Five Skills a Nursing Discharge Manager Needs

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Years ago, when patients’ hospital stays were extensive, a nursing discharge manager simply met with patients to make sure they knew how to take their medications, and then made follow-up appointments with their doctors. Patients are now discharged after only a minimal hospital stay, which means the discharge manager plays a larger role.

Shorter stays for hospital patients mean they need more follow-up services and more attention paid to their home care. As a result, the duties of a discharge manager have become more complex and comprehensive to optimize the chances for a positive outcome.

A nursing discharge manager needs skills in fact-finding, strategy, diplomacy, awareness of resources and communication.

Duties of a discharge nurse

1. Ability to assimilate relevant information

Discharge planning begins with admission screening. A discharge manager must be able to analyze and assimilate relevant information to obtain facts necessary for proper screening of the patient at admission. The screening needs to be done with a view toward services that may be needed at discharge. The screening includes a review of basic information such as:

  • The age of the patient.
  • Living conditions.
    • Does the patient live alone?
    • In a nursing home?
    • With relatives?
    • Is the patient homeless?
    • Is the patient under the care of hospice?
  • Reason for the hospital admission.
    • Is it for a simple surgical procedure?
    • A medical emergency or crisis?
    • Is the patient a crime victim?
  • Any other relevant information.

2. Assessment skills

A comprehensive assessment is required, which builds on the admission screening. This involves a patient interview and review of past medical records, as well as those applicable to the current hospital admission.

The assessment includes evaluation of the patient’s housing needs and whether any accommodations will need to be used. For example, someone who has been relegated to the use of a wheelchair but has a bedroom at the top of a flight of stairs will need more services than someone who had an appendectomy and plans to take a few days off work.

3. Diplomacy skills

Many health care providers will be involved in discharge planning, including, for example, dietitians, pharmacists, physical therapists and physicians. The discharge manager needs to be able to work with all those involved to put together a comprehensive plan that meets all the patients’ anticipated needs.

4. Awareness of available resources

Problems that have been identified need to be met with resources to solve them. The discharge nurse manager needs to be aware of what those resources are and how they are accessed. For example, a newly diagnosed diabetic patient may need general education about diabetes, as well as a meeting with a dietitian. A newly bedridden patient may need help in accessing a medical supply company for a hospital bed at home and coordination with the insurance provider for payment.

5. Communication skills

Implementing the discharge plan does not mean “telling” the patient what the plan is. It should be genuine communication based on the patient’s needs and the resources that have been found to meet those needs. For example, the diabetic patient may be resistant to diabetes education. The discharge manager needs to communicate effectively so the patient will be willing to use resources and not feel those resources are being imposed.

edited by Colin Seymour

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