If she was just released from an inpatient psych facility she has enough on her plate and needs to focus on getting her life back on track, not on getting a new boyfriend. As with transfers to another outpatient provider, the facility should be given all the information they need to provide appropriate clinical care to the patient. Whatever the reason, there is a generally accepted process for ending the treatment relationship in a manner designed to protect the interests and well being of both the patient and the psychiatrist. Improving the System As we have mentioned throughout this Fact Sheet, discharge planning is an inconsistent process that varies from hospital to hospital. While information is probably communicated in a much higher percentage of cases, Dr. Other reported problems included readmission and return to the Emergency Department 10 , problems with medications 8 , not-prepared for discharge 8 , and hospital complications or questions 4.
The risk management considerations are similar in both cases and revolve around communicating. There are two common types of transfers of care when outpatient psychiatrists are treating a patient: to another outpatient psychiatrist and to a facility. Feelings of empowerment were reported by 31% of patients. You may have physical, financial, or other limitations that affect your caregiving capabilities. The bottom line is that psychiatrists must exercise their professional judgment when ending the treatment relationship.
We have not gotten any services. This generic notice would specify the date of discharge and explain the procedure for the patient to obtain an expedited review of the medical necessity for continued inpatient care. Descriptive statistics were used to tabulate the frequency and percentage that patients reported a post-discharge problem. However, once the patient leaves the hospital and ceases to be a patient, the situation is different. The discharge planner should be familiar with these community supports, but if not, your local senior center or a private case manager might be helpful. He also reported the therapist to his boss.
In addition to every article from the print issues, our website offers interactive features including blogs written by hospitalists, surveys asking hospitalists for their opinions on important issues, and the most comprehensive recruitment software listing jobs for hospitalists. Our low response rate highlights the challenge of doing this type of work with recently discharge patients in low income, underserved areas. Likewise, telephone calls from knowledgeable professionals to patients and caregivers within two days after discharge help anticipate problems and improve care at home. © 2009 Family Caregiver Alliance. Also include a note specifying who your are exactly so she isn't wondering who this guy is.
It was her way of preventing further fighting and cooling off. What do all three cases have in common, besides being real-world problems that occurred at an academic medical center? Published questions are edited and may be shortened. Will I get in trouble if I visit him if he is no longer my patient? Think about what is best for her. Patients, family caregivers, and healthcare providers all play roles in maintaining a patient ʼs health after discharge. So exactly where should nurses draw the line about becoming involved with their patients? Because nurses have lost their licenses for less than that. If you saw her every Wednesday, then take a chance and go on Wednesday. You might simply be given a list of facilities, and asked to choose one.
The experiences of these patients may be unique to this site. And the few studies that do exist show that technology creates its own types of errors. Providing appropriate clinical care is always the most important goal, and if the psychiatrist determines he or she cannot provide that in his or her practice setting, he or she should notify the patient and the facility that he or she will not be available to the patient on discharge. You have a choice between hiring an individual directly or going through a home care or home health care agency. Married couples get into altercations of a verbal nature all the time. The patient said I was abandoning him—is he right? Such confusion, they say, could put both patients and nurses at risk.
But many still think that e-mail has too many security issues to be reliable for sensitive patient information. I agree with RescueNinja on this one. First you were part of her healthcare team, second it was a psych facility so she is part of a vulnerable population which makes it even worse. A patient, who will remain on your ward for at least a few weeks following a road accident, asks you if you will go on a date with them after they are discharged. Tell her you would enjoy getting to know her and if she feels the same, to please give you a call and give her your number. Similarly, since data were collected through interviews and adverse events were discussed, these results are subject to recall bias.
Even without impaired memory, older people often have hearing or vision problems or are disoriented when they are in the hospital, so that these conversations are difficult to comprehend. What I consider horrible advice, is acting like you're a know it all, and telling other posters they are wrong for providing different viewpoints. One potentially promising service would allow hospitalists to autosearch any primary care physician in the country. Results Forty-two percent 27 of patients reported 42 different post-discharge problems. Either way, a follow-up letter should be sent to the patient explaining that the psychiatrist will no longer be providing treatment on discharge and referring the patient to the facility discharge instructions for continuing care. Introduction Recently, there has been an increased focus on improving communication during care transitions for older patients as they leave the hospital.
In my estimation, I believe this was a very, prudent decision on the part of the nurse and her therapist husband. The psychiatrist should be wary of prescribing large amounts of medications around the time of termination. After discussing these points, the pertinent information should be provided to the patient in writing so that the patient can reference instructions, recommendations, and resources later. The risk management advice here is the same as when the psychiatrist terminates the relationship, but without the notice requirement. But there is no way to confirm that a fax was received, which makes it very one way.
The portion of these regulations applicable to hospitals under original Medicare are codified at 42 C. If you are a caregiver, you play an essential role in this discharge process: you are the advocate for the patient and for yourself. As long as, the nurse is not a therapist as well, I believe she is okay. Can I legally date a patient after she has been discharged from the psychiatric hospital in which I work? Go to the hospital with your business card or your phone number on a piece of paper, and tell her you would like to speak with her, in private, for a moment. How long the will the medicine have to be taken? Nurses are held to a higher standard. These new rules, along with some guidelines for beneficiaries, will be discussed in further detail in our next Alert. I was bullied and targeted by colleagues after that for being the whistleblower and was not supported.