[ACRN06]

I've been a floor nurse for 2.5 years now. I never did like the faxed report.

The problems
1. Like someone already pointed out, the floor nurse is sometimes the last to know about the admit until the patient is rolling into the room. You give the "*****!" stare, go to the fax machine, and lo and behold. Report. *sigh*
2. The "report" that is faxed is about as helpful as a kardex. Sure it tells you the basic info. It even has the last round of VS and other info. But its just different.
It would be like a floor nurse coming on to shift and having a written report on her patients instead of verbally passing it on.
Everyone has their little bits of information they like to know about a patient to feel ready to take on the care for them.

HOWEVER

On the flip side, I really do understand why the ER's are wanting to switch to this method. Its convinient, its easier, is quicker.
I've seen nurses put off taking report from ER... sure they've got stuff to do, but if you think that you can wait til everything slows down to take report, you're never gonna take it! I think its safe to say the ER is pretty dang busy too!
I also feel for the ER nurses who have to give report to a floor nurse who expects a 5-star-thourough-complete-down to the patients freakin eye color and room temperature preference!

Ok...exaggeration. But I just don't expect the ER to do a full skin assessment on the NH patient in for dehydration. I'm not saying they don't do one, but thats something that you can figure out when the patient gets up to the floor. I hear nurses up on the floors taking report and asking all sorts of questions that I'm just like "really? do you really need to know that NOW? aren't you going to assess the patient yourself??"

Blah. Ok I'm ranting. I'm just ready to get off the floors.

I guess my main point is, I understand why they want this system to work. But theres just no way in heck you're gonna be able to develop a system that'll please everyone.
Nurses don't like change when it comes to the way things are run in the hospital. We each have our own ways, systems, habits that are our "control" in the equation of the chaos we face.
When our control group is thrown off, our system is thrown off... our tried and true gets-us-thru-the-shift system...
So we get mad.

I personally need some change. Hence why I'm getting off the floors. They've served me well... I've built a great foundation, I need to change it up----
Hope any of the above made a lick of sense
AC

[FERN-tastic]

We fax report to the floors, along with the med rec form now (which I don't understand because it's filled out by the RN and not signed by an MD). I also fax the orders for the patient.

In theory it seems like a time saver, but it never is. The floor never gets the fax, and even if they do I end up giving a phone report anyway because the report form never seems to have the info the floor nurses want. I actually much prefer to send pt's to the unit because it's a phone report with none of the phone/fax tag we play with the floors.

[TraumaNurseRN]

Originally Posted by ACRN06

I've been a floor nurse for 2.5 years now. I never did like the faxed report.

The problems
1. Like someone already pointed out, the floor nurse is sometimes the last to know about the admit until the patient is rolling into the room. You give the "*****!" stare, go to the fax machine, and lo and behold. Report. *sigh*
2. The "report" that is faxed is about as helpful as a kardex. Sure it tells you the basic info. It even has the last round of VS and other info. But its just different.
It would be like a floor nurse coming on to shift and having a written report on her patients instead of verbally passing it on.
Everyone has their little bits of information they like to know about a patient to feel ready to take on the care for them.

HOWEVER

On the flip side, I really do understand why the ER's are wanting to switch to this method. Its convinient, its easier, is quicker.
I've seen nurses put off taking report from ER... sure they've got stuff to do, but if you think that you can wait til everything slows down to take report, you're never gonna take it! I think its safe to say the ER is pretty dang busy too!
I also feel for the ER nurses who have to give report to a floor nurse who expects a 5-star-thourough-complete-down to the patients freakin eye color and room temperature preference!

Ok...exaggeration. But I just don't expect the ER to do a full skin assessment on the NH patient in for dehydration. I'm not saying they don't do one, but thats something that you can figure out when the patient gets up to the floor. I hear nurses up on the floors taking report and asking all sorts of questions that I'm just like "really? do you really need to know that NOW? aren't you going to assess the patient yourself??"

Blah. Ok I'm ranting. I'm just ready to get off the floors.

I guess my main point is, I understand why they want this system to work. But theres just no way in heck you're gonna be able to develop a system that'll please everyone.
Nurses don't like change when it comes to the way things are run in the hospital. We each have our own ways, systems, habits that are our "control" in the equation of the chaos we face.
When our control group is thrown off, our system is thrown off... our tried and true gets-us-thru-the-shift system...
So we get mad.

