Bedside Shift Report

[Seasoned]

In the words of Dr Phil: "How's that work'in for ya?"

• Violated any HIPAA laws lately?
  
• Patients, family members, blasted you with tangential comments / questions or issues discovered that hold you there much longer than you should stay?
  
• Sneaky off-going nurses use it as a way to get help to do some last minute nursing care?
  
• Managers refuse to acknowledge or problem solve the glitches (of which you discover there are quite a few)?
  
• Works for medical units where the patient is 98% of the time in a bed but not in a psych unit setting where the patients are usually in grouped activities together?
  
• Drawn that bedside curtain that is supposedly magically keeps the other patient in a semi-private room from hearing his roommate's business?
  
• Is the best thing since apple pie, the river-of-denial style?
  

Please, I invite you.

Weigh-in with your opinion, trials and tribulations on this thread...

[ICULINDA]

I agree that it works great in a ICU setting. If getting report from some nurses on my unit I will only get report from the bedside. I insist on it simply because in the pass the nurse had no idea what side the lines where on, vent settings, what drips where going at,etc. so it gives me a chance to verify on this info and do a quick look at me patient before getting report on pt number two. Other times report is done right outside the room. One thing that is a must for me is looking at the EMR while getting report. And verifying restraint orders.

Sent from my iPad using allnurses.com

[beckyboo1, BSN, RN]

I seem to be in the minority but I like bedside reporting. And if it's the 2nd or 3rd day I've had the patient, it goes pretty quickly. Could be that it's better because at my hospital, we have all private rooms. Our patients really like that we do bedside report. We also have dry erase boards at the bedside with what diet they're on, what tests are coming up, expected discharge date and who their nurse, tech and doc are.

[HyperSaurus, RN, BSN]

The previous floor I worked on (med/onc with tele) implemented bedside reporting a few months before I left. I had mixed feelings about it. We would usually cover sensitive information such as social history, prognosis, and test results outside of the room (semi-private rooms) and just go over plan of care and updates at bedside while introducing the on-coming nurse to the patient and looking at dressings/wounds. We were supposed to round an hour prior to shift change telling patients that report is in an hour (or less) so, would they like to use the bathroom/get water/pain meds now? We were usually only compliant during the weekdays (when management present), otherwise, bedside reporting had mixed results. For us, it did shorten the length of report by cutting down on chit-chat and rehashing of everything that was already on the report sheet, but sometimes patients would monopolize our time with 'storytime' or a bunch of requests.

[applewhitern, BSN, RN]

I would only like it in the ICU setting, and only if it is a private room. I would be upset if I were a patient in a semi-private room, and the nurse was giving report where anyone could hear my private information. I work in ICU; we give report at the desk, and all the nurses take report on all the patients. On our medical-surgical floors, same thing, all the nurses take report on all the patients, in a secluded area with the door shut. You might get report on 30 patients~ you could never do that at bedside.

[Here.I.Stand, BSN, RN]

I am an ICU nurse and I agree it's helpful in our setting. That said... Our policy is bedside report, but nobody follows it to the letter. We do the full report in our alcoves or at the desk; then we go into the rooms, introduce the oncoming nurse, check the drips, do a neuro check together, do a quick skin check (especially helpful for our multiple traumas--here an ex fix, there an ORIF, everywhere an abrasion abrasion). But yeah our policy is also not to ask family members to leave. NO WAY am I going to mention our 21 y/o's suspicious penile discharge, or fill them in on family dynamics issues in front of their visitors.

I worked at an LTACH for a yr and a half, and during that time we started using COWs (computers on wheels.) We were supposed to do a "rolling report"--i.e. bedside. Uh, no. On the day shift we had 4-5 pt's, and the assignments were frequently such that those pts would be split up among 2-3 nurses for the night shift. So did the night shift each have 2-3 pt's, you might ask? Nooooo. Night RN would GET report from several day shift nurses. It would have been logistically impossible to do bedside report in the half an hour we got to do it in. Especially given that, if you know anything about LTACH populations, they have had long courses and are extremely complex. Sometimes it took longer than half an hour even just giving it at the desk when so many nurses had to connect with each other, wait for the ones we needed to talk to to finish up with the one they're talking with now... Uh, no. Wouldn't have worked at all.

[Morainey, BSN, RN]

I used to really, really hate bedside reporting, but I've cut it down to what most people here are saying - a quick hello to the patient, and a more detailed report in private. We have had a couple of instances where codes/rapids were discovered long after the nurse came on duty and didn't get to that person until 0830 or whenever. I think it's good for both nurses to lay eyes on the patient. It holds us accountable.

