Sunday, April 12, 2009

Dumbstruck Doc!

Early discharge from hospital can be problematic for the patient. These days hospital stays are shorter, sometimes due to advances in treatment but sometimes due to the risks associated with infections - the longer you are in hospital the more chance there is that you pick up some kind of infection - and hospital acquired infections are notoriously difficult to overcome.

In the past it was not unusual for children (and maybe adults too) to be readmitted within days of being discharged because they had been discharged too early and required further treatment.

This happened with Hari on more than one occasion. It was most infuriating when it happened after there was no diagnosis of the problem that had caused the admission - creating the impression that the readmission could have been avoided if more attention had been paid to her needs. But generally it was a 'virus' and she was deemed to have recovered.

On one occasion Hari was particularly unwell but the GP had just fobbed us off and insisted that there was nothing wrong with her. The following day I took her to A&E at the children's hospital and she was admitted. No diagnosis or cause was identified and within a few days she was sent home again.

The system, at that time, was for the lesser gods to complete a discharge summary form which was placed in a sealed envelope for the parent to hand deliver to the GP.

Did they really think that we didn't open the envelope and read the contents?

On this occasion they refused to give me the discharge summary - stating that it would be sent in the post. They weren't refusing to give it to me because they were worried that I would read it - but because they knew that I had every intention of leaving a 'suitable' message for the GP when I delivered it - after all - he had insisted that there was nothing wrong with her just a day before she had to be admitted!

However, within a couple of days Hari was readmitted - clearly having been discharged too early. Yet again there was no diagnosis or identified cause of the problem and eventually she was discharged again.

On the morning of the day she was being discharged I was walking along the corridor and encountered the lesser god in attendance. He stopped me and said that he would be along to the ward shortly to do the discharge summary. I was surprised that he was going to give me the discharge summary and said so. He responded by claiming that they hadn't done the summary on the previous admission as they expected Hari to be readmitted.

Now if that was the case why did they discharge her in the first place?

I wasn't fooled for a minute and quickly informed him that I knew that the real reason for the earlier lack of a discharge summary was that they had been trying to prevent me from accompanying it with a 'suitable' message for the GP.

There was no response apart from the look on his face!

Don't you just love it when you are SO right that you leave them speechless!!!!

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