A friend of mine recently had very major surgery and will require months of follow-up. Discharged after five days he came home feeling tired, unwell and unable to cope. He had concerns about pain, his wound, how much he should do and how quickly. After three days he was a nervous wreck and began phoning the hospital for support. His wife was equally anxious, bearing the burden of his worries and also her own concerns about his condition. For the first two weeks she felt she had taken on the role of the nurse.
Getting out of hospital quickly has clear gains for the patient and health services – reduced risk of infection, perhaps better sleep and food are all positives, but there is a trade off when things don’t go according to plan.
I felt my friend and his wife had probably been told everything before discharge but in the euphoria of knowing he was well enough to go home didn’t take it in.
When my friend’s wound started to leak they had to go back to the ward. When he felt very weak he was rushed back for blood tests and the burden fell on his wife to keep it all together. Not only did he feel worried each time he was called back in but it was also exhausting to travel to and from the hospital.
So I am left wondering if we send people home too quickly or whether support services are sufficiently developed to help those who do go home early to deal with problems as they arise.
The problems for so many patients are the simple things: When can I have a bath? What should I do if I feel unwell? How far should I walk?
They aren’t questions you take to the GP and I suspect many of us would not want to bother the ward by ringing up.
It seems to me that going home early is great if you feel you are getting better, but those who have major interventions need care to ensure their recovery is as free as possible from stress.
It would be great to hear about your experiences of discharging patients and how early discharge can be improved.