Do you do assessments after a patient is discharged?
- 0Dec 12, '12 by Nurse ABCWe do assessments at 8am and 2 pm on my shift. If someone is discharged at 9 am and you haven't gotten to the assessment yet is it necessary even if they are still there for hours? Some nurses on our unit don't bother with it reasoning that if they have a discharge order they are stable enough to go home and thus don't need one. Others say they receive everything as normal until they actually leave. What's your opinion?
- 7Dec 12, '12 by loriangel14 GuideI would still do it.If there was any question about their condition on the day they left the charting would show an assessment was done that day before they left.Just becasue they are leaving soon doesn't mean you shouldn't assess.What if there was a change in their comndition before they left?
- 0Dec 12, '12 by KelRN215, BSN, RNHow can you do an assessment after the patient is discharged? Discharged patients aren't there to assess, are they?
When I worked in the hospital, if I had a patient who I "knew" was being discharged soon, everything was still done per usual. I've seen many patients with one foot out the door who ended up staying for whatever reason. If the discharge papers are signed at 9am and the patient is still waiting for a ride when it's time for their next assessment then, no.
- 2Dec 13, '12 by melmarie23yes of course. If you know they are an early discharge, then I would priortize my assessment on them (provided the rest of my pt's are stable for the time being).
It may not get charted until AFTER they've left, but at least the assessment had been done and I am charting accurate and relevant pt status information. And as others which as other's have pointed out...that assessment could delay or cancel their d/c all together if they for example took a turn for the worse.
- 0Dec 13, '12 by chorkleOP--
Since you asked for (our) opinion, here is mine.
Your post is unclear, thus it is impossible to respond appropriately, despite the above 5 responses.
"Your" patient was discharged at 9 a.m. (your example) but is still "there . . for hours."
Was the patient discharged, or not? Or, what exactly did you mean (but not explain) by "discharged"?
- 4Dec 13, '12 by ~*Stargazer*~I think the OP means that the discharge order was written at 9am, but for whatever reason, the actual discharge process took hours to accomplish. This happens a lot, like if outpatient services are being arranged, or for obtaining transportation, or if the destination isn't prepared to receive them yet.
To answer the question, yes, I would do it. Just because the patient has a discharge order written does not mean they are discharged. They aren't discharged until they have physically left the hospital, and until that time, if you are the nurse assigned to care for them, you are still responsible for their nursing care. Also, no matter how stable they appear, there could be a change in condition between the time the order to discharge is written and the time they actually leave. Additionally, it is important to document their condition upon discharge.
When I was a CNA, I was transporting a patient who had been discharged. I had just gotten him into the wheelchair and had taken maybe three steps toward the elevator, when he slumped over and became unresponsive. Needless to say, he was not discharged.
- 0Dec 13, '12 by ~PedsRN~We assess at the start of our shift and then PRN (of course) - if a patient already has discharge orders written, I will do a quick assessment prior to their discharge. If they have been discharged and are waiting on a prescription/ride/etc, then no - I do not perform an assessment. They are on their way out the door!
- 1Dec 13, '12 by NurseOnAMotorcycleThis happens a lot where I work. The patient has their discharge papers and is dressed to go, but they don't have a ride home until 1600. So they sit around until their ride comes.
I don't usually document reassessments after they have been officially discharged, but I do check on them and see if they need snacks, etc while they are waiting. The elderly are especially checked on. I will still turn/position right up until they go.