Transfers and discharges are easier if a co-worker helps you. So is moving the person to a new room. When asking for help, politely tell your co-worker:

• The procedure you need help with

• When you plan to do the procedure

• What you need the person to do

• How much time it will take

Remember to thank the person for helping you.

See Delegation Guidelines: Admissions, Transfers, and Discharges.

DELEGATION GUIDELINES

Admissions, Transfers, and Discharges

When admitting, transferring, or discharging a person, you need this information from the nurse. You also need the same information when moving a person to a new room.

• If you need to admit, transfer, or discharge the person or move the person to a new room

• If moving to a new room, the person’s new room and bed number

• The person’s method of transportation to or from the center—car, ambulance, or wheelchair van

• How the person will move about within the center—walking, wheelchair, stretcher, or bed

• The person’s room and bed number

• What equipment and supplies are needed

• If the person stays dressed or needs to wear a gown or sleepwear

• If the person stays in bed or can be in a chair

• When to report observations

• What specific resident concerns to report at once

See Promoting Safety and Comfort: Admissions, Transfers, and Discharges.

PROMOTING SAFETY AND COMFORT

Admissions, Transfers, and Discharges

Safety

The person may develop pain or become distressed during admission, transfer, discharge, or when moving to a new room. If so, call for the nurse at once. Stay with the person. When the nurse arrives, assist as needed.

Comfort

Admission, transfer, or discharge may be stressful for the person. So may moving to a new room. Some persons are happy. Others are sad and fearful. Some anxiety is normal. To provide for the person’s mental comfort:

• Explain what you are doing and why.

• Do not rush the person.

• Be sensitive to the person’s needs and feelings.

Admissions

An admission coordinator starts the process. The goal is to make it simple and easy. Often the process starts 2 or 3 days before the person enters the center.

The person’s identifying information is obtained. This includes the person’s:

A nurse or social worker explains the resident’s rights to the person and family. They also receive the rights in writing.

Admitting papers and a consent for treatment are signed. The person signs them or the person’s legal representative does so. The nurse or admission coordinator obtains needed signatures.

The person’s photo is taken. Then the person may receive an ID (identification) bracelet. The photo or ID bracelet are used to identify the person (Chapter 12).

Admission is often a hard time for the person and family. They do not part until ready to do so. Remember, the center is now the person’s home.

See Residents With Dementia: Admissions.

RESIDENTS WITH DEMENTIA

Admissions

Persons with dementia and their families may need extra help during the admission process. Often confusion increases in a new setting. Fear, agitation, and wanting to leave are common. The family also is fearful. Many feel guilty about the need for nursing center care. The health team helps the person and family feel safe and welcome.

See Focus on Rehabilitation: Admissions.

FOCUS ON REHABILITATION

Admissions

Patients are admitted to rehabilitation units from hospitals. Often they arrive with special equipment and supplies.

A nurse usually greets the person and starts the admission process. Assist as needed. The nurse may ask you to complete parts of the admission process if:

• The person’s condition is stable

• The person has no serious discomfort or distress

Preparing the room

You prepare the room before the person arrives. Figure 34-1 shows a room ready for a new resident.

Fig. 34-1 The room is ready for a new resident.

PREPARING THE PERSON’S ROOM

Procedure

1 Follow Delegation Guidelines: Admissions, Transfers, and Discharges

2 Practice hand hygiene.

3 Collect the following:

• Admission kit—wash basin, soap, toothpaste, toothbrush, water pitcher and cup, and so on

• Bedpan and urinal (for a man)

• Admission form (Fig. 34-2, pp. 524-525)

• Thermometer

• Sphygmomanometer

• Stethoscope

• Gown or pajamas (if needed)

• Towels and washcloth

• IV (intravenous) pole (if needed)

• Other items requested by the nurse

4 Place the following on the overbed table:

5 Place the water pitcher and cup on the bedside stand or overbed table.

6 Place the following in the bedside stand:

• Admission kit

• Bedpan and urinal

• Gown or pajamas

• Towels and washcloth

7 If the person arrives by stretcher:

a Make a surgical bed (Chapter 19).

b Raise the bed to its highest level.

8 If the person is ambulatory or arrives by wheelchair:

a Leave the bed closed.

b Lower the bed to its lowest position.

9 Attach the signal light to the bed linens.

10 Decontaminate your hands.

Admitting the person

The room assignment is made before the person arrives. Some residents arrive by ambulance or wheelchair van. Attendants take them to their rooms. Some arrive by car. A nurse usually greets and escorts the person to the room. The nurse may ask you to do so if the person has no discomfort or distress.

Admission is your first chance to make a good impression. You must:

• Greet the person by name and title. Use the admission form to find out the person’s name.

• Introduce yourself by name and title to the person, family, and friends (Fig. 34-3).

• Make roommate introductions.

• Act in a professional manner.

• Treat the person with dignity and respect.

Safety and security

Physical and mental comfort are important. So is feeling safe and secure. Do not rush the admission procedures. Rather, treat the person and family as guests in your home. Offer them a beverage. Visit with them. Tell them some of the good things about the center.

Introduce residents in nearby rooms. This way the person knows other residents. They can provide comfort and support. They understand, better than anyone else, what a nursing center is like.

The center is the person’s home. Help make the room as home-like as possible. Also help the person unpack. Perhaps the person needs help putting clothes away. The person may want to hang pictures or display photos. Show care and compassion. Help the person feel safe, comfortable, and secure.