Registered: May 2001
Location: Oklahoma City
I am curious to know how everybody feels about walking report? They are starting walking rounds or room to room report where I am working on Sep. 1. I DO NOT think it will be confidential or prudent. They are also qualifying it by saying it is JCAHO recommendation (policy). I have several problems with the concept.
2. Inability to access pertinent data IE chart, Kardex, MAR
3. Inconvienance for the Client
4. Limitations on giving pertinent details Ex: Mentioning a Dx. HIV
in a public access area (re:confidentiality)
5. The simple fact that some people can not think on their feet
6. Tired Nurses forced to make rounds will be grumpy, hurried, incomplete, and sloppy.
7. Family members will undoubtedly interfere, interupt, ask for any number of things and be impatient to be assissted by two Nurses.
I really don't think anyone has thought this through thoroughly. Furthermore I can't see how JCAHO could possibly condone such a breech of confidentiality.
Anyone who has been using this method please enlighten me to your results and feelings on the method. I am anxious to hear what everybody thinks.
I am an Lpn working Agency D/T pay
Aug 26, '01
I can understand the confidentiality end of it...information such as HIV etc. But speaking from experiences that I've had and so have several other people who have been on the patient side.....when report is going on we were told we had to wait, or totally ignored.
I think the walking report is good because:
1. The shift coming on can SEE that everything is done as it was supposed to be, precluding anyone saying they didn't do their job completely on the shift before.
2. Will still give the patients accessability to medical or other attention as they are needed and let them know that shifts have changed and who their new nurse is.
As far as I can see this is basically a win-win situation....but the confidentiality portion should be worked on.
Aug 26, '01
In theory it is great. In actual practice it was a disaster!!
The confidentiality thing was a biggie for me. IF we can't keep written charts at the bedside due to confidentiality, why on earth would talking out loud be any more acceptable?
The other thing is that while you are on rounds.....you are virtually unavailable to the rest of your patients. What we did was a written report handed over by the team leader to the entire oncoming team. All three teams got report at the same time in less than 10 minutes. The entire off going shift was available to catch call lights and bedpans for the 10 minutes. Almost always everyone got off at a reasonable time.
Then any serious matters were taken to the bedside by the off team leader and the on team leader......serious meaning.....fresh post ops.....blood transfusions...epidural patients.....mainly to do a quick catch, but also to assure that the new nurse saw the patient right away.
Aug 26, '01
we have always taped our report and if anything happens after we tape we give verbal update in the break room. i think the walking report would be full of interruptions as we all know we have those certain pts. that need something or have a question everytime they see a staff member.not to mention the pts with legitimate needs. plus the shift change is a busy time especially on the evening one--we get off at 6:30. the pts eat and get alot of their meds at 6pm. as soon as they are done eating(which some manage in 5 min) it's pottying and bedtime to the pts. plus someone has to count narcs(we are getting the pixxus??? soon. and whoever clocked in early to count is leaving 15 min early. however our tape player is always getting dropped/broken and after 10 years on the job and a new manager we were told it was not in the budget. we chipped in and got our own. its worth it. don't even think about giving oral report all together in the break/conference room. everytime you say something someone has to bring up a story about what happened yesterday/last week/last year... get the point.
Aug 26, '01
I guess I don't understand how this will work. You will go room to room and discuss each patient individually? Do you do this in front of a patient? Outside the door? What about double occupancy? How do you discuss behavioral issues? Drug seekers?etc...
What are you suppose to do if pt has visitors? How about the terminally ill pt whose family listens to how bad their loved one has deteriorated during the past 8 hours?
If report is done in front of the pt, you KNOW you will have at least one in the bunch that will want to elaborate for you and you will spend another 15 minutes listening to the pt give report as well!
I have never heard of such a thing. I hope the wife of the pt that has been just diagnosed with a cancer doesn't get the news from the nurses changing shift before her husband can gently tell her.
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