Bedside report - hate it? Like it? Love it?

[ixchel]

I had the worst experience in a very long time giving report this morning. My unit requires bedside report, which I actually love. Apparently a recent new grad hire hates it. Waited until 15 min into her shift to even try to get report.

She came to room #1. Parked across the hall and silently waited. I called her in, we got started. Shortly into it (I mean, I had just finished saying background info), newbie nurse turns the patient's lights off and leaves the room. I looked up and saw the patient was confused, too. Nurse says the patient was sleeping. Patient denies it, which was obviously more than enough evidence to verify the patient was, in fact, awake.

Finished up (at the bedside), went to #2. I walked in the room thinking she was right behind me. She definitely was NOT. Once again, butt hugged the other side of the hallway, just waiting.

The thing is, not only was today an accreditation visit, but these two patients were extremely complex, both unstable, both with multiple skin "things" going on. #2 had had an RRT called on her a few hours prior. Lots of stuff going on there!

And, bedside is required!

Room #3, she took the lead on introductions, and then actually told the patient we would be leaving the room to do report in the hallway. I stopped her the doorway, told her this patient actually prefers report at the bedside and reminded her that bedside is required on our unit (and management was crawling all over the place tidying things for our horrible, day-destroying visit).

She came back in. Patient #s 3 & 4 were quick and easy, so we were done there quickly.

Personally, I absolutely love bedside reporting. When the situation is inappropriate, I may opt out of it, but I love getting to visualize and verify the patient is alright.

So, me, I vote love it. I also think if you have opposite feelings of the person you're sharing patients with, whichever one of you is giving report should choose location if you are able. If you have had that patient all day long, you know if that patient is appropriate to include.

What do you guys think and do for report?

[NOADLS]

Really depends on the situation. For the majority, I don't think it is a good idea. Takes more time. I should be able to interpret verbal report and ask the necessary questions which is enough in most cases.

If I am in a spot where I need to know more or need specific clarification on something, it would be helpful.

The tl;dr - only do it to save time; don't do it if it will take up more time

[Farawyn]

Hated it. The nurses and I would often go in to a room together to eyeball the patient if further clarification was needed after report. I liked the privacy of report at the Nurses' Station, I felt it was encompassing, and it was faster.

[mrsjonesRN]

Our facility does "bedside rounding." We get report at the desk on all of our patients, then we go to the patients rooms and introduce the oncoming nurse, verify drip rates, bed alarms, etc.

I've been to a facility where bedside reporting was done and the patients would not understand what words you were using to describe certain medical conditions then the patient would start asking questions which would prolong report. Plus if the Patient was resting, it would interrupt the patients sleep.

I do agree with rounding on patients at shift change, no matter the method. Too many errors happen and are not found for hours if patients are checked on immediately.

[nealiiih]

hate it. takes too long, confuses pts/family, and I need to be able to look at the computer and have a surface to write on while getting report. I absolutely agree with a hand off, after report to place eyes on the patient and verify gtt rates , lines, tubes etc. after report has been given.

[MunoRN, RN]

Having a bedside component of report is absolutely a good idea, doing the full report at the bedside where it's more difficult to access the chart, the EMR, or to write notes is not generally a good idea. Many nurses don't mind a full bedside report, but when nurses don't feel like they can get a good report that way, for whatever reason, it should be done however it's most effective and safe for the patient, which may often include the need to be undistracted, sitting with a writing surface, access to the EMR, etc.

[ProgressiveActivist, BSN, RN]

If the charge nurses eyeballed the patients liked they used to, there would be a direct line of accountability to the middle management and care would improve.

[FL_Nurse92]

My facility also does bedside shift report. The only reason I don't like it is because yes it makes report so much longer than it should be, it forces us to squeeze 2 computers and at times 4 nurses (nurses and their orientees) into a pretty small room, and I don't like waking my patients up at 7 am (because patients never sleep at night!) Some patients ask not to be bothered with it and I respect that.

[meanmaryjean, DNP, RN]

In peds I'm fine with the 1900 bedside, but HATE the 'entire report happens in the room' 0700 one. Because child and parent are usually asleep- and I have a strict rule about waking sleeping children. That is: I only wake sleeping children if the building is on fire.

You can never be quiet enough. to avoid waking one or the other or both.

I do see the importance of bedside CHECKS- as I have caught a couple of errors that way (mine and the off going nurse's).

[nynursey_]

I hate bedside report. I feel that in 90% of cases, it's highly inappropriate. It's a sure fire way to ensure the patient actually has MORE questions and it takes up to 50% longer to actually give report on a full patient assignment.

What I am all for is rounding after report to do a quick head-to-toe and see all the drips, tubes, and lines. It's also useful for introductions as it allows the patient a minute for closure to see that the oncoming nurse has in fact been briefed on their care by the offgoing nurse. I never, ever mind popping in to lay eyes on the patient, but I am adamantly against bedside report, and I'm pretty sure our management knows that, because the threats to enforce it have gone unfulfilled.

If the offgoing nurse keeps trying to lead me in that direction, I offer to go in AFTER report to lay eyes on the patient as a nice compromise. But I don't mind providing AMPLE examples as to why it's inappropriate. Usually, they get it, and there has never been an issue.

[ArmaniX, MSN, APRN]

I love it. It saves lives. Many times that is when you will catch a change in patient condition. If I didn't do bedside reporting I'd have to explain when the patient stroked out. But if done at bedside it then is referred to the off going nurse.

When I worked stepdown, yes it was tedious because of the fear that the patient will keep interrupting but if it happens squash that immediately and continue through report.

Now that I'm in an ICU it is imperative to do it bedside. And is less "tedious" because half the time they are not able to participate in their report. I'd like to notice fixed dilated pupils with the off going RN bedside rather than come back thirty minutes later and find them on my own.

[FL_Nurse92]

That's not to say you can't peak in on your patient, introduce yourself and say hi. Also in the ICU you have what, 2 patients? And yes half of them are intubated and essentially asleep. Believe me, things still go unnoticed, even with bedside shift report.