The Collaborative Approach to Resident Discharge
Resident discharge is a complex, multi-step process that begins well before the day of departure. While licensed nurses and case managers handle the intricate medical and logistical planning, the nurse assistant (NA) or Certified Nursing Assistant (CNA) provides essential direct care and emotional support. Their presence ensures that the resident's physical and emotional needs are met, making the transition as stress-free as possible. The NA's tasks, though often focused on comfort and readiness, are foundational to the discharge plan's success.
Preparing the Resident Physically
A nursing assistant's role in preparing a resident for discharge is hands-on and crucial for ensuring comfort and dignity. This includes assisting with personal hygiene, dressing, and grooming. NAs also provide mobility support, helping residents walk to the transport area or assisting with transfers to a wheelchair or stretcher using proper safety techniques. In some cases, a nurse may direct the NA to take final vital signs.
Coordinating Belongings and Paperwork
The NA plays a key role in organizing personal items and discharge papers. They use an inventory checklist to pack belongings and may help gather paperwork like the discharge summary and medication lists under supervision.
Providing Emotional Support
Leaving a care facility can be emotionally challenging, and the NA's compassionate support is vital. They can talk with residents about their feelings, address anxieties about going home, and help facilitate goodbyes. Involving residents in packing can also empower them and help them feel ready for the next phase.
Comparison of CNA and LPN Discharge Duties
The nursing assistant's duties are distinct from the more advanced responsibilities of a Licensed Practical Nurse (LPN) during discharge, though both work collaboratively.
| Duty | Nurse Assistant (CNA) | Licensed Practical Nurse (LPN) |
|---|---|---|
| Patient Preparation | Assists with personal care, dressing, and physical readiness for transport. | Manages and supervises the CNA's preparation tasks, while focusing on medical aspects. |
| Medication Management | Communicates basic reminders about medication schedules, but does not administer or prescribe medication upon discharge. | Prepares or administers final doses of medication and provides detailed medication education to the resident and family. |
| Patient Education | Reinforces discharge instructions explained by the nurse and answers basic, non-clinical questions. | Performs detailed patient education using methods like 'teach-back' and provides more complex medical instructions. |
| Documentation | Records final vital signs and documents the collection of personal belongings. | Completes and verifies the discharge summary, including a recapitulation of the resident's stay. |
| Discharge Planning | Provides feedback on the resident's functional abilities and emotional state to the supervising nurse. | Collaborates with the discharge planning team to create the formal discharge plan. |
Conclusion
In conclusion, the nurse assistant plays a critical and supportive role in the resident discharge process. While they operate under the supervision of licensed nurses, their contributions are vital for ensuring the resident's physical comfort, emotional security, and logistical needs are met. The NA's attentiveness to detail—from packing personal items to offering reassurance—helps create a smooth and dignified transition for the resident and their family. Their work directly supports the larger discharge plan, contributing significantly to a successful outcome and minimizing stress during a vulnerable time. Their last act of care helps set the resident up for a safer, more confident return to their next living situation.
One helpful resource for CNAs looking to understand discharge protocols is the guide on patient safety during discharge published by the Agency for Healthcare Research and Quality (AHRQ).(https://psnet.ahrq.gov/perspective/patient-safety-during-hospital-discharge)
