Your reg is about to discharge a patient but you think discharge would be detrimental. What would you do?

Your reg is about to discharge a patient but you think discharge would be detrimental. What would you do?

• A. Escalate to consultant immediately.
• B. Discuss with reg why you think the patient shouldn't go home.
• C. Tell the patient they must go home.
• D. Involve social worker.

Answer: (B)

When you’re worried that discharging a patient would be detrimental, the first and most appropriate step is to discuss your concerns with your supervising registrar and explain why you think discharge isn’t safe. This leverages senior clinical judgment, supports patient safety, and keeps you within the proper team-based approach. It also opens the door to re-evaluating the plan, considering alternatives such as continued observation, additional investigations, a different discharge arrangement, or arranging appropriate inpatient care or community support. Telling the patient they must go home bypasses clinical judgment and can risk harm, so it’s not appropriate. Involving a social worker can be helpful for discharge logistics or social factors, but it doesn’t address the immediate clinical risk on its own. Escalating to a consultant right away may be needed in urgent situations, but the usual path is to raise concerns with the registrar first to trigger the appropriate escalation and ensure a safe, well-considered plan.

When you’re worried that discharging a patient would be detrimental, the first and most appropriate step is to discuss your concerns with your supervising registrar and explain why you think discharge isn’t safe. This leverages senior clinical judgment, supports patient safety, and keeps you within the proper team-based approach. It also opens the door to re-evaluating the plan, considering alternatives such as continued observation, additional investigations, a different discharge arrangement, or arranging appropriate inpatient care or community support.

Telling the patient they must go home bypasses clinical judgment and can risk harm, so it’s not appropriate. Involving a social worker can be helpful for discharge logistics or social factors, but it doesn’t address the immediate clinical risk on its own. Escalating to a consultant right away may be needed in urgent situations, but the usual path is to raise concerns with the registrar first to trigger the appropriate escalation and ensure a safe, well-considered plan.