Wednesday, 28 November 2007

Are We a Hotel or a Hospital

One of the patients on my ward has been medically fit for well over a week, unfortunately he just won't go home. In fact, he probably never needed to be admitted in the first place. He does have a number of issues, and does require some level of support but not medically. At the moment he has his own room with private bathroom and he gets fed three times a day. We're not doing anything for him, he's just using the hospital as a free hotel!

He was admitted with complex symptoms which needed to be investigated but he could have gone home a few days after being admitted. Coincidentally, when he was admitted, his partner (who provides the care he needs) was to be admitted for an elective procedure the next day (so wouldn't be there to provide support for him). The cynical among the staff, suspect that this isn't the coincidence it was made out to be.

And so it is, we're stuck with him, don't get me wrong, I think he probably did need some help at home when his partner was going into hospital but hospital isn't the place. He's medically fit so is just tying up a bed at the moment and who knows when he'll go home. I suspect in the old days he'd have just been kicked out, but now, there are complex issues when it comes to discharges, especially in complicated cases. As a result, its almost impossible to get rid of someone who just won't go.

We're not a hotel, we're a hospital. A hospital that is currently in the midst of a serious bed crisis, so much so that we might be closed next week - not a surprise really with patients like this.

n.b. Patient details changed and omitted for confidentiality.


dr_dyb said...

Own room, private we study medicine in the same NHS?

You only get one of them if you have C diff or MRSA up here.

the little medic said...

dr_dyb yup - the ward has just been refurbished, all side rooms have their own bathrooms and all other bays have 3 beds and a bathroom.

Most of the side rooms are taken up with c diff or MRSA patients but some people just get lucky.

Pro et Contra Medic said...

Last year I had clinic at a medical department, where I had a consultant specialised in Geriatric-medicine as my supervisor. At that time we also hade some challenge with, no empty beds or space for patients.
Even though some of the doctors where rambling around a little bit faster than there usual. My consultant just said in the same came voice as she always had, that we still should make an proper examination of patients, now matter how tight it became. But in your example, I guess that the patient has been thru the usual examinations.
If I may ask, have they threatened to close down the hospital?

I hope it will turn out all well for your patient and the number of beds.
If it is any comfort to you, it may well be a result of yours care. that makes him to stay.

AMiB said...

sign the discharge papers, call security, and if you can, get them a taxi/bus voucher...that's how we used to do it back home...

Anonymous said...

Couldn't they make the stay a little...less comfortable?

PhD scientist said...

Is the partner having the elective procedure back home fully fit and able to provide the necessary back-up as per usual? - might be the question.

Being able to discharge someone who is going to have "care issues" once discharged is presumably heavily dependent on there being an adequate "regime" to discharge them to. Sending them home if they won't be able to manage their problems there will just bounce them back to the NHS in short order.