Why does it takes so long to get released from the hospital after doctor's ok?

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  #31  
Old 01-26-2015, 09:31 AM
dillywho dillywho is offline
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I seem to always be on the other side of the coin in discussions, but I try to look at all aspects of subjects.

I have talked about this with our doctors and have noticed a change in how they talk about it to their patients. I have also put it on every hospital follow-up survey. Just because Doctor A tells you that he is discharging you, does not translate to right away for many reasons. Many of them now say, "You can go home today, but I cannot tell you a time so just sit back and relax in the meantime."

I will try and list some of the reasons I know about:

He/she often has many patients on the same floor and must complete paperwork (write orders for all, including the decision to release along with writing scripts, etc.). Seeing the patients includes answering their questions, reviewing care plans with them, explaining why they are perhaps ordering additional tests, etc. This takes time and they are not going to sign off on everything until all of this has been done and they have gone over everything with the staff. They do not do all of this one patient at a time.

Sometimes, you have to be seen by all your doctors (specialist(s), primary) and then they have to sign off before the hospital doctor can. Not all doctors can/do make rounds at the same time. Some do rounds after their surgeries have been completed and/or emergencies addressed.

Nurses cannot tell Patient B that they will have to wait for their meds or care because Patient A has been told he/she can go home today and will be upset if they don't get IV's out, discharge papers signed by them, etc., right away. RN's are the ones that have to do all of this and are the only ones allowed to dispense meds or do discharges.

Last, but not least, everything comes to a screeching halt if one of the patients gets into a life-threatening situation and all resources are directed to that patient. I'm sure someone was waiting impatiently to go home when my husband went into cardiac arrest in 2013. Because of the skills and teamwork that morning, I still have him today.

I guess all I am trying to say is that all these people have a job to do and it absolutely has to be done correctly; maybe not yours, but someone's life might be at stake. Nurses and doctors are dedicated people; otherwise they would have chosen much easier professions for themselves. Any business, including hospitals and doctors, is about money. No money equals no hospital or any other business. All of us not in business worked for money....nothing wrong with that, either. The fact that these people have to make life and death decisions everyday is priceless. I cannot imagine having the burden of having to tell someone that their loved one is going to die no matter what or has died, despite all efforts to the contrary nor can I imagine having a job that someone's life depends on how I do that job.

Please try a little more understanding and patience. Hospitals are miserable necessities and not 5-star hotels as some patients seem to think by the way they treat the nursing staff when they are there. They cannot leave just because their shift ended at 6:00 or whatever. If they are in the middle of some patient's care, they can't just say, "Sorry, my day is done.", but continue that care until it is finished. Sometimes a new patient is admitted 45 minutes prior to their shift end and they have to stay until everything is set up with that patient. There is much work behind the scenes that many people never know about.
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  #32  
Old 01-26-2015, 09:40 AM
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Ok it must be different depending on the hospital and or insurance. Hubby was in a hospital in Bellevue Wa for a stint. Kept him or an extra day to make sure no blood clots. The surgeon and his personal doctor who both member/owner doctors of the hospital signed off after morning rounds and home he went within an hour. Now when I was in my doctor signed off on a Sunday and it took three hours for the paperwork same hospital, but it was a weekend. However neither of us was on Medicare at the time.
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  #33  
Old 01-27-2015, 03:59 AM
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A couple of years ago, my husband was admitted to The Villages hospital four different times. Each time his cardiologist said he could go home, it took as long as 8 hours for the admitting doctor (from the ER) to sign the discharge papers. In the meantime, I am sure, there were other patients in the ER waiting for a room. There is definitely something wrong with the process. Hopefully, by now, they have improved.
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  #34  
Old 01-27-2015, 09:10 AM
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Quote:
Originally Posted by dillywho View Post
I seem to always be on the other side of the coin in discussions, but I try to look at all aspects of subjects.

I have talked about this with our doctors and have noticed a change in how they talk about it to their patients. I have also put it on every hospital follow-up survey. Just because Doctor A tells you that he is discharging you, does not translate to right away for many reasons. Many of them now say, "You can go home today, but I cannot tell you a time so just sit back and relax in the meantime."

