Discharge

[tknrn]

Hello,

I was wondering if anyone has a policy on discharging patients from the ED. A PA that was employed at our hospital had wirtten as policy that all patients were to be taken to and discharged from the ED via WC. Our CEO is now concerned because this policy is not being followed. It seems to be a little restrictive to me. ANy help would be appreciated. Thanks.

[JStyles1]

If the person has not received medications that will affect gait (ie: narcotics, bp meds, etc), and there is not contraindication to being ambulatory then I don't see a reason why someone could not walk out of the ED on their own. I mean after all, as nurses aren't we supposed to promote independence? :)

[lpnflorida]

We have the same thing, until escorted to their vehicles I think liability can still be the hospitals. We escort all patients to their cars. We have had a few people hit by cars in the parking lots, so we do not assume our parking lots are safe.

[Katnip, RN]

As long as that policy is in place you'd better be following it. It will take only one discharged patient to slip in the lobby and hurt himself to get the discharging nurse into serious trouble.

Push for policy change, but until then, follow what's there.

[rjflyn, ASN, RN]

Never worked a a place with such a policy. But what do you do when there are NO wheel chairs? Now a lot of places have policies that inpatients get discharged per wheel chair.

As far as not following the policy, it just like any other, you risk liability if anything happens if you don't. For example if you discharge someone without one because there are no wheelchairs and they fall. Well thats not excuse, you should have waited for one.

As someone stated dont like it change the policy.

[RedSox33RN]

I would not like having such a policy, but would follow it if we did. It does seem very time consuming to have to escort ALL pt's to their car (and what if they are waiting for the bus? Do you have to wait with them until the bus comes??). I know our facility just does not have enough RN's or tech's to do that. I am one to use a w/c for all pt's that have had narcotics or are a fall risk of any sort, but to use a w/c for a pt that came in for a small lac repair or got an RX for a sore throat seems like a waste of time and resources.

[argos]

A patient has the right to refuse a wheelchair to the exit and any other treatment. I would try to comply with policy but if the patient wants to walk out they have that right. Some people see leaving in a wheelchair as a loss of dignity and all patients have a right to be treated with dignity.

[Larry77, RN]

I think we have that same policy for the floors but not the ED. I've never heard of an ED requiring a w/c for DC...all we need is more work...sheesh.

[lpnflorida]

A patient has the right to refuse a wheelchair to the exit and any other treatment. I would try to comply with policy but if the patient wants to walk out they have that right. Some people see leaving in a wheelchair as a loss of dignity and all patients have a right to be treated with dignity.

"

You are absolutely correct patient have the right to refuse a wheelchair. I solve it by saying okay you can walk, I will walk with you and then wheelchair will be here just in case it is needed or you change your mind."

To me it is then a win/win.