Giving Report! Ugh!

[AKA_Glamour_Pearl]

i know this is a dumb question. well, at least it feels like a dumb question. i'm a new rn. when i'm giving report, i feel like i'm in a contest to tell the most extravagant and lively story. most of the nurses that i hear can give a 3-5minute report on one patient. report takes forevvvvvveeer. then when it's my turn to give my report on the patient it's half a minute and if something major occured, then it may be a full minute. it just always feels too short and no one appears to be really listening to me. they just say "ok" after my 30-45 second spill.

today i gave report and i knew that it was comparable to what the other nurses do because i was animated, and i threw in a few exaggerated comments about "how rough" it had been. i had everyone's undivided attention. they seemed interested in my every word. they made eye contact with me and asked questions about the patient.....but that's not the kind of report that i want to give. i want to give the information that i feel is important and keep it short and sweet.

i don't want to give report that is like "woooooooo, what a night. do you have the patient in room 113? well, let me tell you about the crazy man and his little crazy wife that won't leave. she makes you spell the names of all the medications and she writes them down and looks them up before you give them. then mr. crazy man will take each pill one by one. if you smell a funny scent in the room it's his wife's feet. last night she asked the nurse aide to give her a bath too. mr. crazy man pressed the call light a million times and he said he just wanted to see if it worked....

in nursing school when we gave report we used sbar. it seems like sbar is not really at work anymore in the actual setting. i don't know. i just feel like the new nurse reciting the facts....where the iv is, the condition. pain level and methods of pain control, times that major things occured during the shift, if the physician was called, lab values, if the patient ate/voided (how much/color,) etc. i guess that's boring information that the oncoming nurse can look up if she wanted. i guess.....

i just want to give the information that is essential, not tell a "story" for 6 or 7 patients every shift.

"woooooo. let me tell you about patient #2 in room 116. get ready for this one...."

if i'm supposed to tell a dramatic story, please let me know. that's just not how they showed us in school... it didn't take an hour either. how absurd? or maybe that's common..... i don't know.

when you're receiving report, what information do you really want?

[AKA_Glamour_Pearl]

Thank god we only give verbal reports for unusual cases/rought shifts. The rest is left as written report sheet and most of the time I wait to see that the oncoming nurse arrived and leave!

Wow! I wish we did that! I did clinicals at two facilities where the nurses would tape report and the oncoming nurses would listen to it. I thought that was GREAT! It would certainly save time! I think that someone said that it would be patient abandonment to do that and not wait to formally give report though. I guess every facility is different. It would certainly save money on overtime too! I always have overtime. Overtime is nice, but going home on time is priceless, especially since I have an hour long commute!

[WillowNMe]

In my acute care job, we record on the phone and the max is around a min and a half. Some people go over, some are less, but mine are about a min in length. The oncoming shift listens, if they have questions they ask, then we're done. Nothing fancy.

[Orange Tree]

We use hand off sheets, although a verbal report is still given. I cater my reports to the person I'm giving them to. I'm chatty with some people and very direct with others. I also let my expectations (or non expectations) when taking report be known. Everybody knows that I don't give a **** if an IV is in the left wrist or in the right AC, I just want to know if the patient has IV access.

[xtxrn, ASN, RN]

Can you imagine the administrators' faces if Joint Commission was doing their inspection and asked a nurse about how they give report, instead of parroting off the whole SBAR spiel they said "Well to ensure a safe patient handoff, I always use BFMRDS! (pronounced, "buff murds," of course.)

:lol2:

[Jenni811, RN]

If it is someone i had before, or have had them for a while just tell me the new things that occured over the previous shift.

If it is someone new, or i never had before, i usually just care about where the came from (i.e. home/nursing home etc.) just because if we are looking at discharge soon i know what kind of paper work has yet to be done etc. ALl i really care about is something like "Joe was mowing his lawn yesterday and developed chest pain. he called 911 and was brought to TEC. An EKG was done and there were no changes. Chest pain went away with nitro. Underwent a cardiac cath in the right femoral. A stent was placed yesterday. Pulses are 2+. no hematoma, no signs of bleeding or infection."

^example of my made up patient "joe" and pretty much the only things i care about.

I listen to other things like "His INR is 5.4 so we are going to hold the coumadin tonight" things like that are important.

But i could care less about how his wife has smelly feet and her socks didn't match. Then Joe's wife went to KFC for dinner because the hospital food was grosse and joe wanted KFC and the doctor said he couldnt have KFC because of the salt. So the CNA ordered Joe some chicken from the kitchen with some seasoning so it tasted to KFC but it wasn't KFC. His wife tried to sneak him some mashed potatoes and gravy from KFC but the gravy spilt on her purse. her purse then smelt like gravy.

^that stuff i don't care so don't tell me. i got 30 minutes to get report so get down to what is important.

[nurseprnRN, BSN, RN]

money drives a lot of management decisions. so: start putting in for overtime. i mean it. when they squawk, tell them it's because report lasts so long. you are entitled to ot if you are required to be there, and since you can't leave until report is given, there's your time.

if your management isn't listening in on report, invite them. then after they catch their collective breaths, offer to ask the staff development people to give a brief refresher on how to give report and ditch the commentary. meanwhile, go back to "just the facts, ma'am," and consider you're doing a favor to the off-going shift who wants to go home on time. as new hires, floats, or travelers join your merry band, take them aside and tell them to keep it short, too. eventually it will come around. but ot will drive it.

[nyrn5125]

did you say your'e done a minute but they take 3-5 min when you come on shift?. That means that you get out quicker when you hand off. Hurry up and go home. If they aren't listening that is their problem. Anyway what my facility give to the nurse coming on is a report sheet with some of what I give them verbally in report so they don't have to write, they just have to listen.

Verbal report example: pt Smith 80 y/o of Dr W. came in 8-27 for right fem pop bypass. Has a history of COPD, PVD,DM,cabg,ICD/Pacemaker.

surgery was done on 8-28. pt was hypotensive post op. 80's systolic and received 500cc ns bolus. On the 29th he received 2 units of prbc for h+h of 7.0/25.today h+h is___

pt a+o x3. 2l nasal of o2, sats are 97%. lungs clear, right leg with staples/ covered with gauze dressing, doppler pulses, extremity warm, b/l leg edema right >left. legs elevated on pillow, NS @50cc/hr, IV from 8/29. His blood sugars are ACHS. order in chart to keep SBP over 100 and less than 160 parameter. Dilaudid for pain q3hours, arterial line right radial correlating to cuff pressure. pt needs encouragement to use incentive spirometer. oob to chair today with assist of 2 and walker. plan is to increase activity, mange pain, wound care.

[That Guy, BSN, RN, EMT-B]

I read my brain from left to right, then add any things not covered or anything that was weird for the night.

Name, allergies, code status, admission reason, Hx, IV site/fluids, O2, PT/OT, morning labs to draw, diet, activity, sticks/slides, tests/procedures that day. Thats the main bit that I want.