Patient Involvement in Health Care Upon receiving an assignment at the start of the shift, Colin Jennings, RN, makes initial rounds of the patients. One pa

Patient Involvement in Health Care Upon receiving an assignment at the start of the shift, Colin Jennings, RN, makes initial rounds of the patients. One patient, Amed Kyzeel, as reported by nurses on the previous shift, has been difficult to work with, demanding the attention of staff throughout the shift.

Mr. Jennings visits Mr. Kyzeel last during rounds so that additional time is available for an assessment. Upon entering Mr. Kyzeel’s room, Mr. Jennings asks him how he is feeling about going home. Mr. Kyzeel complains about a variety of minor concerns about his pending discharge. Accepting that Mr. Kyzeel’s perceptions are unique and valid to him, Mr. Jennings spends a few minutes just listening.

Because Mr. Jennings knows that Mr. Kyzeel is to be discharged today, he asks the patient what he knows about his pending discharge and his goals for leaving today. Mr. Kyzeel admits that he is concerned about leaving the hospital because he does not know what to expect during the first 24 hours at home. Mr. Jennings talks with the patient and asks him what goals he wants to achieve while in the hospital and upon returning home. Mr. Kyzeel identifies two to three goals that he would like to achieve in the hospital and says that he would like to have someone stay with him at his home for the first night because he is not sure that his wife will be able to take care of him like the nurses do in the hospital.

Of the goals identified, Mr. Jennings and Mr. Kyzeel identify the most important ones and the order in which Mr. Kyzeel would like to achieve them. Then Mr. Jennings and Mr. Kyzeel identify activities that can be done by the patient and the staff to achieve these goals. Before leaving the room, they agree on the goals, their priority, and the specific activities to be done, and they arrange for Mr. Kyzeel’s wife to be involved in the discharge planning.

Having established times when Mr. Jennings and Mr. Kyzeel will briefly talk to evaluate achievement of the goals, Mr. Jennings leaves the room and Mr. Kyzeel calls his wife to begin work on the activities he needs to accomplish.

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