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Hospital discharge question - UPDATE post 100


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#1 Freddie'sMum

Posted 21 October 2019 - 11:00 AM

UPDATE - post 100

Yesterday, DH went biking and fell off the back of his bike and landed very badly on his back.  I was out with the girls so when we got home, I found him in bed feeling very sore.  

I couldn't get hold of an after hours doctors (Sunday) so ending up phoning the nearest hospital and the woman I spoke to told me to call an ambulance.  So I did that and soon afterwards an ambulance arrived and DH was taken away on a stretcher bed thingy.

The two paramedics were very good - very calming and said that DH's injuries were (obviously) not life threatening and they would take him to the hospital and he would be seen by a doctor.

The paramedics told me to phone the hospital in about an hour and a half's time - so that made it about 2pm(ish) when I phoned the hospital.  DH was having x-rays done and then when I spoke to him later on, he was sent for a CAT scan.  His mobile phone was running out of power so he told me to phone back later in the afternoon.

By about 5pm, he texted me to say that he thought he would be staying the night and I said I wanted to go and see him - the girls were very worried about him - so we drove to the hospital and saw him.  Then we drove home again about 7pm.  

He then sent me a text about 8pm saying they wanted to do more x-rays and he thought he would be staying the night.  All good, I said.

At 11pm he texted me again to say that they were now going to do the x-rays they had talked about earlier and after that, he was to be discharged.  Not quite understanding (it had been a very long day) I said "so you want me to come and get you now?"  And he said "yes, they are going to do another x-ray and then you can come and get me".

I panicked a bit and then went and knocked on my neighbour's door and asked if she could just stay in our house in case our kids woke up and then I drove to the hospital.

DH was discharged at about 12:30am.  We got home about 1am.

I guess my question is - is this the usual practice?  Do hospitals generally discharge people in the middle of the night?  What was I supposed to do if I didn't have anyone who could look after our kids while I went to collect DH at 11:30am / midnight?

I just found it so surreal.  Would it really have mattered if DH had stayed another 6 flipping hours (from midnight to 6am) and then at least both of us would have had a proper sleep and I wouldn't feel like a zombie driving there and back in the middle of the night?

Edited by Freddie'sMum, 23 October 2019 - 08:06 PM.


#2 seayork2002

Posted 21 October 2019 - 11:04 AM

I guess they needed the bed?

DH was taken to hospital in an ambulance at midnight, spent a few hours there and then was sent home at 4ish am in a taxi I think from memory ( a while ago now and not in Aus but I am guessing the system is the same) - he had pneumonia

I presume people come and go 24/7

#3 lucky 2

Posted 21 October 2019 - 11:11 AM

Yes, it's usual practice, I've been discharged from ED at all hours, last time it was 4 am after treatment for a broken arm. That was a public ED.
I took an uber home as dp couldn't leave dd asleep.
It's not optimal but if you're ok they need to clear the bed for the next person, night and day they are busy!

In a private ED they moved me somewhere and I slept the rest of the night and went home in the morning, but they had officially discharged me from ED overnight.

Once you are no longer an emergency and not requiring admission then you go home.

Remembering the numerous times in ED with on or the other parent, the older and more frail they were the discharge waited until morning, they were not fully indepenent.

It's different from a hospital inpatient/ward discharge.

Edited by lucky 2, 21 October 2019 - 11:17 AM.


#4 rowd

Posted 21 October 2019 - 11:14 AM

Totally normal if it's from ED. If you're not admitted then they will send you home whenever they have finished doing what they think is needed. I would find it strange if they discharged someone from a ward in the middle of the night though.

Hope your husband is feeling OK today.

#5 Kaz83

Posted 21 October 2019 - 11:20 AM

Yep, the powers that be dont care about your sleep, your kids sleep or your husbands sleep. They care about their numbers looking pretty and if they had a bed that could be empty being taken up by someone that in their opinion didnt need it for 6 hours someone would need to answer to that. Or, they were super busy and your husband was the least unwell so he got kicked out.
Very inconvenient to you for sure but the hospital admin dont see patients or families they see numbers.
Hope your husband is feeling better today and youve all caught up on some sleep.

#6 amaza

Posted 21 October 2019 - 11:25 AM

Yeah that's very normal, especially for an ED.

#7 born.a.girl

Posted 21 October 2019 - 11:25 AM

Yes, standard practice.

The last time I took my mother to hospital, I'd driven from Melbourne to Northern Victoria, then took her to hospital and was waiting around.  Very late in the evening they said they would probably keep her in overnight, were just waiting on test results to come back. There's a section near emergency where they keep people who just need observing for a while longer.

