For some reason, I find making decisions in terms of discharging patients one of the most daunting tasks that we are required to do. Many times have I found myself during team meetings during my gerontology and rural placements freeze and stutter when asked if the patient is ready for d/c. It is quite obvious in such meetings that physio input is very vital in the decision to discharge a patient.
There were plenty of times that I was undecided on whether the patient is ready to get discharged (from a physio perspective) or not because I could only base that decision on the outcome measures that I took and the physio sessions that the patient has had. You’ll never know if the patient decides to change their daily activities radically to the point of getting hospitalized again. I’m aware that it sounds silly but I struggled on that before. It’s very easy to feel responsible for the outcome of each patient post-discharge despite having the rest of the team make a decision for discharge. So the lesson I’ve learned is to continuously liaise with other health professionals and know the discharge destinations (e.g., home, high care, low care, etc). Personally I find liaising regularly with the OT and the social worker to be beneficial, as they usually know a lot about the patient’s ADLs and home/living situation.
1 comment:
I find it a bit daunting too. It is a difficult thing to know, and I guess our very little clinical experience makes it a lot harder! As you said, it’s really important to liaise with other members of the team. If you have an idea of the different strategies that are being implemented by other allied health workers, it would give you more of an idea if the patient could cope on return to home. I guess it’s also important to figure out why one might be reluctant in discharging a patient – is it the daunting thought of giving the green light for the patient to go, and the risk of them not being ok, or is it because there is a question in their ability. I guess if everyone’s input is received, it will develop a more holistic idea of the patients progress and potential, and hopefully take some of the stress out of the situation.
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