Post Hospital....Orders

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When a current patient is discharged home, does the hospital fax the orders to the agency ? (med changes, labs, etc)

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When my patient is discharged home, his parent receives the discharge instructions with the orders included. I transcribe those orders to physician's order (supplemental) sheets and send them to the agency. The nursing supervisor also copies the orders from the discharge instructions, when she makes her post hospitalization visit. That has been the way it was done with all of my patients, with different hospitals, different patients. I imagine, the agency and hospital could communicate directly if they chose.

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We do not always get discharge paperwork. I write all the meds down from discharge paperwork in the home. Then we tell the patient you have to see your PCP bring your list and then see if the PCP makes changes. Especially with the face to face with medicare pts they have to sign paperwork and have to see the patient within 30 days of SOC.

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I had a post hosp visit late over the weekend, no d/c instructions, she was previously on several meds. all she got at d/c was a couple of scripts (only one was filled) andpts dr not on call that eve. i called the floor the pt was on, and was told i would have to request medical records on monday. instructed fmly to go get remaining rx filled, and got pt to take take the one rx that she had available. ....later on that night i decided to call the hosp one more time and finally got someone to look it up for me and she said she would fax b4 the end of her shift . (7a.m.) . next morn i called case manager (home health) and reported everything. she said the med list was on fax and that i needed to come pick it up and do visit on pt on my own time b/c getting meds straight was part of the post hospital visit. i said i would do another visit on pt but not without a legitimate visit. i told her the patient needed to be seen whether it was me or another nurse. cm said "she gets one visit a week and she already got it, she's not getting any more." (I'm paid per visit).

pt ended up in hospital next day. i was told that it was my fault. then got fired about 30 minutes later.

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Without thinking too deeply about what you said in your post, seems to me you got scapegoated on this one. What a lousy way to treat employees. Someone was wrong here, but I am not certain it was you. No matter how many visits a week, if the patient comes home from the hospital, they are due a post hosp visit by the cm/clin supvr within a certain time frame, which I believe is 48 hours.

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:cool:
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I saw the pt for the post hosp visit after she came home that sun eve, but unfortunately it didn't do her much good b/c I had no orders other than those two scripts she came home with.

This was her 2nd hospitalization since being on home health.

I was worried so I called the state board of nursing. It was almost time for her to get off so she didn't get to the part about if I was in the wrong, she just said: the pt requires a new assessment, MD contact, further care plan development, and detailed documentation.

caliotter3, you are right. I was upset about being fired, but I don't need to work somewhere that the only thing that matters is the bottom line. I'm not anyones flunkie either.

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Good luck getting a new job. I hope your next employer is more reasonable.

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Even unreasonable sounds like something I could deal with now.

I have to turn my timesheets in monday, and I really don't want to do that.....not without a cross and some holy water.

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Even unreasonable sounds like something I could deal with now.

I have to turn my timesheets in monday, and I really don't want to do that.....not without a cross and some holy water.

Make sure you stop by the church on your way!

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In my experience...we wouldn't have done the first hospital visit without a copy of the orders.

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Kids, that would have been the logical choice, but they would have said "why didn't you do the visit?"

They are cartoon nurses.

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