Needing Advise - page 3

I am needing help with a problem at work. I had a patient that was in the hosspital for 20+ days. The MD usually comes at night (which he did) We were expecting a discharge. After he came in he... Read More

  1. by   EmmaZ06
    Soooo I'm feeling a little confused. Why was a patient who had been there 20+ days discharged at that hour? Seems like an issue between the MD and management. I doubt it wasn't a surprise that the patient was ready to go home. I am trying to look at all the possible scenarios, and I am just not finding one where there is no option but to send a patient home, who has been in the hospital for 20+ days, in the middle of the night. NO ONE on dayshift was aware that the patient was ready to go home? After 20+days did those magical 4 or 5 hours make the patient stable to go home? Even if they were waiting on test results or something the MD could have written "DC patient if ____ results are ____" then dayshift could have just called and gotten a final verbal discharge order. After 20+ days the patient should be ready from a CM standpoint so that shouldn't be an issue. You were put in a bad position, and there is no excuse for your supervisor to make you come back to the hospital on no sleep after working all night to reprimand you face to face. That goes beyond bullying, driving that far on no sleep can be deadly. You didn't hurt someone, there were no missing narcs, she is just abusing her position. If I were you I would be looking for a new job, and I understand in this economy that can be difficult, so I would at least turn my ringer off during the day.
  2. by   cmbuckley
    Though this may seem like a simple matter it is actually a complicated one and one of the reasons there is QA, PRI, D/C Planning,Case Managers, whole teams ( Social Workers, OT`S, PT`S, RN`S) involved in a patient`s care. This one fell through the cracks and naturally the primary care RN is going to be hung out to dry. It is a reason there are care plans long and short term. It is why there are consultations and why they need to be read by RN`S as they affect outcome. References should be made to these consultations in the RN`S notes especially with a patient in hospital for such a long time. I`m an ED RN and in a hospital I worked in there was a section to tick in the triage area if D/C Planning was indicated. I did this routinely with with complex cases (be it medical and social) and made a referral to our Social Worker immediately even before they were evaluated and was thanked often for foresight. Otherwise the ED was left with a patient who could not be safely disposed. Remember admitting a patient is no longer a safe dispo as you expose them to a variety of potential dangers ie: infection, falls, loss of resources such as shelter.
  3. by   Brianrn
    I held my ground. The supervisor backed off.

    The way guide speaks sounds exactly what her point of view was. (I understand the information you are attempting to relay- Appreciate it)

    However, in the same situation. I would do it again.

    and Again
  4. by   Brianrn
    In case someone is ever in my situation, what I did was I printed out the States Nursing practice information. I read to her that "A Registered Nurse is required to clarify any order- verbal or non-verbal with a physician.