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Running head: DISCHARGE PLANNING

Discharge Planning
Emma Jagasia
Florida Hospital Tampa

Running head: DISCHARGE PLANNING

Tiffany Turner, age 25, arrived in the Emergency Department on

January 19th complaining of alternating chest and back pain. AN EKG was
done showing no presence of any arrhythmias or an elevation of the ST
segment. Her troponins were tested three times and the results were
negative each time. Persisting that she was in grave pain, Ms. Turner was
sent to 4M for observation. During her time on the floor, her heart has been
sinus rhythm with no signs of any arrhythmias. Ms. Turner states that her
pain started on the 16th of January and that she feels weak from the
consistent throbbing she feels in her back. The pain is aggravated with
movement and relieved with pain medications and rest. Ms. Turner says the
pain is a constant thing in her life. The patient also has a history of
hypertension, hyperlipidemia, depression and anxiety.
Going through the medical record, it was noted Ms. Turner is a
frequent visitor to Florida Hospital. In the month of January alone, she has
been in three times for alternating pain in the back, right leg, and chest.
When speaking with Ms. Turner, she expressed concern about her current
situation. She stated she has three kids, but they dont live with her for
reasons not shared. She currently lives in an apartment with her boyfriend,
his two children, and their dog. Her main concern about this living situation
was the abuse she stated receiving from her boyfriend. According to Ms.
Turner, her boyfriend beats her, talks down to her, and keeps things from her.

Running head: DISCHARGE PLANNING

When the patient was notified of the discharge plan, she was
confused and angry. She stated she was at the hospital to be treated for
pain; she still has pain, so why is she leaving. For the type of pain she claims
to have, it is important that she be educated on medication compliance and
alternative methods to control pain. With her pain medication, it is essential
she only take the prescribed dose at the designated time. She was also
educated on proper mediation compliance and side effects with pain
medications. Ms. Turner was informed about alternative means to control
pain. Various positions were demonstrated to show how body placement can
help relieve pain in certain areas. She asked about the best setting to be in
to try and relieve pain. The nurse explained to her that for many people
sitting in a quiet room that is slightly dim can sometimes provide relief. Due
to her other disease processes, education on proper nutrition with a heart
healthy, or cardiac diet were provided. A decrease in salt intake was
suggested along with an increase in daily fruit and vegetable consumption.
Ms. Tuner did not meet any of the requirements for core measures, so none
of that education was required.
Ms. Turner was given a full list containing all for her medications
that included the proper dose, next time the dose is to be given, and any
considerations such as take the medication with food. The list was gone over
prior to her discharge. The patient had no questions regarding reasons for

Running head: DISCHARGE PLANNING

taking the medications or concerns about any of the side effects. Many of the
medications were home medications, so she was pretty familiar with them.
The concern the patient had about her living situation was
addressed by the case manager. Many resources such as numbers to
shelters, womens homes, the police department, were provided and
discussed with Ms. Turner. She didnt meet any of the necessary
requirements or the case manager to report the abuse, so the case manager
suggest Ms. Turner report it herself. She also suggested The Spring of Tampa
Bay, a womens home, for safe housing. The patient stated that she could not
go back there. When asked why, the Ms. Turner said it was a long story and
she wasnt going back. When speaking with the case manager privately she
showed some frustration due to the lack of motivation from Ms. Turner to
remove herself from her current situation. The case manager also showed
concern because she did not feel like Ms. Turner had the adequate resources
to obtain her medications. When she talked to Ms. Turner about these
concerns, Ms. Turner informed her that she had a lot of friends who helped
her get what she needed. The patient had Medicare, which covered all of her
medication expenses. Ms. Turner told the Case manager that she wanted
home health. However, due to her current condition she did not qualify and
the insurance would not cover the cost. The patient expressed great
dissatisfaction and the case manager explained that she had done
everything within her power to help.

Running head: DISCHARGE PLANNING

When Ms. Turner was getting ready to be discharged an

appointment was made with her primary doctor for Wednesday January 21st
at 1:00 pm. Before she left, she went to the 5th floor to see her boyfriend and
make sure he did not need anything despite concern from the nurse. He was
also in the hospital at the time. The courtesy van can to pick Ms. Turner up
and her discharge was complete. When considering Ms. Turners situation and
looking at her history, there are some concerning items to look into regarding
readmission. The administration suggested readmission is more than likely
going to happen, for they believe the patient comes to the hospital to have a
comfortable, clean place to stay. Unfortunately, the healthcare system in the
US does not have any specific means to keep these types of patients out of
the hospital. It is expected Ms. Turner will remain a frequent visitor at Florida
Hospital.