The purpose of the meeting is to follow up with nurses about their patients. So, the case manager, house supervisor, dietitian, and speech therapist met with each nurse and asked her about her patients. They do it in the conference room every day. So, my nurse was floated to CCU; we had two patients for discharge, so my preceptor updated them on their situation. The first patient had a stroke, Sneddon syndrome, and she had GI bleeding ( was on warfarin before and held due to the bleeding) and had an episode of syncope and seizer on Keppra IV. The case manager was waiting for the doctor to put the discharge order. The doctor was waiting for the case manager to arrange for the patient’s DLO appointment so she could check her PT, PTT, and INR to follow up with her hematologist in OU ( my preceptor was communicating between the two ). The doctor didn’t do the reconciliation of medications, and didn’t add Keppra for the patient ( finally, the case manager contacted the doctor and got everything done) patient went home. The other patient was going back to her nursing home (psych facility); she has history of altered mental status, dementia, bipolar, and schizophrenia. she had the case manager arrange the transportation, but the nurse told them that she could leave by 0130 PM due to IV potassium and magnesium running. And there is a protocol that if the patient is restrained cant be transferred to another facility ( considered unstable ). The patient was restrained because she was pulling the tubes and scratching herself( my preceptor informed the house supervisor, so he arranged for a sitter to come and stay with her until she transferred, contacted the doctor about the restraint that could be discontinued). The nurse got the brother to inform him that she was going back to the nursing home. In my opinion, the nurse was reminding and making sure that everybody was doing his work for the patient’s safety, such as the doctor should have done medication reconciliation and checked that Keppra should not be stooped suddenly.

And the patient with a psych issue had a foley catheter; my preceptor was questioning why she needed it as a source of infection, so she asked the doctor, and he put an order to remove it. I agreed that the nurse did her job and other people’s jobs to make sure that patients discharge home safely and make sure that they understood the discharge plan and that all their questions are answered.