit before being released and that could be 3 days later.
That 3 days could have had another patient in and treated.

Guest101

Pop_Up_Pirate wrote: »

That isn't true.

Hospitals quite often keep patients in who are waiting for operations or treatments when the initial op is cancelled. - what outpatients? that's highly unlikely. In patients - yes because they need care? They do this thinking its 'easier' to keep them in a couple more days rather than send them home then have to come back a few days later and have to fill out all the paper work again. - absolute rubbish. Clearly you've never sat in a bed management meeting.

Saves time but takes up bed space. - nope. sorry absolute daily fail rubbish

Doctors sometimes keep patients in longer than really necessary to cover their own behinds too. - nope. sorry again rubbish. Rather safe than sorry. Again, takes up bed space.
As the docs don't always visit the same ward each day - what are you on about now? , a patient often has to wait for the next visit before being released and that could be 3 days later. - You have a consultant, and they have a team. That team may visit wards on behalf of the consultant, but no it wont take 3 days to discharge a perfectly healthy person.
That 3 days could have had another patient in and treated.

Im sorry but this is daily fail propaganda at it's best

sacha28

Guest101 wrote: »

Yes but the point is s.136 only applies to those situations covered by the MHA, not general medicine, surgery, whatever.


So why not be clear about it?

But general medicine, surgery and MH (more medicine and MH tbh) are all interlinked. If a patient has discharged themselves against the advice of the doctor but they are still medically unwell then the 136 can be applied because the illness can temporarily disable mental capacity. This can be decided by a consultant in the patient's absence and can be reconsidered once the patient has returned (which is an absolute ball ache in itself because a 136 has to be lifted by a psychiatric consultant iirc, try finding one of those when you need one!!)

They can do this if they think you have a mental illness and are in need of care. A place of safety can be a hospital or a police station. The police can move you from one place to another. this being a quote from rethink.org. The important word here is think. It can be applied and then removed should opinions change.

Of course this is all relative.

OP I don't understand what you mean? There is only a small timeframe in which you can suture a wound due to the risk of infection (although I am A&E so it may work differently) which is 12 hours. Are you saying that your DH had an operation and they left the wound open? What type of operation was it?

Guest101

sacha28 wrote: »

But general medicine, surgery and MH (more medicine and MH tbh) are all interlinked. - of course they are, mental capacity can be affected by all sorts of drugs. But you were phrasing it as though any patient could be brought back under s.136. If a patient has discharged themselves against the advice of the doctor but they are still medically unwell then the 136 can be applied because the illness can temporarily disable mental capacity. - can be, not will be. In rare circumstances.

They can do this if they think you have a mental illness and are in need of care. A place of safety can be a hospital or a police station. The police can move you from one place to another. this being a quote from rethink.org. The important word here is think. It can be applied and then removed should opinions change. - it must be justifiable to the reasonable person





Of course this is all relative.

OP I don't understand what you mean? There is only a small timeframe in which you can suture a wound due to the risk of infection (although I am A&E so it may work differently) which is 12 hours. Are you saying that your DH had an operation and they left the wound open? What type of operation was it?

Mentally disordered persons found in public places.E+W
(1)If a constable finds in a place to which the public have access a person who appears to him to be suffering from mental disorder and to be in immediate need of care or control, the constable may, if he thinks it necessary to do so in the interests of that person or for the protection of other persons, remove that person to a place of safety within the meaning of section 135 above.
(2)A person removed to a place of safety under this section may be detained there for a period not exceeding 72 hours for the purpose of enabling him to be examined by a registered medical practitioner and to be interviewed by an [F1approved mental health professional] and of making any necessary arrangements for his treatment or care.
[F2(3)A constable, an approved mental health professional or a person authorised by either of them for the purposes of this subsection may, before the end of the period of 72 hours mentioned in subsection (2) above, take a person detained in a place of safety under that subsection to one or more other places of safety.
(4)A person taken to a place of a safety under subsection (3) above may be detained there for a purpose mentioned in subsection (2) above for a period ending no later than the end of the period of 72 hours mentioned in that subsection.]