Bedside report - page 4

by jrwest 7,706 Views | 41 Comments

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... Read More


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    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!?)
    wooh likes this.
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    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
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    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.
    anotherone likes this.
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    Quote from 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!
    .
    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.
    jrwest likes this.
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    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! :/
    jrwest likes this.
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    Quote from mappers
    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
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    how does the ed mess things up? just curious. we do bedside report at the ed i work in. (please excuse grammar)
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    Quote from Roseyposey
    ....I think it could be embarrassing and perhaps frightening for a patient to hear that twice a day. "This is Mr. Smith, he is a 68 year old DM2, with a history of ETOH abuse, schizophrenia, hypertension, MI, etc, etc, etc. He had a left TKA yesterday and because he is on daily pain medications, he has needed x, y, z, for pain management and rates his pain at 15/10. His latest labs show a whole lot of crazy scary stuff that his doctor hasn't reviewed with him yet, and it is really freaking him out to hear me tell you. I put in a call to Dr. Important regarding his total lack of urine output, but they have not bothered to call me back. We are waiting for a social worker consult before discharge because his (insert family member) is believed to be stealing his pain meds and unable to care for him at home. Let me just keep saying a whole lot of stuff that you really need to know, but is scaring and angering Mr. Smith at the same time, blah, blah, blah." Awesome customer satisfaction scores or incomplete reporting? I guess that's our choice.
    LOL, my thinking EXACTLY!

    How, precisely, are nurses supposed to convey information like "Mr. Smith has Stage 4 lung CA, mets to everywhere, and about 15 minutes to live---we sure wish his doctor would mention that to him, but Doc has been away skiing and plans to tell the family when he gets back sometime next week."

    And let's not forget "keep an eye out for any visitors trying to get in to see this patient here....he's been caught having various people attempting to slip opiates to him. If you can't head off visitors, you should be sure to keep the crash cart handy...."

    And don't miss out on "Mrs. Jones is completely lucid during the day, but sundowns so badly at night you'll wish you could posey her to the bed like we used to. But as it stands now, she isn't aware of the problem and family refuses to accept that there IS a problem, but don't worry, a social worker might be in to see them sometime in the next day or two. Meantime, for your nightshift, prepare to have this perfectly lovely lady swinging from the sprinkler heads by midnight!"
    weemsp, wooh, and jrwest like this.
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    ^^^^^ good one !
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    Omg I hate that I had to revisit this thread, but now we are 1) being told we are to WAKE UP the pt so they are interactive in the report (????????), and 2) that we are not to be having ANY overtime due to this- if we do we will be written up.
    How is waking the pt up going to help satisfaction scores???
    It's a no win situation.

    I wish I knew how to do something other than nursing


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