Is this a common discharge practice?

Nurses General Nursing

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Specializes in ICU (med/surgical/transplant/neuro/ent).

I just wanted to ask around and see what people thought about this (and listen to my vent:angryfire):

First of all I work in the ICU and I am a fairly new nurse (1 1/2 years). People rarely discharge (well at least to home) from the ICU at my facility, and I have never personally discharged a patient to home. As a student I have observed patients being discharged, and even wheeled them out to the front of the hospital with their family/ride home.

Which brings me to today, my mother's boyfriend ("Bob") was injured at work a few days ago (squashed his hand in a printing press, had surgery). Today they discharged him, without letting anybody know he was being discharged. He told the nurse that his ride (my mother) wouldn't be able to pick him up for a few hours (this hospital is a good 1 1/2 hrs from where we live). They told him, Nope you have to be out by 3pm. So right now my mother is on the way to the hospital and "Bob" is downstairs in the hospital lobby with all his stuff waiting for her (official discharged). Did I mention he has been on IV pain medication the last few days? He did not walk away AMA, so this whole situation seems EXTREMELY negliegent to me.

Like I said, I work in a hospital, and know all too well the push from bed control to move patients along/transfer. But this does not seem right to me.

Also earlier today, someone (his nurse?) called and mentioned something about a PICC line (he didn't have one yesterday, I can only assume they put one in overnight or are planning to put one in tomorrow). They told me to be there tomorrow afternoon to go over PICC stuff, the way she spoke it sounded like he was being discharged tomorrow and someone needed to be there to go over PICC care since d/t his injuries he can't take care of it himself. The whole situation sounds screwier by the minute.

Anyway my point is: is it a common practice to discharge patients to the hospital lobby knowing that noone will be there to pick them up for several hours?

Any opinions on the matter would be greatly appreciated!

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Specializes in Med/Surg, ICU, educator.

not where I work! That's a big nightmare waiting to happen

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Specializes in ICU (med/surgical/transplant/neuro/ent).
not where I work! That's a big nightmare waiting to happen

That's exactly what I'm thinking! He's in good health and stable, but ANYBODY could code at ANYTIME (extreme scenario, but it could happen) As a nurse, I would not feel right knowing that my patient (discharged or not) is sitting in the hospital lobby for hours under no one's direct care. Eek!

I'll just feel better when my mom gets him in the car and safe at home away from that place.

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Specializes in Telemetry/Med-Surg.

OMG no if I have someone who is d/c'd I always tell them that the room is theirs until they have a ride. Not only is that rude to the patient to push them out the door but the hospital should look at it like they are responsible for the care of that patient and to ensure that they are d/c'd safely to a place to continue the healing process as well as have access to pain medication. I would write a complaint to the hospital.

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As scary as it sounds, I have heard of this before. This is some 'great idea' to speed throughput and open the beds up faster. The idea is to have stable adult patients waiting for a ride placed in a 'discharge lobby' with at least one hospital employee in attendence [i can only hope it is a nurse and not a volunteer!] At the first sign of trouble, the patient is sent to the ER, not back to the floor because ... their bed has someone else in it!

I can tell you that I am not interested in a policy like this for my hospital but, in the interest of making money and filling beds, I know it could happen.

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Specializes in ER.

I discharge patients from the ER to the lobby all the time. They have to wait for a ride or for the bus to come. There isn't much else to do. The toothache needs to leave now so we have a bed for the code coming in. However, discharging a patient from the ER is different than the floor. I agree with you in your situation. It is not ideal to discharge anyone without a responsible person but it happens.

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I have never seen this but am assuming they need a unit bed, in that case, a transfer to the floor would have been safer. A PICC line without discharge teaching, or is home health following up? That part is a little confusing which I am assuming is to you also.

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Specializes in NICU.

I got kicked out of my LDRP room after having my daughter. I was supposed to be getting an antibiotic at 6 pm, but l & d got slammed, so literally at around 11:30 am, the nurse walked in, told me that since I hadn't been symptomatic the doctor d/c'd the antibiotic, read me some discharge instructions really quick, and told me that I was discharged and needed to be out of the room ASAP. My daughter was in the NICU, my husband had ran home to grab some things, and my mother (who is an RN in the same hospital) had gone to the caf to grab some food. My mother got back to the floor to find me literally crying in the hallway with all of my stuff haphazardly thrown into a wheelchair beside me. She was livid, to put it lightly. I was...well...hormonal and upset about my daughter being in the NICU, and .....well unexpectadly in a hallway when 10 minutes earlier I had been laying in a bed ordering my lunch. Had I had time to think, maybe I wouldn't have signed the discharge papers...but it all happened so quickly that I didn't really get what was going on.

I don't care how much I need a bed, I will NEVER treat a patient the way I was treated. I don't understand how it can seem acceptable to discharge someone with no warning.

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right now i am still only a patient. here is my experience:

ER - Yes discharged ASAP regardless of if there is a ride there, walk (or have seen some people wheel in hospital wheelchairs) out self.

Day Surgery - No. Ride needs to be there PRIOR to surgery, they will not start if the person is not there. Wheeled to edge of unit by nurse, mother rest of way.

GI Procedure Unit - No. Same policy as above, but when mother was caught in traffic while on way they started anyway figuring she would be there by the time I was ready to go. Wheeled to edge of unit by nurse, mother rest of way.

Unit - No. Ride is there when discharged, no bus or other public transport allowed need vehicle there. Nurse wheels down to vehicle.

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