I personally need some change. Hence why I'm getting off the floors. They've served me well... I've built a great foundation, I need to change it up----
Hope any of the above made a lick of sense
AC

AC: goodluck on your change.....maybe the ED is the place for you.

[ACRN06]

Originally Posted by TraumaNurseRN

AC: goodluck on your change.....maybe the ED is the place for you.

Heeeyyy! How about that? Thats exactly what I did!

Just got a job in the ER... start Monday... soooo excited! I've been waiting over 2 years for this! I've got my experience under my belt that I wanted...I don't regret doing M/S Tele first... I've learned a TON. Developed crucial skills and an intuition that you just don't have out of nursing school.

I think its good to start out on the floors to develop a good sound foundation of knowledge and skills on which you can just keep adding to!
Wish me luck!

[Roy Fokker]

I'm an ED nurse and personally, I don't like the whole 'faxed report' thing.

Yeah sure, it means that the bed gets cleared and ED throughput is somewhat maintained. I agree with that and on somedays it's downright vital that it happens.

BUT...

... I don't think it gives the necessary "continuity of care". IMHO, the whole idea of "report" is to guage actual 'progress' of the patient. Typically, when I call report on a patient, I focus less on the 'documentation' and more on my 'assessment'.

Any idiot reading a piece of paper can figure out that a pt. who presented with 'SoB and sats of 90% responded to 2 neb treatments and is now satting in the 98% range'. But I think that report introduces certain nuances and other extras that are sometimes crucial to providing a better version of the over all "big picture".

When I give report, I stress my nursing view of pt. care. I emphasize my clinical picture of when/how patient presented initially to where/how pt. is now.

I add little tid-bits such as "I know he's been ordered 1 mg Dilaudid but it might be prudent to give 0.5mg or less each time because the last time he got 1 mg, he got pretty woozy and thought he saw talking cats".

Or "when the patient is sleeping, his HR drops to the low 50s. Don't freak out - this is normal for the pt."

I think it's important for such things to be passed along. Patient care is more than just numbers and figures.

cheers,
Roy (former floor nurse)

[aknurs]

Years ago when I worked ER, we would call report to the floors. We would also read the Dr. Orders for them, as we had one Dr. who's handwriting was atrocious...We could read it easily, because we were used to his writing, the floor nurses were not . Most of the time we had the pt.s I.V. etc going, just to be nice & how do you tell someone about pertinent things that pertains to the patient. A verbal report is a lot better than a machine spitting out a piece of paper , that you "hope" someone has the time to get.Fax machines can run out of ink,& break..

[mcknis]

We get our reports faxed, but it doesn't give descriptions. Ours just gives us a brief statement from the pt why they came in, meds given in ER and VS trends. I wish we could know more about why they came, if they are a FF, little details that mean something (if they can move independently, stable on feet, received home meds, etc.). I could really care less if I got a detailed report from em. I figure they don't get a detailed report from the squad so i totally understand where they come from...

[lovelylpn]

At the hospital I used to work at we did faxed reports to all units including ICU which is where I worked. If the patient were really complicated, though, a verbal report would be given (i.e. the pt I once received who'd been coded three times in the ED and was still a full code but stable enough for transport to the unit. By the way, that pt ended up coming to the unit and was already in PEA by the time we went from stretcher to bed. Died later that nigt after two more codes). Anyway, the fax report system worked well for us. The nurse had to confirm the fax was received and then wait 20 minutes before transferring the pt up, though. Like someone else stated, there is no way to please everybody with this system, but I liked the idea of a follow-up call to the receiving unit to make sure there were no questions and all was clear and understood.

[JessicRN]

We fax reports. We love it, the only floor we don't do it on is ICU. It is very detailed and a pain in the butt to do it but we get no complaints and the nurses have 10 minutes to contact the supervisor and stop the transfer or we send the patient to the floor (name past med hx, Admitting MD,DX, Allergies,Code status,IV meds given EKG results, interventions,VS on arrival and on transfer,abnormal lab etc)we do not have to discuss it