Bed Side Report - page 2

by 280090

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So I am an RN student and the hospital I am doing clinicals at has now started to do bedside report. May of the RN staff complain about this change. Is it best to do bedside rounding or not? Have any of you other nurses had to... Read More


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    I work on a psychiatric unit and bedside shift report was recently made a requirement for us . We only do it once a day, from days to evenings. It's actually worked better than anyone expected. Not only does it give my patients a way to know who their oncoming staff is, it also gives them the chance to ask questions and it gives staff the chance to pass on any information that a patient may try to use to split staff. It's has practically eliminated all staff splitting from shift to shift. As far as addressing negative behaviours in front of the patient we do it in a matter of fact way. Pt did this, this and this earlier but after seclusion, or prns or whatever intervention they were able to turn things around. It allows our patients to reflect on thier behavior as normal when stated matter of factly and not as something to be ashamed of. Which we all know those with mental health issues have enough shame. As far as our more psychotic or paranoid patients all we do introduce the oncoming staff, ask if they have questions and complete report outside their room. And we never wake a patient for report. We just do it outside their room. It has provided a much smoother transition between shifts for staff and patients. Staff are more punctual as well because report has to start on time and if they're late they have to go back and get report on their patient's from someone when reports over. None of us wanted to do bedside shift report and thought it was stupid in the psychiatric setting but I'm happy to report we were wrong. If you give it a chance and work out the kinks it really is a good thing.
    anotherone and Meriwhen like this.
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    I don't mind bedside rounding for the most part. I try to do a final round myself on all my pts about 30-45 minutes before so that hopefully any last minute requests or potty trips are taken care of. We peek in & if the pt appears to be sleeping/dozing, we just do report outside the door. Any sensitive info is given out of pt's hearing.

    Actually, come to think of it, I give report at the bedside in the AM, but I receive report in the evening at the desk, usually because most pts are trying to get to sleep plus no managers around. Comparing the two, I think I usually am able to get through report in the AM faster than when I receive it at the desk in the evening. Evening RNs often seem to add a bit more chit chat, but the AM RNs are usually chomping at the bit, ready to go. (There's one RN that hardly waits [or wants] to even hear report; you have to chase her down.)
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    Quote from dawnv368
    I work on a psychiatric unit and bedside shift report was recently made a requirement for us . We only do it once a day, from days to evenings. It's actually worked better than anyone expected. Not only does it give my patients a way to know who their oncoming staff is, it also gives them the chance to ask questions and it gives staff the chance to pass on any information that a patient may try to use to split staff. It's has practically eliminated all staff splitting from shift to shift. As far as addressing negative behaviours in front of the patient we do it in a matter of fact way. Pt did this, this and this earlier but after seclusion, or prns or whatever intervention they were able to turn things around. It allows our patients to reflect on thier behavior as normal when stated matter of factly and not as something to be ashamed of. Which we all know those with mental health issues have enough shame. As far as our more psychotic or paranoid patients all we do introduce the oncoming staff, ask if they have questions and complete report outside their room. And we never wake a patient for report. We just do it outside their room. It has provided a much smoother transition between shifts for staff and patients. Staff are more punctual as well because report has to start on time and if they're late they have to go back and get report on their patient's from someone when reports over. None of us wanted to do bedside shift report and thought it was stupid in the psychiatric setting but I'm happy to report we were wrong. If you give it a chance and work out the kinks it really is a good thing.
    Interesting. I do notice that you're not always giving the entire report at the bedside though, which is good.

    I'm glad it's working out for your facility. Overall I still don't think it's the best idea for psych, but should bedside reporting come up as a topic again, I shall bring your experiences back to share with them.
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    We started doing bedside reports awhile ago but no one ever really complies unless management or "the higher ups" are around. Before our Joint Commission visit, everyone made sure they did report at the bedside...after we passed, no one really does it anymore.

