Admitting or Discharging a Patient

maryloufu · Apr 1, 2008

The admission process is different for different patients. Some patients are direct admit- and you have to start an IV on them and do all of the paperwork. The history and medication reconciliation take some time.(Especially if they have a story for every ailment and only know that they take a pink pill in the morning and a green and white pill with lunch.... etc)

When you discharge you have followup appointments to make, you have to make sure that all new meds have prescriptions, you have to make sure the doc addresses home meds.

Usually when you discharge you have an admit- so it is a lot of work.

SCnurse2be2008 · Apr 1, 2008

I think that discharges are way more easier to do rather than new admits...although if your sending a nursing home patient back that could take some time. On the floor I am fixing to start on they try to have a nurse be the admitting nurse who does all the paperwork so the nurse only has to assess them and maybe start the IV. There are too many papers to admit someone, in my opinion at my facility. Admitting a patient just adds a little bit more to all the work you are struggling to complete as it is. On busy floors you will see a patient be d/c then 5 minutes later here comes one to be admitted so you never get a break. Hope this helps!

NeosynephRN · Apr 1, 2008

In my area (ICU) admissions are much more time consuming...I mean 9 times out of ten they are going down the tubes...many doctors need to be called, lots of new meds and drips need to be started. Once we get them stablized we have 3 pages of standard ICU orders to implement, not to mention how many the docs have written. Then we still have to help the family understand what has, and is going to be happening.

We rarely discharge, but we do transfer and that is much easier, obviously they are healthier...or about to die (hospice) So there is not that urgent rush...and there are alot less orders to deal with. But those transfers open my bed up, for a new and hopefully challenging patient.

jessiern, BSN, RN · Apr 1, 2008

I have had some time consuming discharges, for example when the patient is going home with home health/special equipment, or when they have a fair amount of education that needs to be done (and no one else has bothered to start it for the week they have been inpatient). As a general rule, admission are more time consuming, and usually the patient are sick and don't want to be bother with 50 questoins that they just answer in ER or their Doctors office. When I started, I would take hours to do an admit because I was always having to go back to the room for something I forgot to ask. But now, I usually can do it in about 30-45 minutes if they don't have too many problems. Some d/c can be as quick as you can get the IV out and let them sign a paper. Admitting a patient basically you are just getting their past med. history, what's wrong with them now, a base line assessment, and pt teaching about diagnosis.

imanedrn · Apr 1, 2008

I would like to know which one is harder for the nurse to do. Is it admitting or discharging a patient.
I have noticed that, my nurses complain a lot about the number of admissions they have had for one day.
What are the procedures nurses do during an admission or a discharge?
And how long does an admission or a discharge takes for one patient?
Please, enlighten me by giving specific procedures you do.
I am a nursing student and nurse asistant. Your reponses will help me grow in my learning to become a nurse.

Admissions are VERY time consuming. We have to do intake vitals (no biggie), assessment (like any physical assessment, just much more thorough), and history (which the ER usually does but doesn't input in the computer, so I have to input everything they've already typed up in their report. It's not horrible, but it's time consuming.

Discharges are easy peasy. I fill out the discharge form (short and sweet) and add and special information based on the doc's d/c orders. If there are new RXs, I print out med info for the patient. If they have a specific disease process with which they're unfamiliar, I print out info for that. I present all that to the patient (which takes 5 or 10 minutes, depending on how much information I'm presenting and how many questions they have). I chart the d/c teaching. I close their record & d/c them in the computer. I (or the CNA) escort the patient out, and that's it!