500,000 Hospital patients sent home to soon

[snoopy29]

The Daily Mail's lead article today is 500,000 Hospital patients sent home too soon www.dailymail.co.uk

In these days of unacheivable Government targets I cannot imagine there is a nurse in the country who is surprised by this figure, saddened yes, surprised no.

In A and E I see on a far to regular basis patients discharged in the morning and back by the evening. I have had the odd occasions when an ambulance crew have transported a patient home and by the time they have got home felt that the patient was not well enough to leave and have brought them straight back. Unsurprisingly their newly vacated bed will have been filled by someone else in the never ending desperate bid to prevent a breach. Often relatives will say that they have said that they did not feel their relative was well enough to discharge but it happened anyway.

I have previously wondered if anyone has ever worked out the cost of discharging then re-transporting, assessing and clerking a patient. I am pretty sure it will come in much higher than keeping a patient until they are really ready to go.

The thing that concerns me most is that the group this affects most is the elderly and chronically sick. I think the NHS has much to be proud of but the contstant pressure on beds forces early discharge with the silent but accepted message being no you probably aren't well enough or ready to go but we need the bed!!!

This is unfair on patients, and we lose credibility. I feel embarassment and frustration when yet again a pt returns on my watch but don't believe things will change unless hospitals capacity is increased or targets become about the patient not the number

[Silverdragon102, BSN]

As you said saddened but not surprised. When I worked in the medical admissions unit saw it regularly

[XB9S, BSN, MSN, EdD, RN, APN]

We see it on the wards as well with a push to early discharge, with your young fit patients who can recover fairly easily this isn't such a problem, but the elderly who do need that extra day or social input aren't so resilient. We do get quite a few re-admissions, having said that it is a clinical decision to discharge, it shouldn't be a managerial one and I know of quite a few occasions that nursing staff have delayed discharge because the patient isn't ready. It is frustrating when trying to get electives in to be told if you can discharge a patient we may be able to get this patient in. Not good practice.

I know it's different for EU, your under different pressures to the wards.

If we are going to discharge early then we do need to make sure that there is sufficient care set up in the community to provide that additional support, and that there is someone who will check our patients are coping at home.