Roll on to midnight and the new emergency doctor said they would release her in a few more hours.  I was pretty disappointed because I'd been driving for three hours, hadn't had dinner and it was way past my bedtime already.

She was discharged somewhere between 2 - 3am and it was minus three degrees according to my car. They didn't ask if I was able to stay with her - not really their problem if it's not made their problem.

She was 95.

They need the beds.

#8 hills mum bec

Posted 21 October 2019 - 11:26 AM

I would assume that in this case he wasn't admitted to the hospital in the first place and he spent the entire time in ED.  This has happened to me before and I have called DH at 3am to come and collect me after being taken to hospital by ambulance.

#9 born.a.girl

Posted 21 October 2019 - 11:32 AM

As per others, they're not really 'discharging' you in the same sense as those who've been admitted.

They're releasing you from the emergency department, which operates around the clock, because you no longer need to be there.

#10 2_little_boys

Posted 21 October 2019 - 11:32 AM

Totally normal - its ED - not a motel!

Another, sicker more at risk person may need that bed, they cant just have your DH taking up a bed because you would rather not collect him in the middle of the night.

#11 IamtheMumma

Posted 21 October 2019 - 11:33 AM

Yes normal.

#12 Luci

Posted 21 October 2019 - 11:34 AM

I hope your DH is feeling better today OP.

I agree with the other posts, I think it is pretty normal practice. Emergency Departments are open 24 hours. Your can arrive at any time of the night and similarly leave at any time of the night. I have been to Emergency in the middle of the night a couple of times and found it to be very busy with 20 or 30 odd people waiting, and more arriving all the time.

There would be no way all those people could stay there in a bed all night, once you have been seen by the staff and subsequently given the OK to leave you have you go.

#13 lucky 2

Posted 21 October 2019 - 11:40 AM

I think it helps to be assertive when stating a middle of the night discharge isn't good, such as with pp above with a 95yo mum!

If they had a quiet place for her to rest and another Dr said ok, I'd bee inclined to stand my ground and refuse to leave until early morning!
Obviously it may not always work but I'd do my best.


#14 luke's mummu

Posted 21 October 2019 - 11:51 AM

Yes that’s quite usual. If necessary you could have bundled your kids into the car and taken them. Or DH could have taken a taxi/ Uber home.

#15 SkeptiHandsOnMum

Posted 21 October 2019 - 12:00 PM

Absolutely standard. Demand for emergency department beds is too high to keep people there who do not need to be there.

I work as a paramedic, and we take 100 yr old patients home at 3am. It is awful disturbing a person of that age and moving them around in the middle of the night, but the beds are needed. Even if there are a multitude of empty beds, the concept is operational readiness - it will only take one balcony collapse/nightclub brawl/multi-car accident and the bed will be needed.

#16 born.a.girl

Posted 21 October 2019 - 12:02 PM

 lucky 2, on 21 October 2019 - 11:40 AM, said:

I think it helps to be assertive when stating a middle of the night discharge isn't good, such as with pp above with a 95yo mum!

If they had a quiet place for her to rest and another Dr said ok, I'd bee inclined to stand my ground and refuse to leave until early morning!
Obviously it may not always work but I'd do my best.


It was the earlier doctor who said they'd keep her overnight, the later one said they would release her in a few hours.  I guess perhaps the earlier one wasn't expecting her to recover enough??  (Hadn't been able to keep anything down for 12 hours.)


After that, and other experiences, when she had the fall she was never going to have at 98, and ended up in emergency, none of us went up there for a few days.  It sounds awful, but it was pretty much the only way we could ensure that she wasn't sent home until a full geriatrician assessment had been made.  Quite rightly, she was fairly quickly moved to the geriatric rehabilitation section where she remained for about a month, and was then deemed not fit to return home.

If I'd known how it was going to pan out, I'd have gone out and got myself something to eat (didn't get to eat for nearly 24 hours), and hopefully it wouldn't have been assumed there was someone to take her home and look after her.

Edited by born.a.girl, 21 October 2019 - 12:05 PM.


#17 SkeptiHandsOnMum

Posted 21 October 2019 - 12:02 PM

 lucky 2, on 21 October 2019 - 11:40 AM, said:

I think it helps to be assertive when stating a middle of the night discharge isn't good, such as with pp above with a 95yo mum!

If they had a quiet place for her to rest and another Dr said ok, I'd bee inclined to stand my ground and refuse to leave until early morning!
Obviously it may not always work but I'd do my best.
Refusing to leave does not help the others who may need the bed. It is an emergency department. It might be inconvenient for you/the older person, but it has to happen that way.

#18 jayskette

Posted 21 October 2019 - 12:02 PM

it is interesting that some people feel that ED discharges at odd hours are abnormal actually!

