End of shift report

  1. 0 I work on a 32 bed telemetry unit. Up until November we were general medical/surgical. Now 16 of our beds are for cardiac monitoring. We also changed from recorded reports to verbal reports at the beginning of our shift. It is taking me on average 45-60 minutes to receive report from the 4-6 nurses that I need. The quality of the report is SO much worse than when it was recorded. I kind of feel like if it wasn't broke don't fix it.

    Management wants us not only to do verbal reports, but also go in to each room with the oncoming nurse and do report at the bedside. By the time I find all of the nurses, wait in line for her to give report to me, and go into each room to do report my 1830 shift doesn't actually get started until ATLEAST 1945...and that's not including getting pertinent information off the electronic charts.

    Does anyone have any suggestions on how to organize this process? It's taking too much time, we are all frustrated, and any suggestion would be very appreciated! thanks in advance!
  2. Visit  jekajoy profile page

    About jekajoy

    jekajoy has '2' year(s) of experience. From 'Indiana'; Joined Sep '07; Posts: 3; Likes: 1.

    15 Comments so far...

  3. Visit  rkitty198 profile page
    0
    That sucks to be the nurse trying to go home! Ugh!

    We did recorded reports and it was very hard to get the time needed to sit and record the report. Then I would go find my nurse getting the recorded report who would sit there and listen and rewind, listen and rewind, and then come to find me only to ask me basically to give report again.

    I think if it recorded report worked for your unit, then stick with what works!
    Didn't work on mine, but if anything worked to get me home faster and get report more efficiently I would do it.

    How long have you been doing it like this? I would get with your co-workers and complain.
  4. Visit  Flo. profile page
    1
    My unit switched from recorded to verbal. They are now trying to switch to bedside report. I think your unit is trying to do too much too fast. You should just be doing verbal now and once the unit gets used to it then switch to bedside report. I really prefer verbal report. I get to ask questions and clarify info right there. In time you will all get faster.

    My manager said it is a new JACHO initiative so I doubt you will be able to convince your manager to let you go back to recorded report.
    Chin up likes this.
  5. Visit  ticklemenita profile page
    0
    We have the same thing at our hospital. From what I see what makes it go smoother is when they do assignments they try to hand over the entire team to the same nurse. When some people get discharged and that is not possible the on coming nurse usually only has to find one other nurse which makes it easier. As far eaving on time. They started mandatory over time which is 15 min before and 15 min after each shift so that makes it more likely that the nurses will do the in room rounding since we can't clock out anyway. As time went on people got better at it.





    Quote from jekajoy
    I work on a 32 bed telemetry unit. Up until November we were general medical/surgical. Now 16 of our beds are for cardiac monitoring. We also changed from recorded reports to verbal reports at the beginning of our shift. It is taking me on average 45-60 minutes to receive report from the 4-6 nurses that I need. The quality of the report is SO much worse than when it was recorded. I kind of feel like if it wasn't broke don't fix it.

    Management wants us not only to do verbal reports, but also go in to each room with the oncoming nurse and do report at the bedside. By the time I find all of the nurses, wait in line for her to give report to me, and go into each room to do report my 1830 shift doesn't actually get started until ATLEAST 1945...and that's not including getting pertinent information off the electronic charts.

    Does anyone have any suggestions on how to organize this process? It's taking too much time, we are all frustrated, and any suggestion would be very appreciated! thanks in advance!
  6. Visit  NaKcl profile page
    0
    It has the good and bad side of bedside reporting.

    The good side is you get to have quick assessment done during the report. check their IV site, surgery site, pain scale and etc. especially, if the patient is overweight, you can turn him/her to see the site, the reporting nurse can give you a hand.

    The bad side is it can violates patients' privacy when you are in a double occupancy room. The other patient can listen to the other patient's personal history.

    they are adding new stuff everyday to already hectic nursing work....
  7. Visit  jekajoy profile page
    0
    Quote from Flo.
    My unit switched from recorded to verbal. They are now trying to switch to bedside report. I think your unit is trying to do too much too fast. You should just be doing verbal now and once the unit gets used to it then switch to bedside report. I really prefer verbal report. I get to ask questions and clarify info right there. In time you will all get faster.

    My manager said it is a new JACHO initiative so I doubt you will be able to convince your manager to let you go back to recorded report.

    I really just want some ways to make it better. Maybe a designated area to find the oncoming staff. Maybe only 2-3 RNs maximum to report off to. Last night I had 6 to report to before I could leave. The quality of the reports are horrible. You don't get a clear picture or any sort of pertinent hx that would be important say....if the pt codes and the MD needs certain info.

