How to get out of hospital alive

What's Hot
jackiojackio Frets: 70
I used to work in this area as a doctor with experience in health care improvement. "The most under-used resource in the NHS is patients". Be armed with the information you should have. I know it, so should you.

Insist (insist, as Drs we can predict a lot about the duration of an acute illness but a few of us are...hmmm.....maybe arrogant??) you get the answers to the 4  questions below. If you don't, demand (really) to speak to the ward manager (nurse), the matron (nurse), the head of service (often a Dr), the clinical director (often a Dr), the chief nurse, the medical director, the chief executive in sequence. Don't be in hospital if you could be safely recovering at home.

The terms of the dedicated human-beings above the ward teams are usually 'bronze', 'silver' and 'gold' in command. They will all want the hospital to work but the invisibility of problems is real. So make them visible.

4 questions every patient/relative/carer needs to ask every day:

1) What is wrong with me and what are you doing about it?
2) What is happening to me today and why can't I go home now?
3) What do I need to be able to do/what do my tests need to show for me to go home?
4) On what day and at what time am I going home?

Write the 4 qns above down (along with every medication you are prescribed including ones you don't take because they make you ill and how they make you ill so you don't get prescribed them in hospital and get predictably ill) and tell everyone you know the 4 qns above and to write down their meds.

The NHS is good, but has massive variation in how clinical teams work. Take your own care of these inefficiencies and insist you are told the answer to the 4 ins above every day and that they are written down for you. There are many hospitals (no-where near enough) where there are cards by each bed for each human, filled in daily, answering the 4 questions.

If you, your neighbours, your relatives, your friends can go home at 5pm vs 9am the next day, at 11am instead of 4pm, at 10.45am instead of 12.30pm, the NHS will cope better and people will live who might otherwise have been harmed by waiting.

Write the 4 qns down. Share them. Safe discharge is set on admission.
2reaction image LOL 2reaction image Wow! 8reaction image Wisdom · Share on Facebook Share on Twitter

Comments

  • TeetonetalTeetonetal Frets: 5638
    Every time I see a thread on issues with the NHS I'm so glad I live in a country with a proper healthcare system, that functions, is well funded and is not abused.

    2reaction image LOL 0reaction image Wow! 0reaction image Wisdom · Share on Facebook Share on Twitter
  • Moe_ZambeekMoe_Zambeek Frets: 2192
    Every time I see a thread on issues with the NHS I'm so glad I live in a country with a proper healthcare system, that functions, is well funded and is not abused.

    And where you can talk about problems and how to resolve them without it becoming a proxy war for political ideologies.
    3reaction image LOL 1reaction image Wow! 2reaction image Wisdom · Share on Facebook Share on Twitter
  • quarkyquarky Frets: 2046
    Saving to Onenote!
    0reaction image LOL 0reaction image Wow! 1reaction image Wisdom · Share on Facebook Share on Twitter
  • CarpeDiemCarpeDiem Frets: 103
    Very helpful advice - thanks.
    0reaction image LOL 0reaction image Wow! 0reaction image Wisdom · Share on Facebook Share on Twitter
  • boogiemanboogieman Frets: 4849
    As much as I read about problems and failings within the NHS I can only comment on what has happened this week. It’s just personal experience and take what you want from it, I’m not claiming this is a universal experience.

     On Tuesday my mum, who’s 92, had a fall at home. She rang us and when we got there my wife, who’s an ex nurse, realised she’d probably broken something and dialled 999. The ambulance arrived within 20 minutes despite very heavy traffic. Mum was admitted straight to the HDU dept in A&E where a couple of X-rays showed she badly broken her hip. Overnight they found a bed for her and she was moved to a ward. Yesterday she had a half hip replacement. 

    The treatment my mum has received has been generally very good. Certainly she got prompt attention on the day and has been treated well by all the staff, both physically and emotionally. The departments were obviously all extremely busy but they seem to be coping and nobody looked to be cutting corners (as far as my wife could see; I’ll take her word for it as she’s the ex professional).

    I’m sure there are people with horror stories about how the NHS has failed them or their relatives. My own uncle died years back in hospital, indirectly caused by conditions of neglect that could have been avoided. Watching Newsnight yesterday, it’s plain to see that the NHS is under huge pressure, especially in A&E, and there’s a crisis in both funding for beds and staffing levels, which will only get worse unless something is done soon. As far as I’m concerned though, god bless the NHS. They’ve done a great job for my mum. 
    0reaction image LOL 1reaction image Wow! 5reaction image Wisdom · Share on Facebook Share on Twitter
  • NeillNeill Frets: 372
    edited January 12
    A few years ago I experienced the most miserable 24 hours of my life - I'm not exaggerating - going through the A&E admissions process at our local hospital.  It taught me a lesson. 