#19 laridae

Posted 21 October 2019 - 12:13 PM

It sound like he wasn't admitted to the hospital (ie had a bed in a room on the ward) and was only in emergency. And if so, they kick you out as soon as they are finished. They need the bed, otherwise another patient doesnt get looked at.
its either admit to ward or go home. And it sounds like it wasn't necessary to admit to ward.

#20 Kiwi Bicycle

Posted 21 October 2019 - 12:15 PM

My DH has been in ED twice over the last few months and they are pretty quick in deciding when to move you on when they have test results back and a doctor to look over them. DH has twice been moved at midnight via patient transport ambulance to another hospital and once had surgery at 3am ( I hoped the doctor had had a good days rest beforehand).
I have always told DH to take a Uber or taxi home if it's after 9pm and he was discharged but that hasn't happened and he's always ended up with a lengthy hospital stay. I am also really good at packing bags for hospital stays now as well.

#21 seayork2002

Posted 21 October 2019 - 12:17 PM

 SkeptiHandsOnMum, on 21 October 2019 - 12:02 PM, said:

Refusing to leave does not help the others who may need the bed. It is an emergency department. It might be inconvenient for you/the older person, but it has to happen that way.

This, If am not (or anyone I know) meant to be at a hospital there is no reason to be there and stamping my foot and doing a sit in is not going to help anyone.

no way do I want a bed taken for people who do not need to be there

#22 born.a.girl

Posted 21 October 2019 - 12:19 PM

 laridae, on 21 October 2019 - 12:13 PM, said:

It sound like he wasn't admitted to the hospital (ie had a bed in a room on the ward) and was only in emergency. And if so, they kick you out as soon as they are finished. They need the bed, otherwise another patient doesnt get looked at.
its either admit to ward or go home. And it sounds like it wasn't necessary to admit to ward.


Where my mother was (Bendigo base hospital) they have a section where emergency patients who just need to be monitored for longer stay for a certain period. They did tell me there was a minimum in that section (when I was first asking what time I should come back). That frees the 'treatment' emergency bed, without the person having to be admitted and all of the palaver of paperwork the staff have to do for that.

#23 MrsLexiK

Posted 21 October 2019 - 12:25 PM

Yeah it sucks we typically go to the small country one which has no short stay only Ed and wards. The other night when DH had to go (because he leaves it til you know 6.00pm at night not when drs are you know open!) we all went down, stayed a while. Me and the boys got dinner. I was happy for him to catch an Uber home. (Though not sure how it works when being discharged from Ed?) I physically can’t lift our kids anymore (they are too long) thankfully my IL’s live really really really close to the hospital so I dropped the kids off there for a bit and MIL put them to bed. DH was discharged (and we had to find emergency dentist/dental hospital) after 12am.

At the bigger one (where we go for more serious stuff) they have short stay, so you can get admitted for longer without being “admitted” it’s where I would get admitted when pregnant with DS2 pre a certain amount weeks when needing fluids for HG. It’s where they put the patients coming off ice when the psych ward was full as well and where you stayed when you waited for your bed in a real ward but it was taking to long and they needed the bed in Ed. A lot of falls/observations etc go in there.

#24 Anonforthistime

Posted 21 October 2019 - 12:26 PM

While certainly inconvenient to be having to go and get him during the night, I think it helps to consider the people waiting in ED awhile, who will be seen to once that bed is clear.
I don’t think Kaz83 is being fair to those of us who are juggling to balance the arrivals and departures from
ED  

 Kaz83, on 21 October 2019 - 11:20 AM, said:

Yep, the powers that be dont care about your sleep, your kids sleep or your husbands sleep. They care about their numbers looking pretty and if they had a bed that could be empty being taken up by someone that in their opinion didnt need it for 6 hours someone would need to answer to that. Or, they were super busy and your husband was the least unwell so he got kicked out.
Very inconvenient to you for sure but the hospital admin dont see patients or families they see numbers.
Hope your husband is feeling better today and youve all caught up on some sleep.

We ABSOLUTELY see patients and families. This comment is quite saddening.
If you were waiting in ED ago be seen, and we called in at 3am because we had just sent someone else home, I suspect you might see it differently.

#25 Freddie'sMum

Posted 21 October 2019 - 12:30 PM

Thanks for all your responses.  He was admitted through the A & E and was under observation after that.

It was a first for me / us and I am sorry if I didn't understand the process of letting people leave at all hours.

He's still very sore and needs a follow up appt with our regular GP and a referral to an orthopaedic surgeon.  He didn't say anything at the time in front of the kids, but he was actually very frightened when he was in hospital.  We talked about it this morning after I dropped the kids to school.




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