A short-staffed shift and pressure to discharge
NMC OSCE practice station
Professional values · 1 min to read · 10 min to perform
A written station. Free to try, no sign-up.
The task
You are a registered nurse on a medical ward. The ward is two nurses short and the bed manager phones, asking you to discharge Mr Tom Fenwick, aged 81, by 5 pm. He still has a raised temperature, has not walked since yesterday, and his daughter says no care package is in place at home. The bed manager says the emergency department is full. In the response sheet, write what you would do, explain why, and say what you would do afterwards.
What this station tests
- A bed pressure or target never replaces a clinical assessment of whether a patient is safe to go home.
- Make the decision with the right people: the nurse in charge, the doctor and the discharge team.
- Be professional and calm with the bed manager; explain the risk and offer to update them.
- Involve the patient and family in what is needed at home before discharge.
- Staffing concerns are raised through incident reports and the escalation route, with clear records.
Sources for the clinical content
- NMC: Raising concerns, guidance for nurses and midwives
- NICE NG27: Transition between inpatient hospital settings and community or care home settings
- NMC: The Code
An original practice scenario with invented patients. Not an exam question.