[canigraduate]

I like it in ICU, tolerated it in Med-Surg. Caveats being when I follow a crappy nurse who wants to do her dressing/line/tubing changes at shift report. (Big, fat NO! You can finish after report, I can read your charting later.)

Where I worked in Med-Surg, the expectation was that on day shift you rounded the hour before shift change and told your patients that you wouldn't be available. You did let them know you would bring the next nurse in to introduce them and get them familiar with their care, but that was it. It worked pretty well. On night shift, I would ask the patient the night before if they wanted to be woken up, and skip bedside report if not. We still snuck in to check IV pumps, but let the patient sleep if they wanted. If there was family in the room, we asked them to step out.

[DookieMeisterRN]

I used to really really hate bedside reporting, but I've cut it down to what most people here are saying - a quick hello to the patient, and a more detailed report in private. We have had a couple of instances where codes/rapids were discovered long after the nurse came on duty and didn't get to that person until 0830 or whenever. I think it's good for both nurses to lay eyes on the patient. It holds us accountable.[/quote']

This.

[TnRN43]

Hate it. With a passion. 5-6 pts? Nope, 7. We are also supposed to be doing bedside reporting. If we actually did it? In reality it would be almost 8 before night shift left and I got started. We are a med surg floor with alot of high acuity and totals. And several pts always needs a bedpan, drink, pulled up, or get into the conversation and ask questions about what we are talking about and what the plan is and when will the doctor be here and on and on. THAT is the reality on my floor. No thanks.

[BluegrassRN]

I work on an acute care floor, nights. Usually start the shift with 3-4, end with 5ish pts. I do beside report 95% of the time. I prefer it. I am always out on time. We have private rooms, fyi.

I love it because I've eyeballed my pts by 7:20 at the latest. I then use the next 15-20 minutes to look up any information I didn't get in report that I want, then I start my rounds. Usually have at least 2 pts assessed with assessments charted by 8pm. I rarely have any issue with bedside report (pt interrupting or requesting bathroom assistance, etc). I usually ask visitors to step out, and if the pt chimes in and says they can stay, fine.

Everyone hated it when we first started. Now about 50% of the people hate it. Mostly the older, more experienced nurses, it seems. Maybe because the newer ones haven't experienced anything else at our hospital. I actually hate when I float to other floors and the nurses refuse to do bedside report (they are supposed to).

[ICULINDA]

Our policy is no visitors back during shift change, actually from 6-8, I work in a close ICU unit.. If visitors are already back we leave it up to the nurse to let them stay or leave, of course we only allow 2 back at a time unless the pt pass away or are doing comfort care, for the most part visitors leave during that time and come back. We try to keep them updated at all times. same goes for phone calls, the UC will tell them to call back after 8. Our team of docs do bedside rounds outside the room then go in and assess and discuss plan of care.. We are a teaching university as well so a team of docs could be 5-6 peeps. Rooms can get crowded with vents, CRRt, IVs,etc and ppl piled in for report. If looking at the EMR while getting report and you find a the nurse hasn't done a task scheduled for 7 or say 630 do you ask them why they didn't do it? Especially if the pt isn't a super busy pt. Or why they didn't chart certain things or just let it go?

Sent from my iPad using allnurses.com

[canigraduate]

Our policy is no visitors back during shift change, actually from 6-8, I work in a close ICU unit.. If visitors are already back we leave it up to the nurse to let them stay or leave, of course we only allow 2 back at a time unless the pt pass away or are doing comfort care, for the most part visitors leave during that time and come back. We try to keep them updated at all times. same goes for phone calls, the UC will tell them to call back after 8. Our team of docs do bedside rounds outside the room then go in and assess and discuss plan of care.. We are a teaching university as well so a team of docs could be 5-6 peeps. Rooms can get crowded with vents, CRRt, IVs,etc and ppl piled in for report. If looking at the EMR while getting report and you find a the nurse hasn't done a task scheduled for 7 or say 630 do you ask them why they didn't do it? Especially if the pt isn't a super busy pt. Or why they didn't chart certain things or just let it go?

Sent from my iPad using allnurses.com

Depends on what it is. I usually just ask them about it while they're with me. If it's a late daily medication, then I usually do it myself. A lot of the time it's something that just hasn't been charted yet even though it's done. I never "let it slide", by which I mean I always ask, even if I have to call the nurse at home later. If it's something simple, I'll take care of it myself. If it's something major, we have a little chat and I escalate if necessary.