Bedside report

[martymoose]

I know there are many posts on this subject. We were just told we WILL be doing this under no uncertain terms. We have semi private rooms. We have dementia pts,confused people , psych pts, drug seekers, etc now. How is bedside report going to help them feel like a special snowflake when they arent even able to participate in the report, yet their room mate probably will know more about them then they do.

Are all hospitals going to this crap, or is it just "magnet" ones? More like opposing magnet.

oh, and when iI read prev. posts that " oh we just give the abbreviated versions in front of the pt ( so i guess they can feel all warm and cozy inside that we chose to include them in their" plan of care , lol), we have also been told NO- we will the the WHOLE report in the rooms- there are not to be any nurses out at the nursing stations sitting down. And we will also be having senior management personel following us around and critiquing our reports.

Gee, if I wanted to become an actor, I would have gone to school for that.

Any thoughts??

[martymoose, BSN, RN]

THAT is the one weapon you have. Make it take longer. Once the incidental overtime starts adding up, and this idiocy costs money, only [/Quote]

One of the more "senior" nurses did bring this up. I guess we will just have to make sure we are "thorough" in our reports:sarcastic:.

[martymoose, BSN, RN]

Ok found it online- per studor :

#9)If the patient is non-compliant, then the off-going nurse should not say “uncooperative” to the oncoming nurse. You could say “He/she was

informed of …but the patient chose to disregard and …..” “I have

explained that if he refuses to use the walker for assistance, the likelihood

of a fall and injury increases.”

Oh and I guess this "addresses" the hipaa thing lol:

# 8) If visitors are in the room, explain that you are doing the Bedside Report

and ask the patient if he/she wants them to step out. You should say “We

will be talking about your condition and your progress this past shift. Since

we want to maintain your privacy would you like your visitors to step out

for this report?” If there are concerns about the patient being able to

answer this honestly with visitors in the room, ask the patient during the

shift when patient is alone.

I mean, this all looks so good and proper on paper, but the reality is going to stink.If every nurse was cut from the same mold, maybe this would work. Well since report will take longer, I guess I will enjoy the extra money LOL

[wooh, BSN, RN]

Nurse A: The patient has chosen to disregard using his walker...

Patient: What do you mean "disregard"???? I'll give you something to disregard!!!!!!!

Imagine all the healthcare that could be paid for with the money hospitals give to Studer, Press-Gainey, etc. to make nurses' lives miserable...

[pamelalayn]

My facility tried that crap. Going room to room and talking in front of the patient. How would you feel if two people were talking about you in front of you. This also puts us in a pickle when they stop and say what is this that etc. We cannot interpret and this has put staff in situations with patients and their families for many of the reasons listed by others on this post. We get report at the desk then do a walk through to check on the patient. This is more than efficient. I have no clue why we would be discussing their labs tests etc. in front of them. The doctor is the person to discuss this.

[mom2cka]

I'm currently on a handoff taskforce (the precursor to bedside report, it seems) and we're discussing using Epic (our EMR) to indicate the sensitive things so we can get the "talking" piece of report done quickly... the labs are evident in the computer, the braden score, fall risk, code status, precautions, problem list shows history, last vital signs are there, etc. We need to take advantage of our technology, but this shift in thinking away from the kardex - write every last thing down on paper so you can report it off to the next nurse - will be very difficult for many of our nurses (new and seasoned...) it should be interesting!

on the other hand - as a nurse, a mother ,a daughter, and if I was a patient - I would wonder why are the nurses saying things that I cannot hear / should not hear? I think it can be done, but we need to put aside the defensiveness and begin to see it as a patient safety issue. We may not like the world we're in (patient satisfaction driven) but I am proud to be at a Magnet hospital and be part of the planning process for changes like this - I'd rather have my input be an integral part of the change, and help my colleagues with that, than to be told what needs to be done, knowing that there wasn't input from the floor staff.

[martymoose, BSN, RN]

Nurse A: Mr Smith has chosen not to acknowledge that his doctor will not write him anymore orders for IV dilaudid'

Mr Smith:you better get me my pain meds!!!!!!!!!

LOL

Oh we could have so much fun with this part.

Nurse B: Ms Jones has chosen not to eat the prescribed diet here, and has had her family bring in 2 big macs and a large order of fries, with a coke, so her Bg"s have all been off the charts......

