Patient and Family Education, Advocacy, and Professional Practice
Education
Teach with plain language and teach-back: ask the patient to explain in their own words when to take pain medication, how to care for the incision, activity limits, and warning signs such as fever, bleeding, worsening pain, or shortness of breath. Provide written instructions at an appropriate reading level and include family or caregivers. Document what was taught and the patient’s response.
Discharge criteria
Discharge requires objective criteria, not elapsed time: stable vital signs, alertness, controlled pain, minimal nausea, adequate oxygenation, and understanding of instructions. Use Aldrete or PADSS as your facility requires. Ensure safe transport and a responsible adult.
Advocacy and professionalism
Advocate for pain relief, dignity, privacy, and safety. Verify informed consent was obtained by the provider; the nurse witnesses. Follow ASPAN standards and your scope of practice. Use SBAR for handoffs and report concerns through the chain of command. Protect confidentiality and report impaired practice or unsafe conditions.
Traps
Do not discharge solely because a set number of minutes has passed. Do not assume understanding because instructions were given. Avoid giving discharge teaching while the patient is sedated. Recognize that family presence can support advocacy but must not compromise privacy.
Worked example
A patient is ready for discharge but cannot repeat when to call the surgeon. Use teach-back, re-educate, involve the caregiver, and document; delay discharge until understanding is demonstrated.
Rule of thumb: if the patient cannot teach it back, they are not ready to go home.