I work on a very busy med/surg floor. Docs start making rounds at about 0730, and as the morning goes we are getting discharges and admits fairly close together. Of course, as any med/surg nurse knows, this is the busiest time of our day. We are just out of report, checking med sheets, getting blood sugars and insulins readied, passing trays, making a first round/safety checks on our pts, and getting pts off to surgery... and about a million other things, too!
Because we are so busy with things that cannot be delayed, the early discharges are left until we are caught up on the higher priority tasks. We try to tell pts that it will be a little while to get their paperwork together, (usually tell them an hour or so). It seems some of them still get upset having to wait. You can't put off insulin and early morning meds, or getting pts off to surgery. Can't put off passing trays or feeding pts. Can't put off checking on our pts, (some of which need incontinence care,etc.). Can't put off the hurting pt needing pain med, or the vomiting pt, or the ones needing assist to the BR. Can't put off the newly arriving pt needing admission vs's,weight, IV start, etc.
We have very few aides, so most of the above has to be done by the nurse. The charge nurse many times takes pts, too, so they are not able to help.
So, how is it done in your hospital? Do you have a system
that gets discharged pts out promptly? Do you ever have pts angry about having to wait to go home? What do you tell your pts that keeps them smiling, instead of scowling, waiting for their papers and a w/c?
