Content Reviewers:Lisa Miklush, PhD, RNC, CNS
Contributors:Patricia Nguyen, MScBMC, Evan Debevec-McKenney, Sam Gillespie, BSc, Evode Iradufasha, MD
Admission refers to the official entry of a client into a healthcare facility, and a transfer is moving a person from one room to another, from one department to another, or from one healthcare facility to another. Discharge refers to the official departure of a person from a healthcare facility. These processes can be impactful and disruptive to a client's normal routine. The good news is that, as a nursing assistant, you can help the clients feel less overwhelmed as they check in and out of the healthcare facility.
Alright, after the new client arrives in the healthcare facility, the admitting nurse fills out the client information on the admission sheet, including the client’s full name, the current address, and date of birth. The client is then given an identification number. As a nursing assistant, you will be asked to escort the client; this is a great opportunity to make a good first impression and help the client feel as comfortable as possible. Some clients may need to be transported in a wheelchair or on a stretcher depending on their health status. Remember, you’re the one who will take care of most of the clients’ basic needs. So, be sure to make them feel welcome and comfortable. First, greet every client by name and title, like Mr. or Mrs. You can find the client's name in their admission sheet or by asking the nurse. Then, introduce yourself and your title to the client and their family members or guardian if they are present. After the client gets into their assigned room, offer to help them with unpacking and getting changed into a gown or pajamas if needed. It’s also important to make a list of the client’s belongings to make sure that nothing gets lost. Make sure that the client feels respected and is treated with dignity.
When the client is settled and relaxed, take their vital signs and measure height and weight. Usually, the nurse comes to make the admission assessment, which involves gathering the client’s information, including personal preferences, abilities, disabilities, and habits. It may be obtained from the client, the family members, or a guardian.
Now, sometimes a client may need to be transferred. Basically, transfers occur when the client’s health status improves or deteriorates, and they will be better taken care of in another location. Transfers can be from one room to another, one department to another, or one facility to another. For example, a previously severely ill client in the intensive care unit, or the ICU, can improve and be transferred to a regular room. A transfer can also be from one healthcare facility to another, like when transferring a client with an acute illness from an assisted living facility to a hospital. As a nursing assistant, you’ll be helping with the client’s transfer and ensuring all their belongings are gathered and packed.
If the client needs to be transported to another healthcare facility, the nurse will typically provide a client report to the receiving facility, usually to the nurse that will be caring for the client there. Because nursing assistants spend a lot of time with their clients, they can often contribute to this hand-off by sharing information like the client's personal preferences and habits. After the transfer is complete, document the time of the transfer, people who helped you in the process, where the client was taken, and by which means was the client transported: by wheelchair, stretcher, or in bed. If you are the team member that is physically transferring the client, you also have to document who received the client, whether the client tolerated the transfer, and any other important observations.