Disorganised discharge

Posted in: Injury Time

I was really freakin' cheesed off with my OTs. Despite having had for several days a target discharge date of Friday or Saturday, and having checked out my house for suitability on Wednesday, the OT still somehow only got around to telling me, on Friday afternoon at 14:30, they wouldn't discharge me. And that I'd have to wait until Monday or Tuesday. 14:30, that's one and a half hour's before they left for the day, and right at the end of the working week for the rest of the world who otherwise might be able to help. Which in this case consisted of delivering a suitable commode.

That's right, for the sake of a toilet I was otherwise stuck in hospital!

It was utterly absurd. They wouldn't write a safe discharge plan as they couldn't supply a commode with removable side handles. I apparently needed removable side handles in order to transfer safely from a wheelchair. Putting aside the fact for a moment that this awareness of the lack of equipment had come a full 48hrs after the house assessment, I was in a position where I either had to stay another few days in hospital or supply my own privately. So literally for the sake of a £12/week commode I potentially could've been on the taxpayer's tab for probably another £1,000. (I never quite worked out how much a NHS bed costs per day but by some detective work back-calculating from private insurance costs we came up with £200/day. Plus food, meds, etc.)

The either lack of creative solution seeking or legal hamstringing by the OTs blew my mind. Their attitude was literally as plain as "we don't have the equipment so you can't go home yet." It just stopped right there. No "we've got a goal, how can we solve this?" at all. No sense of "holy resource management , Batman, this guy is costing the NHS a royal f*ckload of cash, consuming a valuable and highly limited resource, not to mention exposing himself to a much higher possibility of infection, and sitting on his ass in hospital!" or "whoa, imagine how I would feel being told I could leave on Saturday and then f*cked around at the dying hours of the working week because I couldn't go find out whether we had a piece of equipment I knew he needed two days ago!" or "how about I get off my ass and find a list of national mobility suppliers?!?!". Nothing.

What was even more galling was that as I rattled through about half a dozen what seemed imminently viable solutions one of the OTs, a thoroughly humorless individual, actually seemed irritated I wouldn't just suck down the bad news and accept my sorry situation.

Legal nonsense

Get this. Even if I demonstrated I was capable of moving from wheelchair to fixed-handled commode, and demonstrated it to the OTs, they wouldn't release me. Even if I signed a legal disclaimer saying I would take no action in any commode-related incident they wouldn't release me. Apparently the manufacturer sells equipment under contract it not be issued in cases where it can't be used. Who ultimately deems that I don't actually know, suffice to say the OTs either couldn't or wouldn't see past this ludicrous bureaucracy.

As it turns out, it is trivial to transfer to a commode with its handles in place. In fact, it's possibly the easiest transfer off the chair to anything I've had to do to date. So it was, literally, pure bureaucracy that got in the way.

So I was left with calling private firms late on Friday afternoon for a next-day delivery on a Saturday. Grrrrreat. My doctor at least helpfully provided one number, but the company couldn't deliver 'til Monday. Thanks to having a wireless hospital internet connection I could at least find other mobility hire places. With great fortune, I pulled myself out of this pickle by finding a place that would deliver on Saturday. So for £112.00 I had myself a commode and wheelchair (you have to supply the latter yourself, or wait for social services) and could get a medically approved discharge plan for a Saturday leave... yay!

I'm tempted to call these folks dumbasses but I really don't know - whether it was laziness, incompetence, uncreativity or genuine legal issues, the bottom line is their action is costing the state, i.e. the taxpayer, money. In pure accountancy terms, I bailed the state out by paying my way privately and expending a fair amount of effort in doing so. It's just that simple. If I'd chosen to take their way I'd be sitting in hospital for at minimum four more days. Crazy.

Anyway, good news is I'm outta here Saturday!

Posted by Paul Makepeace at June 10, 2005 22:00 | TrackBack