Discharge Patient Discharge Paper

TRANSITION OF CARE: EVERYONE’S RESPONSIBILITY Describe the patients medical/clinical condition. This past December I observed the discharge of a patient from the Emergency Department that never should have taken place. The patient was a senior citizen who suffered a fall injury, and was diagnosed with bilateral humerus fractures. Her injuries did not require immediate surgical intervention and her pain was relatively well controlled. Therefore, the physician caring for her did not find it medically necessary to admit her. Unfortunately, the decision to discharge then resulted in a total lack of transitional care planning. Describe the patient's socioeconomic status e.g. financial status, living situation. The patient lacked a warm winter jacket, her clothing was in poor condition and she had a disheveled appearance. She was medically insured by Medicare, and I believe she received assistance for housing and expenses, as she was disabled and therefore did not work. Describe any confounding patient characteristics e.g. literacy level, mobility, sensory, cognition, emotional, polypharmacy that might potentially impact self-care or adherence to planned course of treatment. Due to the shoulder immobilizers that were applied bilaterally, the patient’s mobility
Although I did notify the charge nurse of this potentially dangerous discharge, my concerns were diminished and disregarded. I was then dishearteningly told “we can’t keep everyone here”. Despite the emergency department forwarding the documentation from each visit to patients’ primary care providers, it remains up to patients to obtain follow up care. I believe if discharge was deemed absolutely necessary the patient should have been connected with a care manager, to ensure she received occupational therapy, physical therapy as well as in home