    It has its ups and downs. The good thing is the oncoming nurse can do a quick eyeball of the patient and you can check IV medications (especially if it's something like dopamine or cardizem or something titratable), or to look at a dressing with both nurses so that they are the on same page regarding assessment. I do not like doing report at the bedside at 0645 because most patients are still sleeping and if I were a patient, I would be pretty upset if you were waking me up at that time. Bedside reporting also takes longer because I feel it is always interrupted with random requests...seems like management is okay with paying everybody overtime.
    redhead_NURSE98! likes this.
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    i hate it and try to avoid doing it . enforecement varies. i have done it and just given report like i usually would. if i say something pt doesnt know , oh well. it was done allegedly to increase pt satisfaction and awareness of what is going on. sad. I have always come on and told pt , "you are on clears today , bowel prep tomorrow night and possible colonoscopy and egd tomorrow". sometimes pts have had no idea. i blame the drs. they should be telling pts what the potential plan is first. not nursing .
    Ir15hd4nc3r_RN likes this.
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    We are supposed to do bedside report, but we do report outside the room on everyone then we take a walk in to see everyone,introduce them to the new RN, show them their IV,wounds, etc. let them get a quick look to see if we had forgotten to mention anything etc.
    Meriwhen and Esme12 like this.
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    In a labor unit, you end up doing 2 reports. Very, very time consuming.

    The report the patient hears: This is Ms. So-and-So. She's a G1P0, patient of Dr. X in for an elective induction. Her cervix is 4/80/-1, and her Pitocin is at 20 mu/minute. She has an epidural and a Foley, plans to bottle feed, and is having a girl. Her pediatrician will be Dr. Y.

    What they don't hear, that we do in private: Ms. So-and-So is in room 1, she's a G1P0, Dr. X in for induction with a diagnosis of TOBP (tired of being pregnant). She screamed and cussed half the morning and so she got her epidural at 1 cm. She's 4/80/-1 now and maxed out on Pit. She's got a Foley. She's refusing to breastfeed because she says it's "gross." She's having a girl. There are two men in the room. Neither is the FOB, don't even go there. She's got herpes, but neither one of these men know, so for sure don't go there. No, I don't know who either one is, but they both stay in the room for vag exams. Her mom is a total pain in the bum, keeps demanding soft drinks. She knows it's against policy, so don't let her fool you. They've threatened to sue us all a couple of times, especially because she had to wait 10 minutes for anesthesia to come in for her epidural. Have a great day, sunshine, I am DONE with her!
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    I do not like bedside report, for the reasons that Commuter stated. The patients or their family interrupt constantly, you're trying to give history and they're like "What's that? I don't have that. Oh yeah I did 10 years ago but I don't have it anymore." (Yeah that's why it's called a HISTORY!!!) And in a couple months we're going to have detailed white boards in the room that we're supposed to fill out WHILE TAKING BEDSIDE REPORT. So let's see, they're on a regular diet. Let me write it on my hard copy. Now, let me put down my binder and write it on the white board. Okay, they're going for an EGD today. Let me write that down, now I'll put my binder back down (on nasty room surfaces) and write "EGD" under the "Today's procedures/surgeries" blank. RIDICULOUS.
    jadelpn, anotherone, and Meriwhen like this.
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    Quote from nurseladybug12
    We are supposed to do bedside report, but we do report outside the room on everyone then we take a walk in to see everyone,introduce them to the new RN, show them their IV,wounds, etc. let them get a quick look to see if we had forgotten to mention anything etc.
    Now THIS I can see working in psych: discuss the nitty-gritty out of earshot of the patient, then bring the oncoming nurse in for an intro, look-see, update and to address any issues.

    Since I always make rounds at the start of my shift to introduce myself to the patients and check on pressing concerns, to do this wouldn't really be any excess time spent...at least for me anyway. I may just have to do it a little earlier, that's all.
    Last edit by Meriwhen on Feb 15, '13
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    Ours has been mandatory for a while now, but not many RNs do it the way they want us to - with pulling up two chairs at the head of the bed, involving all the family members in the healthcare team, and answering all questions/comments/concerns.

    Previous posters have listed a lot of reasons why - patient requests (not questions - I'm happy to answer questions, I mean things like "I want a blueberry muffin for breakfast today"), coworker tardiness, and so on. I've found, as a compromise, that giving a detailed report in private is best. You can include details like, he likes his pain medication to be offered but he won't ever ask for it, the wife is demanding and rude, etc. THEN, we go say hello to the patient and give a CURSORY exam. For example, look at this dressing, see the drainage on it? I had to reinforce the IV dressing last night, but it looks ok now, check it out. And so on.
    jadelpn likes this.


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