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Transfer Decision Guide for Patients and Families

This guide will help you understand why transfers are made to the hospital and how you can be involved in that decision.

When Your Condition Changes

The most common reason for sending you to the hospital is a significant change in your condition. This change could be a fever, shortness of breath, pain, an injury from a fall, or other health concern. Your doctor, nurse or aide may have noticed this change or you may have reported it to them. In any case, we take these changes seriously and will work with you to decide what happens next

Making the Best Decision

We want you to make an informed decision if the question of going to the hospital arises. It is difficult to weigh the pro’s and con’s of a transfer to the hospital when you become ill or to decide what treatment you prefer in the middle of a crisis. We will help you understand the risks of going to the hospital, such as:

  • Added stress from transportation to a new environment
  • Having to explain your concerns to new nurses and doctors
  • Increased chance of skin breakdown, infection, or falling

Because of these concerns, you may feel more comfortable staying at Friendship and being cared for by staff who know you. In any case you can count on us to make your health a priority and keep you involved in the decision.

Being Involved in the Decision

You have the right to know what is happening to you, how decisions about your care are being made, and how you can be involved.

You may want to talk to the following people about your choices:

  • Nurses
  • Doctors and other medical providers
  • Social workers
  • Responsible party
  • Emergency contacts

You can make your preferences known by:

  • Talking with the people listed above
  • Putting your wishes in writing and telling people where to find these documents
  • Completing advance directive documents including:
    • Medical Power of Attorney
    • Living will (specifics for your preferences for end of life care)
    • Request for a DNR (do not resuscitate) or DNH (do not hospitalize) order
    • A Physician Orders for Life Sustaining Treatment or similar form
    • The Five Wishes (Learn more about this simple approach to a living will)

Available Treatment at Friendship Health

We are committed to providing you the best possible care at Friendship Health. Our team can coordinate with your current nurse, doctor or other medical provider to give you the best possible treatment.  Many tests and treatments can be provided in the skilled facility or rehab center without you having to interrupt care or transfer to the hospital, including:

  • Medications
  • X-rays
  • Blood tests
  • Oxygen
  • Wound care
  • Comfort care (pain relief, fluids, bed rest)
  • IV (intravenous) fluids in some facilities

If It Is Not An Emergency

If your situation is not an emergency, the nurse will assess your condition by:

  • Asking you what happened, how you feel, and where it hurts
  • Listening to your heart and lungs
  • Taking your temperature, blood pressure, and oxygen level
  • Testing your blood and urine

You can ask the nurse for the results and if your doctor or family will be called. If you have concerns about being sent to the hospital, this is the time to express them.

In An Emergency

In a life-threatening situation, the staff may call 911 to send you to the emergency room right away. They will also call your family, as well as your doctor or other medical provider (such as nurse practitioner or physician assistant). Emergent treatment will be provided and then you will be sent to the nearest hospital.

FAQs about Hospital Transfers

  1. What is a “medical provider”?

Your medical provider may be a physician (MD), doctor of osteopathy (DO), nurse practitioner (NP) or physician assistant (PA). When we ask you about your medical provider, we want to know who can answer questions about your health and care plan.

  1. Why would my doctor or other medical provider consider sending me to a hospital?

If you experience an injury or a serious change in condition (such as fever, shortness of breath, or pain), your medical provider may consider sending you to a hospital.

  1. Why would I want to be cared for at Friendship rather than a hospital?

There are several reasons. You are already familiar with our staff and routines. Because our staff already knows you, your health history, and your needs, there will be less disruption to your routine if you stay at Friendship. The transfer itself may be tiring, even stressful for you. Lastly, complications may occur in the hospital which could impact your health.

  1. Who will make the final decision as to whether I should be sent to a hospital or stay here?

Your doctor, nurse practitioner, or physician assistant will consult with you, your family, and your nurses to make the final decision.

  1. Can I request a certain hospital?

You may make this request. However, in an emergency situation the EMTs will take you to the closest hospital that provides the care you need.

  1. Will my family know where I am? Will they know what is happening to me?

Yes, we are required to notify them unless you have indicated otherwise.

  1. Will I be able to continue receiving physical and occupational therapy if I go to the hospital?

That depends on why you are going to the hospital and how sick you are. If therapy has to be is continued, it will begin again when you are ready.

  1. Will I return here after I am discharged from the hospital?

Yes, if that is in alignment with your wishes and depending on bed hold status.

  1. What happens to my personal effects if I am transferred to the hospital?

Your personal effects will be stored for you here.

Special Information for Family Members of Residents Who have Dementia

  1. Will my family member be sent to the hospital even if he/she has Alzheimer’s disease or dementia?

Your family member may be sent to the hospital unless he or she is under Pallative/Hospice care or has specified no hospitalizations in their advanced directive.

  1. Can the resident still participate in the discussion about transfer to the hospital?

The answer depends on how advanced the memory problem is and how sick your family member is at the time. Residents in the early stages are capable of expressing their wishes, while those in advanced stages may not be.

  1. Even if my family member cannot express his or her wishes, should we tell him or her what is happening?

Yes. Your family member has the right to know what is happening and may become anxious or frightened if moved to an unfamiliar place without explanation. Be sure to use simple, direct words (such as “you are sick”, “your doctor thinks you should go to the hospital”), a quiet voice, and a calm manner when explaining the situation to your loved one.

For more information, contact Friendship Health’s Admissions Team at (540) 265-2088.