In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of referrals in order to:

  • Assess the need to refer clients for assistance with actual or potential problems (e.g., physical therapy, speech therapy)
  • Recognize the need for referrals and obtain necessary orders
  • Identify community resources for the client (e.g., respite care, social services, shelters)
  • Identify which documents to include when referring a client (e.g., medical record, referral form)

Referrals, simply defined, are contacts that are initiated by the nurse and other members of the healthcare team in order to meet the needs of the client at the appropriate level of care and in the appropriate setting. Registered nurses manage and coordinate care along the continuum of care.

Assessing the Need to Refer Clients for Assistance with Actual and Potential Problems

Nurses and the entire healthcare team assess clients and determine their need for referrals relating to actual and potential problems.

Recognizing the Need for Referrals and Obtaining Necessary Orders

When clients have assessed needs that cannot be fulfilled and met by the registered nurse in collaboration with other members of the nursing care team, the registered nurse should then seek out resources, as well as utilize and employ different internal or external resources such as a physical therapist, a clergy member or a home health care agency in the community and external to the nurse's healthcare agency.

These resources are tapped into and, when considered appropriate for the client and their needs.

Identifying Community Resources for the Client

Common referral needs include resources and/or assistance in the community in respect to:

  • Crisis intervention
  • Anger management programs for perpetrators of abuse for example
  • Social work services for uninsured clients and those in need of assistance such as Meals on Wheels
  • Respite care for burdened caregivers
  • Community self-help groups
  • Housing, including emergency shelters, for victims and children affected with abuse
  • Transportation to and from medical appointments
  • Elder day care and in home care of an elderly patient
  • Parenting resources for fathers, young mothers and others who an assessed need for the same

Identifying and Using Appropriate Documents When Referring a Client

Medical data and information including referral forms and the client's medical record are shared with the person, department or community resource that is accepting the client according to their legal need to know this information in order to provide the client with their necessary care and treatments.


SEE - Management of Care Practice Test Questions

Alene Burke

Alene Burke

Alene Burke RN, MSN is a nationally recognized nursing educator. She began her work career as an elementary school teacher in New York City and later attended Queensborough Community College for her associate degree in nursing. She worked as a registered nurse in the critical care area of a local community hospital and, at this time, she was committed to become a nursing educator. She got her bachelor’s of science in nursing with Excelsior College, a part of the New York State University and immediately upon graduation she began graduate school at Adelphi University on Long Island, New York. She graduated Summa Cum Laude from Adelphi with a double masters degree in both Nursing Education and Nursing Administration and immediately began the PhD in nursing coursework at the same university. She has authored hundreds of courses for healthcare professionals including nurses, she serves as a nurse consultant for healthcare facilities and private corporations, she is also an approved provider of continuing education for nurses and other disciplines and has also served as a member of the American Nurses Association’s task force on competency and education for the nursing team members.
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