Admission/Discharge nurse

Thunderwolf, MSN, RN · Oct 8, 2005

We typically utilize an admit nurse...being available at least two shifts at our hospital. Believe me, the admits alone keep the admit nurse very busy...take a number sort of scenario. I value the admit nurse greatly...almost to the point of worship. However, the admit nurse here is not used for discharges. Honestly, due to the complex patient issues (case management) that often need addressed in order for discharge to happen, a discharge nurse other than the nurse at the bedside really doesn't seem too feasible...at least, not where I work.

meownsmile, BSN, RN · Oct 8, 2005

We dont utilize adm/discharg nurses. Each Rn has a team, we do our own admits, discahrges and surgical admits from PACU.

barefootlady, ADN, RN · Oct 9, 2005

I love a good admit/discharge nurse. It can keep the floor running so much smoother, but she has to have good follow through, like putting the plan of care in the computer, putting the initial assessment in the computer, and giving the staff nurse who will have the patient a report. Otherwise, she may make more problems. Same for the discharge nurse, she needs to make the appointments, teach wound care and dressing needs, give med and activity instructions, diet instructions and then chart all of her actions. Believe me, it can be very difficult to write discharge notes on patients when you have no idea what was done. I always refer them back to the discharging nurse, but it is still your license and you need to know somethings about that patient.

pk1 · Oct 9, 2005

We dont utilize adm/discharg nurses. Each Rn has a team, we do our own admits, discahrges and surgical admits from PACU.

Tell me about your team. Who and how many, does it consist of? How many patients does your team care for? And who is responsibable for what?

pk1 · Oct 9, 2005

We typically utilize an admit nurse...being available at least two shifts at our hospital. Believe me, the admits alone keep the admit nurse very busy...take a number sort of scenario. I value the admit nurse greatly...almost to the point of worship. However, the admit nurse here is not used for discharges. Honestly, due to the complex patient issues (case management) that often need addressed in order for discharge to happen, a discharge nurse other than the nurse at the bedside really doesn't seem too feasible...at least, not where I work.

What two shifts is there an admission nurse present? What are their duties exactly? Is there a written job description for them? Do they recieve, complete interview, discharge planning, care paln, initiate orders?

pk1 · Oct 9, 2005

I love a good admit/discharge nurse. It can keep the floor running so much smoother, but she has to have good follow through, like putting the plan of care in the computer, putting the initial assessment in the computer, and giving the staff nurse who will have the patient a report. Otherwise, she may make more problems. Same for the discharge nurse, she needs to make the appointments, teach wound care and dressing needs, give med and activity instructions, diet instructions and then chart all of her actions. Believe me, it can be very difficult to write discharge notes on patients when you have no idea what was done. I always refer them back to the discharging nurse, but it is still your license and you need to know somethings about that patient.

Good point! Our Charge nurse picks up the slack and helps as much as she can with the admits and discharges, but its working her to death. Plus, there are too many people doing parts, easy to miss something!

Thunderwolf, MSN, RN · Oct 10, 2005

Barefootlady describes very well what our admit nurse does. I'm sure they have a job description, but I'm personally not aware of it. Typically they are present during 2nd and 3rd shift, due to high admit rates on 2nd and less staff on 3rd. I would find being a discharge nurse very intimidating due to walking in cold, hoping everyone did their pieces and parts regarding discharge. I would think it would have a great potential for people falling through the cracks. Unless, and I say unless, everything is computer generated and all parties have entered all relevant discharge directions into the data base, where the discharge nurse only has to print out and review with patient. THEN, maybe I could see a discharge nurse being used effectively...but, no, not without this condition. Too many pieces and parts from Docs, PT/OT/ST, case management, nutrition, medications, condition education and ongoing treatment that the patient needs to be instructed on. :eek:

RN-PA, RN · Oct 10, 2005

We have admission nurses and I agree with what Thunderwolf said, " I value the admit nurse greatly...almost to the point of worship." Our unit clerk kids me that I have the admission nurse on speed-dial, so I can contact her the minute I hear I'm getting an admission. I believe there are two for the whole hospital, but I don't know if they are on at the same time. They work 8 and 12-hour shifts and begin around noon, but again, not sure (I work 3-11 when many admissions are finally ready for the floors). I know they're available up to around 2330.

They only do the admission basics since they stay pretty busy and in-demand. They do all the computer documentation of historical and clinical data and choose/enter an appropriate care plan, but it's up to us to personalize the care plan. They only do assessments if the nurse getting the admission is an LPN, and if the admission nurse is too busy, the RN covering the LPN must do the initial assessment. They originally were helping by checking orders and even taking them off, but not anymore. Also, they only work Monday-Friday, so we do our own admissions on the weekends. We also always do our own discharges since we know the patients best, and discharges are rarely, if ever as time-consuming as admissions.

I ~~~LOVE~~~ our admission nurses! :redpinkhe :loveya: :icon_hug:

ljds · Nov 7, 2005

Our floor has an admit nurse, who works from 11a to 7p Monday thru Friday (the rest of us work 7a to 7p). I work night shift, so this doesn't really affect me, but when I oriented on days, it seemed VERY helpful and very appreciated.

We do not have a discharge nurse, but our pharmacy has a pharmacist for each floor, and the floor's pharmacist is responsible for educating the pt on their meds. So that saves the nurse a great deal of time.

pk1 · Nov 9, 2005

I like the sound of a pharmacist on the floor. How many beds do you have on your unit?

ljds · Nov 9, 2005

We have around 40 beds on our floor (semi private rooms) but our census is usually 25-30. The pharmacist for our floor is also responsible for ICU and step down, which has 10 beds total (I think).

For such a small hospital, I'm impressed with the services we offer. No only do we have a pharmacist on each floor, but we also have a social worker for each floor, to help set up home care and resources, and to get advance directives for each pt. It's pretty cool.

I think the hospital has a total of 200 beds, all and all.

Lori