    Because our nearest hospital is 50 miles away my wife couldn't come with me in the ambulance.  We run a business which involves someone being at home most of the time so I assured her I would be ok until the following day.  Fortunately my sister lives nearby and she was able to accompany me through the initial admission process which was ok, but once I was placed on the acute admissions ward and my sister left, things fell apart.  I ended up being treated for dehydration as a direct result of not being given drinking water that night.  And, despite telling two nurses who both wrote it down, that paracetamol makes me violently ill, they tried to give me that very medication.  Fortunately I was compos mentis enough to realise they had prescribed the wrong pain killer but that just meant they didn't give me anything at all.  (On admission I had been given morphine so you can guess I was in quite a bit of pain)  As regards the water, when I managed to attract the attention of one of the nurses I got "can't you see we're busy" in response.   

    Don't get me wrong, I'm very sympathetic to all the problems our health care professionals are up against these days. And just for good measure, if the NHS doesn't get that massive injection of cash that we were promised by the Brexit lobby, I think we're going to see scenes in this country we haven't witnessed since the poll tax riots.  But the reality is, a patient these days needs to be assertive or needs someone to assert on their behalf.  Placing yourself at the mercy of the system could literally be placing your life at risk.     
    0reaction image LOL 1reaction image Wow! 0reaction image Wisdom · Share on Facebook Share on Twitter
  • FunkfingersFunkfingers Frets: 2788
    An elderly woman with a hip fracture deservedly gets priority treatment. The injury is not life-threatening in its own right but it can be the first stage of terminal decline. 

    It is the routine stuff where things get sloppy. 

    Every time I see a thread on issues with the NHS, I'm so glad I live in a country with a proper healthcare system, that functions, is well funded and is not abused.
    The NHS is forever hamstrung by the twin unrealistic expectations that it should provide the very best treatment possible for all who need it, whenever they need it and remain free at the point of delivery.
    I fear the Geeks, even when they bear GIFs.
    1reaction image LOL 0reaction image Wow! 2reaction image Wisdom · Share on Facebook Share on Twitter
  • GrunfeldGrunfeld Frets: 2560
    jackio said:

    4 questions every patient/relative/carer needs to ask every day:

    1) What is wrong with me and what are you doing about it?
    2) What is happening to me today and why can't I go home now?
    3) What do I need to be able to do/what do my tests need to show for me to go home?
    4) On what day and at what time am I going home?

    Definitely. 
    It's been a few years since I worked wards as a physio but those are the questions which every member of the team should be asking themselves all the time (obviously substituting "my patient" for "me").
    And with a good team you actually know the answers to all of those all the time -- or at least know that you've thought about it.
    The super-point remains:  the patient should be pro-active too.  It really helps.
    You ask patients, "Why are you here?"  And omg...
    Is it learned helplessness?  I dunno.
    Good friends of mine, see them only about once a year though, their daughter was sectioned.  Lovely, lovely young woman who I've known since a kid. 
    "So, what's the plan then?"
    They didn't think there was a plan.  I was incredulous but it's not my call.

    Those are really good questions.  Really useful questions.



    0reaction image LOL 0reaction image Wow! 1reaction image Wisdom · Share on Facebook Share on Twitter
  • RolandRoland Frets: 1675
    We’ve just been through this with my ageing mother, who broke her ankle before Christmas. The medical staff were entirely competent, but planning ahead is not their strength. There are so many variables, and patients’ families are prone to come back with “... but you said ...” if anything changes. So they are schooled not to make any predictions. They have my sympathy.

    Personally I’m happy for medical staff to be good at patient care. I’m also happy to draw out from them the main scenarios, reassure them they we know these are only possibilities not firm predictions, and then contribute to their decision making.

    We went through questions 1 and 2 to discover:
    Scenario 1, operate within 24hrs, before too much swelling.
    Scenario 2, wait three days for swelling to go back down, then operate.
    In both cases they wanted to keep her in over Christmas, and possibly weeks after. We told them that she lives in a Care Home with suitable equipment and qualified staff, which satisfied question 3, and she was out within 24hours. We didn’t need to go as far as question 4.
    0reaction image LOL 0reaction image Wow! 2reaction image Wisdom · Share on Facebook Share on Twitter
  • Emp_FabEmp_Fab Frets: 12714
    Trouble is the answer to all of those questions can be “You’ll have to speak to the doctor - we’ve paged him but he’s very busy/on his rounds/missing/dead/in the sluice room with that new nurse” and you remain in bed, whilst a dozen machines are beeping alarms around you on other patients and nobody is checking why.  It’s like those plate-spinning acts you used to see.  When it’s looks like one is about to fall off, someone appears and gives it a little spin then fucks off to spin the next one.