LOL

[anotherone, BSN, RN]

Why is it our concern what the ot thinks we might be saying in report? should drs phone in consults in pts room? " Hi infectious disease dr, this is internal medicine on a pt shooting up heroin with and ID . will need iv abx , please advise" and to care mamager this is a walkie talkie 24 year old . will need picc , can not go home as pt with manor hx of ivd abuse. please advise" yeah sure. inmight say it in front of them. it is what it is. but jt wont help pt satisfaction scores . for some pts this super easy and fine to do at bedside. but those are usually the pts no one would have an issue with bedside report. what about pts in isolation? how is that handled ( writing stuff down!?)

[anotherone, BSN, RN]

bedside report is being more enforced with "secret spies" . most of the staff are sheep afraid to go against it. so i gave bedside report. and i am not going to waste time. do i say kindney labs are worsening or leave it out and let the other nurse look it up? i will not be giving two reports on every pt. i gave a full report like i usually do. ugh. i dont have a problem checking lines , dsgs etc. but i will not be tip toeing around . pt here with ams has not been taking meds for bipolar hx . if that is too sensitive than too bad

[martymoose, BSN, RN]

bs report ( lol bs) sucks- the last two reports 2 things have been missed by the nurse giving report. i wonder if we should write those up. but then i am narc- ing on myy fellow nurse who would be just fine giving report if it was done the normal way.

Hospitals can bite it.

[nureli]

I'm currently on a handoff taskforce (the precursor to bedside report, it seems) and we're discussing using Epic (our EMR) to indicate the sensitive things so we can get the "talking" piece of report done quickly... the labs are evident in the computer, the braden score, fall risk, code status, precautions, problem list shows history, last vital signs are there, etc. We need to take advantage of our technology, but this shift in thinking away from the kardex - write every last thing down on paper so you can report it off to the next nurse - will be very difficult for many of our nurses (new and seasoned...) it should be interesting!

.

We just switched 2 weeks ago to Epic and do / suppose to do bedside report. Epic educators tried to say we shouldnt be writting report any longer. It will be a while before most of us give up our brains in our pockets!. The handoff report screen is ok. Kinda busy and so far as I can find it isnt all on one screen you have to go to 2 or 3. So bedside report for 6 patients logging onto the computer in each room takes forever.

And for those "special snowflakes" (love the term BTW I too will probably be stealing it). We finish that segment of the story in the med room or outside the door depending how special they are.

[WoosahRN, MSN, RN]

I know I'm just saying what everyone else has but I abhor the idea of bedside report . I work PICU. My main hospital doesn't do it (fingers crossed) but I worked PRN in a Peds/picu combo unit and they started implementing it. What a pain in the ass. Every report was glossy for the room while the parent just stared at us and we smiled back oh so charmingly and then when we left the room added all the stuff we couldn't say in front if the family (like, 'that mom is completely nuts'). I left that hospital not too long after. It was just the thing that pushed me to that decision. I can only imagine how it would go at my main hospital where we have higher acuity. Almost every kid has a social work consult and I can't talk about that in front if the family ("social work and CPS has been contacted because of history and suspected non accidental trauma this time. Police have been notified as well"). Or imagine that possible diagnosis that isn't confirmed (suspect leukemia but not confirmed). Or even the family that tries to hide the diagnosis from the kid (oh yeah, that happens). This isn't even going into the interruptions and questions people might have in the middle of report. Basically we would be dumbing down any medical speak so the parent can understand it. And because parents are involved there is ALWAYS a "social report". "Mom is at bedside. Her and 'dad' are not together and fight in the room when they are both in there. Dad is very passive aggressive with staff. Makes care difficult. TL is aware and family has been talked to multiple times." And of course all the CPS, custody, foster situations. Ugh, I could go on and on and on. We do go in the room and double check drips, drains and IVs so there's your safety. I don't understand what a lot of these families would get from bedside report especially since they do rounds each shift (we include families in those if they want) and we keep them pretty up to date. I'm getting ahead of myself since we haven't implemented it yet but it feels like a matter of time. I feel for you OP! :/

[chare]

MunoRn, do you have documentation for what you're saying? I find it interesting as management likes to say that evidence shows bedside reporting as superior.

You might want to review the following:

Riesenberg, L. A., Leisch, J., & Cunningham, J. M. (2010). Nursing handoffs: A systematic review of the literature. American Journal of Nursing, 4(4), 24-34. http://dx.doi.org/10.1097/01.NAJ.0000370154.79857.09

Staggers, N. & Blaz, J. W. (2013). Research on nursing handoffs for medical and surgical settings: An integrative review. Journal of Advanced Nursing, 69, 247-262. http://dx.doi.org/10.1111/j.1365-2648.2012.06087.x