Chapter 13
Admitting, Transferring, and Discharging
GOALS
- Assist residents during admissions with courtesy, accuracy, and warmth.
- Support safe, well‑communicated transfers within and between units.
- Provide dignified discharges to hospital or home, safeguarding belongings and documentation.
- Measure and record weight & height accurately at baseline and follow‑up.
Scenario — Kathy’s Reflection. Early in her career, Kathy rushed through Mrs. McDay’s admission and learned that unhurried attention prevents fear and tears. Discharges bring mixed feelings—joy for recovery and sadness at goodbye.
Admitting a Resident
Admission is a pivotal, emotional moment. First impressions shape trust and cooperation. Prepare the room, gather needed supplies, and welcome the resident by name. Introduce yourself/role, explain routines, and provide privacy.
Admission Checklist
- Verify identity; apply/replace ID band as per facility policy.
- Obtain baseline vitals; measure weight & height; check pain and immediate needs.
- Admission interview: allergies, habits, aids (glasses, dentures, hearing aids), preferred name, routines.
- Orient to call light, bathroom, dining, visiting hours; introduce roommates and staff.
- Ensure comfort (water, blankets, positioning) and safety (bed low, brakes locked, rails per order).
Looking After Possessions
Safeguarding belongings maintains dignity and prevents loss.
- Use a belongings inventory; describe items (e.g., “yellow metal ring with clear stone”) without assigning cash value.
- Encourage sending valuables home; otherwise, secure in facility safe as per policy.
- Label clothing discreetly; set up storage so essentials are within reach.
- Document and report any discrepancies; keep family informed.
Measuring & Recording Weight and Height
- Zero the scale first; use the same scale/time of day; minimal clothing/shoes off for consistency.
- Select equipment: balance beam, wheelchair scale, or lift scale as appropriate.
- Record promptly in chart/care plan; report significant changes.
Helping a Resident Feel at Home
Kindness and inclusion reduce anxiety and foster rapport.
- Smile; address by preferred name; include resident in care conversations.
- Respect family interactions; answer common questions about routines, meals, laundry, and visitors.
- Invite personalization of space (photos, blankets) within safety guidelines.
Transferring a Resident
Transfers—between rooms, units, or facilities—require planning and communication.
Transfer Steps
- Explain reason and destination; allow time for questions and goodbyes.
- Gather records, meds list, equipment, and labeled belongings.
- Report to receiving staff; introduce resident; ensure comfort and safety on arrival.
- Document time, condition, and items sent; report observations to supervising nurse.
Discharging a Resident
To a Hospital
- Prepare appropriate clothing and personal items (robe, slippers, toiletry kit).
- Ensure documents accompany resident; stay until transfer to ambulance staff is complete.
- Secure remaining belongings; clean and ready the room.
To Home
- Check belongings against inventory; assist with packing and wheelchair transport to exit.
- Provide courteous farewell; reinforce follow‑up instructions as directed by nurse.
- Clean room for next resident; finalize documentation.
End of Chapter 13 — Admitting, Transferring, and Discharging