    Theresa May and her government need booting out over this.  They don’t give a shit about the NHS.  It’s for poor people who can’t afford private healthcare.  Why should a Tory care about poor people?
    98% shouting at clouds and 2% laminate flooring
    1reaction image LOL 0reaction image Wow! 2reaction image Wisdom · Share on Facebook Share on Twitter
  • Jez6345789Jez6345789 Frets: 853
    Emp_Fab said:
    Trouble is the answer to all of those questions can be “You’ll have to speak to the doctor - we’ve paged him but he’s very busy/on his rounds/missing/dead/in the sluice room with that new nurse” and you remain in bed, whilst a dozen machines are beeping alarms around you on other patients and nobody is checking why.  It’s like those plate-spinning acts you used to see.  When it’s looks like one is about to fall off, someone appears and gives it a little spin then fucks off to spin the next one.

    Theresa May and her government need booting out over this.  They don’t give a shit about the NHS.  It’s for poor people who can’t afford private healthcare.  Why should a Tory care about poor people?
    Mrs May is the latest in a long line of hapless politicians left in charge of the NHS. It has nothing to do with all Tories have private health care or even financial interest in private health care. 

    Its simply too big to beauracratic and nobody can agree to raise more taxes to fund it.

    a good friend of mine makes fortune as an over paid efficiency consultant to a good few trusts after full time day in day out projects for the last 8 years and the best pay packet of his life even he has said you really don’t need me you just need to implement the changes I have recommended but still the work comes and in the he has taken the view now just do the work and take the money.

    some of the things he consults on even the average man in the street could make reasoned proposals for efficiency.

    Probaly until there are ugly scenes in the street nobody will take direct responsibility away from ministers who all get a few years of tinkering and moved once they fail and they all fail.
    0reaction image LOL 0reaction image Wow! 3reaction image Wisdom · Share on Facebook Share on Twitter
  • TeetonetalTeetonetal Frets: 5638
    Every time I see a thread on issues with the NHS I'm so glad I live in a country with a proper healthcare system, that functions, is well funded and is not abused.

    And where you can talk about problems and how to resolve them without it becoming a proxy war for political ideologies.
    I do wonder if that is fundamentally the NHS biggest problem. It's always treated as a political issue vs how can it be made the best healthcare system in the world, that any British government is proud of.

    I'm sure it needs reform and more NI contribution. People need to wake up to the fact it's not free for all, you just don't pay at point of access and they need to treat it with more respect.

    People's health is important, but I don't think politicians see it that way. 
    0reaction image LOL 0reaction image Wow! 1reaction image Wisdom · Share on Facebook Share on Twitter
  • boogiemanboogieman Frets: 4849
    Every time I see a thread on issues with the NHS I'm so glad I live in a country with a proper healthcare system, that functions, is well funded and is not abused.

    And where you can talk about problems and how to resolve them without it becoming a proxy war for political ideologies.
    I do wonder if that is fundamentally the NHS biggest problem. It's always treated as a political issue vs how can it be made the best healthcare system in the world, that any British government is proud of.

    I'm sure it needs reform and more NI contribution. People need to wake up to the fact it's not free for all, you just don't pay at point of access and they need to treat it with more respect.

    People's health is important, but I don't think politicians see it that way. 
    It needs a massive injection of money to fund better staffing levels and infrastructure and to increase and improve the current building stock. Unfortunately you are right Teetonal, the only way to do this is to raise tax levels and/or NI contributions but that’s not a vote winner so politicians are never going to make it a priority. Ask the average joe if he’d fork out an extra penny in the pound in tax to purely fund the NHS and I’m sure you’d get an agreement from most. However Theresa would much rather spend a billion quid of public money on bribing the DUP to support her skinny majority vote. Seems the majority of politicians are more interested in themselves than the actual job they were elected to perform. 
    0reaction image LOL 0reaction image Wow! 2reaction image Wisdom · Share on Facebook Share on Twitter
  • jackiojackio Frets: 70
    quarky said:
    Saving to Onenote!
    Great idea!
    0reaction image LOL 0reaction image Wow! 0reaction image Wisdom · Share on Facebook Share on Twitter
  • jackiojackio Frets: 70
    You would be shocked by the variation in how individuals and teams work in hospitals. We wouldn't be allowed to run an airline. 

    Money, maybe...but I and an increasing number of colleagues have seen 'more staff' cried too often when the question should be 'how do we standardise how we work to maximise our costly service, so that we can clearly see gaps that do need more staff'.

    The NHS is a political football. 

    Write down the 4 questions and share them, I dare you 
    0reaction image LOL 0reaction image Wow! 1reaction image Wisdom · Share on Facebook Share on Twitter
Sign In or Register to comment.