The discharge sheet in your bag may be the only record of the visit you have, and it may not say whether anything was sent to your regular doctor. Until someone confirms it was, assume passing the news on is your job. That means calling the number on the sheet with a few questions, booking the follow-up with your own doctor's office, and talking to the pharmacist who fills the new prescription.
What the discharge sheet should cover
Hold your sheet against a list of what a discharge plan should cover. It was written for people going home after a hospital stay, so not every line will apply to an emergency visit, but it shows quickly what is missing. A discharge plan should include:
- a description of your medical problems, including any allergies
- all your medicines and how and when to take each one, with any new ones and any to stop or change marked by your provider
- how and when to change bandages and dressings
- the dates and times of appointments, with the names and phone numbers of any providers you will see
- the number to call if you have questions, problems or an emergency
- what you can and cannot eat, and whether you need any special foods
- how active you can be, such as whether you can climb stairs and carry things
Read the sheet line by line with a pen. Tick each item it covers and write a question in the margin for each one it skips. A skipped item may simply not apply to your visit, and the only way to know is to ask: call the phone number the sheet gives for questions, and work down your margin notes. If the sheet has no such number, call the hospital's main switchboard and ask for the department that treated you.
The instructions are meant to be understood by whoever helps look after you as well as by you, so ask that person to read the sheet too. When you pass the visit on, copy the diagnosis exactly as the sheet prints it, so your own doctor and pharmacist see the same words you did.
Will your own doctor hear about the visit?
Not necessarily, so do not count on it. A discharge plan is put together by hospital staff, a social worker, nurse, doctor or other provider, working with you and your family or friends, and telling your regular doctor is not among the items it should include. So when you call the number for questions, ask three things: was anything sent to your regular doctor, what was sent, and when.
Your records are already scattered. You may have a chart at several doctors' offices, and a hospital visit leaves another one at the hospital, which is why a personal health record of your own is worth keeping. A useful one starts with:
- your name, birth date, blood type and emergency contact
- the date of your last physical, and the dates and results of tests and screenings
- major illnesses and surgeries, with dates
- your medicines and supplements, how much of each you take, and how long you have taken them
- allergies, chronic diseases, and illnesses in your family
Add this visit to it: the date, the hospital, what the sheet says you were treated for, and any tests you know were done. While you have the hospital on the phone, ask whether you can see your own record there. Being able to see your records lets you keep track of your test results, diagnoses, treatment plans and medicines.
A new prescription beside everything else you take
Whoever wrote the prescription in the emergency department may not have seen the rest of what you take. Write a list today of every medicine, vitamin and supplement, with the new prescription on it and anything you buy without a prescription, and make sure your doctor knows about all of them.
The list matters because a medicine can harm as well as help. Harm from a medication, an adverse drug event, includes allergic reactions, side effects, overmedication and medication errors. When you collect the new prescription, give the pharmacist your list and ask them to check it against what you already take. If anything on the label is unclear, ask the pharmacist or your doctor before you take the first dose, and keep up with any blood tests your doctor asks for.
If the sheet marks one of your usual medicines to be stopped or changed, follow that instruction, and if any part of it is unclear, ask the pharmacist or call the number for questions on the sheet.
If you already take a weekly weight medicine, everyone who prescribes for you should know about it, because it can change how some other tablets work (see A weekly weight medicine can change how some of your other tablets work).
Help at home, if the sheet says you need it
Going home can still mean needing help with personal care, such as bathing, eating, dressing and using the toilet; with household tasks, such as cooking, cleaning, laundry and shopping; or with health care, such as getting to appointments, managing medicines and using medical equipment. Family or friends may be able to help, depending on what you need.
If you need more than that, whoever handles discharge planning at the hospital can suggest a home health aide, and can tell you whether you need equipment or supplies, such as a walker or cane, a shower chair, or bandages and dressings. If you have already left, call the number for questions on the sheet and ask to speak to whoever handles discharge planning.
Booking the follow-up, and getting ready for it
Look for an appointment on the sheet first. If one is booked, check you have the name and phone number of the provider you will see. If the sheet says to see your doctor within a few days but books nothing, call your doctor's office as soon as it opens, so the visit falls inside the days the sheet gives.
If you have no regular doctor, you can still get checkups (see Weight care is not a checkup, so the screenings are still yours to book).
Before the visit, get these ready:
- your list of allergies and of every medicine, herb, vitamin and supplement you take
- the questions and concerns you want to raise
- a note of any symptoms since the visit, when they started, and what makes them better or worse
- someone you trust to come with you, if you would like company
Bring the discharge sheet with your margin notes. At the appointment, ask for written instructions if you need them, and for the best way to reach your doctor afterwards.
If your weight care is with NicoCares, the physician who reviews your treatment should know about a new medicine too. In Spruce, where your care team answers messages, send them the medicine's name and what the sheet says you were treated for. For a question about taking it today, ask your pharmacist, because no reply time is stated for Spruce messages.
If things get worse before the follow-up
Call 911 for anything that cannot wait. For problems such as heavy bleeding, fainting, sudden confusion, or a severe allergic reaction with trouble breathing, go to an emergency department or call 911. If you are not sure what to do, call your doctor's office or the number on your sheet. If your sheet lists warning signs that mean going back, follow it: it was written for you.
It is an emergency if a person or an unborn baby could die or be permanently disabled. Examples include severe chest pain or pressure, severe shortness of breath, stopped breathing, and suddenly being unable to speak, see, walk or move. For those, call 911 or your local emergency number right away so the emergency team comes to you.