I will try and list some of the reasons I know about:

He/she often has many patients on the same floor and must complete paperwork (write orders for all, including the decision to release along with writing scripts, etc.). Seeing the patients includes answering their questions, reviewing care plans with them, explaining why they are perhaps ordering additional tests, etc. This takes time and they are not going to sign off on everything until all of this has been done and they have gone over everything with the staff. They do not do all of this one patient at a time.

Sometimes, you have to be seen by all your doctors (specialist(s), primary) and then they have to sign off before the hospital doctor can. Not all doctors can/do make rounds at the same time. Some do rounds after their surgeries have been completed and/or emergencies addressed.

Nurses cannot tell Patient B that they will have to wait for their meds or care because Patient A has been told he/she can go home today and will be upset if they don't get IV's out, discharge papers signed by them, etc., right away. RN's are the ones that have to do all of this and are the only ones allowed to dispense meds or do discharges.

Last, but not least, everything comes to a screeching halt if one of the patients gets into a life-threatening situation and all resources are directed to that patient. I'm sure someone was waiting impatiently to go home when my husband went into cardiac arrest in 2013. Because of the skills and teamwork that morning, I still have him today.

I guess all I am trying to say is that all these people have a job to do and it absolutely has to be done correctly; maybe not yours, but someone's life might be at stake. Nurses and doctors are dedicated people; otherwise they would have chosen much easier professions for themselves. Any business, including hospitals and doctors, is about money. No money equals no hospital or any other business. All of us not in business worked for money....nothing wrong with that, either. The fact that these people have to make life and death decisions everyday is priceless. I cannot imagine having the burden of having to tell someone that their loved one is going to die no matter what or has died, despite all efforts to the contrary nor can I imagine having a job that someone's life depends on how I do that job.

Please try a little more understanding and patience. Hospitals are miserable necessities and not 5-star hotels as some patients seem to think by the way they treat the nursing staff when they are there. They cannot leave just because their shift ended at 6:00 or whatever. If they are in the middle of some patient's care, they can't just say, "Sorry, my day is done.", but continue that care until it is finished. Sometimes a new patient is admitted 45 minutes prior to their shift end and they have to stay until everything is set up with that patient. There is much work behind the scenes that many people never know about.
Dillywho, as a retired RN, I can't tell you how much I appreciate your post! You nailed it!
  #35  
Old 01-27-2015, 09:12 AM
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Originally Posted by KyWoman View Post
Dillywho, as a retired RN, I can't tell you how much I appreciate your post! You nailed it!

Two of the smartest people in the universe, and both thankfully friends.
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  #36  
Old 01-27-2015, 09:19 AM
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Quote:
Originally Posted by dillywho View Post
I seem to always be on the other side of the coin in discussions, but I try to look at all aspects of subjects.

I have talked about this with our doctors and have noticed a change in how they talk about it to their patients. I have also put it on every hospital follow-up survey. Just because Doctor A tells you that he is discharging you, does not translate to right away for many reasons. Many of them now say, "You can go home today, but I cannot tell you a time so just sit back and relax in the meantime."

I will try and list some of the reasons I know about:

He/she often has many patients on the same floor and must complete paperwork (write orders for all, including the decision to release along with writing scripts, etc.). Seeing the patients includes answering their questions, reviewing care plans with them, explaining why they are perhaps ordering additional tests, etc. This takes time and they are not going to sign off on everything until all of this has been done and they have gone over everything with the staff. They do not do all of this one patient at a time.

Sometimes, you have to be seen by all your doctors (specialist(s), primary) and then they have to sign off before the hospital doctor can. Not all doctors can/do make rounds at the same time. Some do rounds after their surgeries have been completed and/or emergencies addressed.

Nurses cannot tell Patient B that they will have to wait for their meds or care because Patient A has been told he/she can go home today and will be upset if they don't get IV's out, discharge papers signed by them, etc., right away. RN's are the ones that have to do all of this and are the only ones allowed to dispense meds or do discharges.

Last, but not least, everything comes to a screeching halt if one of the patients gets into a life-threatening situation and all resources are directed to that patient. I'm sure someone was waiting impatiently to go home when my husband went into cardiac arrest in 2013. Because of the skills and teamwork that morning, I still have him today.

