Patient discharge starts upon admission. The patient will be informed early during their care process about their discharge to go home, or Skilled Nursing Facility or transfer to another hospital, or discharge to hospice. Patient discharge planning will include how patient can manage symptoms at home,pain medications, nausea/Vomiting medication, blood pressure medications. The emotional needs and support addressed. Transportation needs, family pick up or ambulance service pick up.Patient discharge to go home is done by the doctor atleast a day before the date of discharge and the nurse will initiate it a day early to make sure that patient discharge needs are met.Written instructions will be given to patient and family.No medical abbreviations on the discharge teaching.Medications reconciliation done. Do not tamper with medical records. Don't criticize other healthcare professionals in your charting.Enter all information in a complete relevant, accurate and factual manner. Avoid bias from written description of others. In discharging a patient with stroke for example educate patient on a healthier lifestyle. For example stop smoking( Recommend gums)reduce alcohol intake ( Give your patient phone number for AAA anonymous),reduce stress, take your medications as ordered, get 30minutes regular exercise every day. Take your medications as prescribed by the doctor. Check your blood pressure regularly document findings and take it to next doctor appointment. If patient is transferred to another hospital or Skilled Nursing Facility arrangement will be made for ambulance service to pick patient to the new facility or hospital at a specific time.Patient must must be cleaned and ready to go to the new facility with all patient belongings. Information about patient fax to the new facility. When ambulance arrive nurse will give report to the EMT team that came to pick up the patient. Case manager is the healthcare professional that made arrangements for the transfer according to the doctor orders.