Stares entry three rotation 4

Stares entry 3 rotation 4

Situation
Today I received a referral on the ward to see an 80 year old lady who was admitted to PHC due to delirium and decreased mobility resulting from a UTI. The referral stated that the patient was ready for a discharge mobility review and could go home once able to transfer independently.

Task
Evaluate the patient’s suitability for discharge home.

Action
I observed the patient’s mobility watching her transfer on and off the bed, did a quick balance screen and watched the patient walk a few metres to her chair. The patient seemed quite confident on her feet.
I then documented my findings in the patient notes, evaluating that the patient would be safe to go home with some support such as a care package. Soon after documenting this in the notes the nurse responsible for this patient came up to me and said “Are you sure she is ok to go home? How far can she even walk? It’s going to come back to us is she goes home and falls.”I began to doubt myself because I hadn’t actually measured the patients walking distance. I had only met this woman once and had only done a quick screen of her mobility. I got the feeling that she would be able to cope at home because the referral only stated that she needed to be able to transfer independently.
I went back to the patient’s room to recheck her mobility. She was able to walk 30 metres with ease using a WZF and her mobility was definitely adequate to go back to her retirement home. I presented this information to the nurse who was still not entirely happy with my decision. After speaking to the coordinator and checking that the patient would be having care support over the weekend, the nurse acknowledged that perhaps the patient should go home.

Result
The patient was to be transferred home with a 7 day per week home support package. This was a good outcome, however I did appear slightly incompetent to some members of the ward’s nursing staff. As well as this, what started as a quick mobility assessment ended up consuming allot of my time a bit unnecessarily.

Evaluation
I had attempted to shorten my assessment by quickly observing the patient and making conclusions based on what I had seen. I was then unable to provide other members of the MDT with objective information, therefore they did not take me seriously, doubting my abilities.

Strategies
Improve my presentation of the evidence – provide team members a systematic, well planned argument.
Learn to tailor my assessment, while keeping in mind the need for objective measures to back up any decisions I make.
Prioritise outcome measures in assessment.
Be confident when talking to other members of the team.