I guess all I am trying to say is that all these people have a job to do and it absolutely has to be done correctly; maybe not yours, but someone's life might be at stake. Nurses and doctors are dedicated people; otherwise they would have chosen much easier professions for themselves. Any business, including hospitals and doctors, is about money. No money equals no hospital or any other business. All of us not in business worked for money....nothing wrong with that, either. The fact that these people have to make life and death decisions everyday is priceless. I cannot imagine having the burden of having to tell someone that their loved one is going to die no matter what or has died, despite all efforts to the contrary nor can I imagine having a job that someone's life depends on how I do that job.

Please try a little more understanding and patience. Hospitals are miserable necessities and not 5-star hotels as some patients seem to think by the way they treat the nursing staff when they are there. They cannot leave just because their shift ended at 6:00 or whatever. If they are in the middle of some patient's care, they can't just say, "Sorry, my day is done.", but continue that care until it is finished. Sometimes a new patient is admitted 45 minutes prior to their shift end and they have to stay until everything is set up with that patient. There is much work behind the scenes that many people never know about.
bump. Great post Dilly. NO, WONDERFUL post Dilly.
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  #37  
Old 01-27-2015, 01:35 PM
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Just a question - are they digital? When I went in at home they had gone digital - A screen pulls up the records the doc signs the screen and the system updates a discharge person comes by you sign the screen and off you go. Now it took them almost two years to convert but now it is up and running it seems to work great.
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  #38  
Old 01-27-2015, 01:48 PM
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It's all about money and legal issues!
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  #39  
Old 01-27-2015, 02:55 PM
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It's all about money and legal issues!

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  #40  
Old 01-27-2015, 03:08 PM
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Quote:
Originally Posted by dillywho View Post
I seem to always be on the other side of the coin in discussions, but I try to look at all aspects of subjects.

I have talked about this with our doctors and have noticed a change in how they talk about it to their patients. I have also put it on every hospital follow-up survey. Just because Doctor A tells you that he is discharging you, does not translate to right away for many reasons. Many of them now say, "You can go home today, but I cannot tell you a time so just sit back and relax in the meantime."

I will try and list some of the reasons I know about:

He/she often has many patients on the same floor and must complete paperwork (write orders for all, including the decision to release along with writing scripts, etc.). Seeing the patients includes answering their questions, reviewing care plans with them, explaining why they are perhaps ordering additional tests, etc. This takes time and they are not going to sign off on everything until all of this has been done and they have gone over everything with the staff. They do not do all of this one patient at a time.

Sometimes, you have to be seen by all your doctors (specialist(s), primary) and then they have to sign off before the hospital doctor can. Not all doctors can/do make rounds at the same time. Some do rounds after their surgeries have been completed and/or emergencies addressed.

Nurses cannot tell Patient B that they will have to wait for their meds or care because Patient A has been told he/she can go home today and will be upset if they don't get IV's out, discharge papers signed by them, etc., right away. RN's are the ones that have to do all of this and are the only ones allowed to dispense meds or do discharges.

Last, but not least, everything comes to a screeching halt if one of the patients gets into a life-threatening situation and all resources are directed to that patient. I'm sure someone was waiting impatiently to go home when my husband went into cardiac arrest in 2013. Because of the skills and teamwork that morning, I still have him today.

I guess all I am trying to say is that all these people have a job to do and it absolutely has to be done correctly; maybe not yours, but someone's life might be at stake. Nurses and doctors are dedicated people; otherwise they would have chosen much easier professions for themselves. Any business, including hospitals and doctors, is about money. No money equals no hospital or any other business. All of us not in business worked for money....nothing wrong with that, either. The fact that these people have to make life and death decisions everyday is priceless. I cannot imagine having the burden of having to tell someone that their loved one is going to die no matter what or has died, despite all efforts to the contrary nor can I imagine having a job that someone's life depends on how I do that job.