    We aren't getting done with report until and hour after we get there. They have also made it so that the RNs get the entire set of vitals at beginning of the shift. I'm thinking the techs could safely get everything except for blood pressures, since it is a cardiac type flood. Any other suggestions to you guys can think of? We can't do glucose checks until 0600 per management, but we are supposed to be ready to report at 0630. I&Os, PCA checks, all accuchecks, and all 0600 meds to be done no later than 0630.
  8. Visit  ErinS profile page
    2
    Joint Commision has mandated that hand-offs must involve the opportunity for asking questions, hence the change you are seeing. I actually have always given verbal report. The two biggest things- limit the number of nurses that need report (so like a previous poster said, pass a team from one nurse to another, not from one to 6). The other thing is everyone got and gave report from the same 'brain'. Our computer system actually printed a report sheet. This made it so all the nurses were reporting the same thing. An inservice reviewing important information to give during report may help: reason for admission, important hx, any events, i/os, activity, meds, pain, vs. Good luck!
    colzanurse and SandraCVRN like this.
  9. Visit  danh3190 profile page
    0
    We sometimes do verbal reports when we don't have time to record. I hate having to track down each nurse for verbal. It takes so long. When we tape, we generally ask the oncoming nurse if they have questions before we leave, which works well. One thing I've noticed in a lot of verbals is that there is a lot of chit-chat in addition to report. Probably if both parties were in a hurry it would go faster.
  10. Visit  carolmaccas66 profile page
    1
    I had a recorded report that went on for nearly an hour one day. Report should only take 15 minutes maximum, if that. I told the NM and CN this takes waaaay too long. Most of it was info that did not need to be on the tape - we had much of the info on our pre-printed handover sheets.
    Do you use the pre-printed handover sheets with info on them? They save time, also call a meeting with everyone (if possible) to discuss this, and also let your NM know - maybe she isn't aware of the situation.
    colzanurse likes this.
  11. Visit  rkitty198 profile page
    2
    I had one annoying nurse ask me to "draw a picture" of the patients abdominal incision! Shoot I told her "go do your assessment and see it for yourself!
    turnforthenurseRN and xtxrn like this.
  12. Visit  Altra profile page
    0
    Quote from jekajoy
    Maybe only 2-3 RNs maximum to report off to. Last night I had 6 to report to before I could leave.
    Why in the world is this happening on a regular basis? What is going on with patient assignments that it is necessary to break up an assignment to that extent? I could see flipping a patient or 2 ... but 6? No reason for it, unless I am missing something major.
  13. Visit  xtine618 profile page
    0
    I agree with the others. You should only be reporting off to 2-3 different nurses instead of 6. One thing that helps is if you're waiting for someone to give you report, read the H&P. Also, make sure your report is organized. Maybe organized from head to toe or by body systems, like you would for an assessment. I would also suggest that nurses who work several days in a row be given the same team as much as possible. This allows for continuity of care too. And besides being face to face, what is the difference from taped report? Are there a different number of nurses from the oncoming shift to the leaving shift? Because if there are the same number of nurses, there shouldn't be too much waiting around. Are patient assignments already done by the time the oncoming shift arrives, or is that something that the oncoming shift has to do before they receive report? Because it's more efficient to have patient assignments already done.

    I think this should be an important topic for your next staff meeting. Perhaps someone could come up with a Do's and Don'ts list for effective and efficient shift report. Good luck. You will get used to it and maybe even like it a lot more than taped report.
  14. Visit  MunoRN profile page
    1
    Quote from Altra
    Why in the world is this happening on a regular basis? What is going on with patient assignments that it is necessary to break up an assignment to that extent? I could see flipping a patient or 2 ... but 6? No reason for it, unless I am missing something major.
    I've also had to give report to 6 nurses when working tele, which certainly isn't ideal, but believe it or not it is sometimes the best option.

    By far my least favorite thing about relief NTL is making assignments. Every nurse wants an assignment that is no heavier than any other nurse's, they want all their patients back (except for the ones they don't want back, which we are just supposed to know who those are), they don't want to walk too far, and they want to get report from only 1 nurse. For the most part, this can't all be done, not even close.

    It may be easier on floors with more long term patients, but the average stay on our tele floor was 26 hours, making it pretty unlikely that yours or anyone else's assignment would not have changed when you come back for the next shift.

    We could guarantee reporting to only 1 or 2 nurses by defining assignments in terms of room numbers. We do have an NTL that just assigns by room numbers (Nurse A gets the first 5 rooms, Nurse B gets the next 5, etc). Of all the varying preferences people have for how their patients are assigned, this method is universally despised, mainly because we put all of our open hearts on the same hall and our heaviest (non-OHS) patients on another, meaning you could end up with all 5 open hearts or the 5 heaviest patients on the floor.

    My first goal is to even out the acuity, second is to give nurses back the patients that they know, third is keep them reasonably grouped together, leaving the number of nurses they report to last on the list; it's a consideration, but not my first, second or even third. (I could go either way with grouping the patients together vs number of nurses to get report from, but if day shift had their choice most would rank the proximity of their rooms to be at least the second highest priority).
    colzanurse likes this.


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