The drivers of self-discharge

Richard Saitz suggests that intravenous drug use, dates of distribution of welfare cheques and other factors may be reasons for patients wanting to be discharged from hospital against doctors' orders.1

But has Saitz ever been a patient on an acute care surgical ward? I was admitted to hospital for removal of my gallbladder, which led to an 8-day stay because full open surgery and insertion of a Jackson-Pratt drain were required. Besides the abominable food and resultant hunger and acid reflux, the constant noise (beeping IV pumps and ringing telephones) prevented sleep, day or night. The nurses were fantastic but should have been issued roller skates. Around 4 am there was generally a lull and I was able to doze off, only to be awakened by someone pushing the door open to see if I was OK. Getting back to sleep was almost impossible. Add to all this the patient down the hall who was smoking in his room (I am allergic to smoke), and you can understand why I announced on day 8 that if the doctor did not sign my discharge, I intended to discharge myself.

Anne Sutton Brown Montréal, Que.