Please try a little more understanding and patience. Hospitals are miserable necessities and not 5-star hotels as some patients seem to think by the way they treat the nursing staff when they are there. They cannot leave just because their shift ended at 6:00 or whatever. If they are in the middle of some patient's care, they can't just say, "Sorry, my day is done.", but continue that care until it is finished. Sometimes a new patient is admitted 45 minutes prior to their shift end and they have to stay until everything is set up with that patient. There is much work behind the scenes that many people never know about.

I am bumping this again and hoping the OP will read it and respond.
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  #41  
Old 01-27-2015, 11:58 PM
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Quote:
Originally Posted by KyWoman View Post
Dillywho, as a retired RN, I can't tell you how much I appreciate your post! You nailed it!

DITTO ....GREAT JOB great post from a working RN waiting to discharge patients too...
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Old 01-28-2015, 12:20 AM
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Old 01-28-2015, 01:40 AM
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Quote:
Originally Posted by dillywho View Post
I seem to always be on the other side of the coin in discussions, but I try to look at all aspects of subjects.

I have talked about this with our doctors and have noticed a change in how they talk about it to their patients. I have also put it on every hospital follow-up survey. Just because Doctor A tells you that he is discharging you, does not translate to right away for many reasons. Many of them now say, "You can go home today, but I cannot tell you a time so just sit back and relax in the meantime."

I will try and list some of the reasons I know about:

He/she often has many patients on the same floor and must complete paperwork (write orders for all, including the decision to release along with writing scripts, etc.). Seeing the patients includes answering their questions, reviewing care plans with them, explaining why they are perhaps ordering additional tests, etc. This takes time and they are not going to sign off on everything until all of this has been done and they have gone over everything with the staff. They do not do all of this one patient at a time.

Sometimes, you have to be seen by all your doctors (specialist(s), primary) and then they have to sign off before the hospital doctor can. Not all doctors can/do make rounds at the same time. Some do rounds after their surgeries have been completed and/or emergencies addressed.

Nurses cannot tell Patient B that they will have to wait for their meds or care because Patient A has been told he/she can go home today and will be upset if they don't get IV's out, discharge papers signed by them, etc., right away. RN's are the ones that have to do all of this and are the only ones allowed to dispense meds or do discharges.

Last, but not least, everything comes to a screeching halt if one of the patients gets into a life-threatening situation and all resources are directed to that patient. I'm sure someone was waiting impatiently to go home when my husband went into cardiac arrest in 2013. Because of the skills and teamwork that morning, I still have him today.

I guess all I am trying to say is that all these people have a job to do and it absolutely has to be done correctly; maybe not yours, but someone's life might be at stake. Nurses and doctors are dedicated people; otherwise they would have chosen much easier professions for themselves. Any business, including hospitals and doctors, is about money. No money equals no hospital or any other business. All of us not in business worked for money....nothing wrong with that, either. The fact that these people have to make life and death decisions everyday is priceless. I cannot imagine having the burden of having to tell someone that their loved one is going to die no matter what or has died, despite all efforts to the contrary nor can I imagine having a job that someone's life depends on how I do that job.

Please try a little more understanding and patience. Hospitals are miserable necessities and not 5-star hotels as some patients seem to think by the way they treat the nursing staff when they are there. They cannot leave just because their shift ended at 6:00 or whatever. If they are in the middle of some patient's care, they can't just say, "Sorry, my day is done.", but continue that care until it is finished. Sometimes a new patient is admitted 45 minutes prior to their shift end and they have to stay until everything is set up with that patient. There is much work behind the scenes that many people never know about.
I personally think that nurses are underpaid Angels.
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  #44  
Old 02-05-2015, 04:25 PM
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I went through the same mess at U F Health, a research facility. It was an act of God to get out of there. I would have walked out but my wife said that if anything happened my insurance would not cover it. The bandits have you at their mercy!!!
  #45  
Old 02-06-2015, 10:15 AM
Warren Kiefer Warren Kiefer is offline
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Quote:
Originally Posted by graciegirl View Post
I am bumping this again and hoping the OP will read it and respond.
While this is a very educated and sane response, my original point is not exactly addressed. My point was simple, why should a patient have to sometimes wait up to eight hours for a hospital doctor to sign release papers. This hospital doctor being someone who has never provided a second of the patients care. And this being after the patient's primary doctor has already signed release papers.
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