What are your Thoughts on Bedside Reporting? - page 2

Many studies that have shown that bedside report is beneficial to patients; mainly because patients feel involved in their plan of care and can make corrections if needed. However, I have been... Read More

  1. by   Apples&Oranges
    While I have my own feelings about beside report, when done correctly, and incorrectly (I have replied to these threads before) are strong, I have to say, AGAIN, that according to the regulations, bedside report is NOT a HIPAA violation!!! It's NOT. Even if you think it is. Even if you want to believe it is.

    There is an entire section in the Joint Commission's Report clearly stating that incidental exposure (and it SPECIFICALLY mentions bedside reporting in semiprivate rooms) is NOT a violation.

    This has been debated to death. I get it. You don't like it. I don't do it at my current assignment, nor did I at my last one, simply because that was not the culture. I did 3 assignments ago, and at my last permanent job, because the culture there was that it was expected. Whatever. When in Rome, dude.

    But I get so frustrated when people throw up this HIPAA BS every time someone mentions a name, diagnosis, symptom, etc., or posts a photo of their kid's thumb lac on FB.

    98% of nurses have not read the regulations, have no idea what the JC, DPW, DHS, or any other regulating body's standards are on ANYTHING, yet they throw out opinions as if they are facts and expect everyone else to share their outrage.

    **Wow, that was a major vent. Not sure where that came from, maybe being told that we are now being written up for not having our whiteboards updated at 8am, since DHS is inspecting...pretty sure that's not their thing, insecure assistant nurse manager Mary...but carry on with your OH, SO IMPORTANT JOB...**

    OP - while it's true that it is NOT a violation, please take the rest of my growling with a shrug and a grin. I just had a bad day ;-)
  2. by   Renell
    I am honestly not a big fan of bedside reporting, but I do understand its importance. If I can get a nice, condensed report ( i.e procedures, labs, discharge plans, stuff I need to prep the patient for, etc.), then yes. I need to know that information. Everything else I can (and actually prefer) to find on my own. For example, one of my patient's was consistently tachycardic (110-140). In report, the nurse just told me that was his baseline since he had his chest tube removed. It wasn't until I looked it up myself that I found the cause. The talc pleurodesis he had a few days prior was irritating his pleural space. It was an inflammatory response. Not only did I learn something, but it made me a bit more relieved that the attending was already aware.
  3. by   Have Nurse
    Quote from Apples&Oranges
    While I have my own feelings about beside report, when done correctly, and incorrectly (I have replied to these threads before) are strong, I have to say, AGAIN, that according to the regulations, bedside report is NOT a HIPAA violation!!! It's NOT. Even if you think it is. Even if you want to believe it is.

    There is an entire section in the Joint Commission's Report clearly stating that incidental exposure (and it SPECIFICALLY mentions bedside reporting in semiprivate rooms) is NOT a violation.

    This has been debated to death. I get it. You don't like it. I don't do it at my current assignment, nor did I at my last one, simply because that was not the culture. I did 3 assignments ago, and at my last permanent job, because the culture there was that it was expected. Whatever. When in Rome, dude.

    But I get so frustrated when people throw up this HIPAA BS every time someone mentions a name, diagnosis, symptom, etc., or posts a photo of their kid's thumb lac on FB.

    98% of nurses have not read the regulations, have no idea what the JC, DPW, DHS, or any other regulating body's standards are on ANYTHING, yet they throw out opinions as if they are facts and expect everyone else to share their outrage.

    **Wow, that was a major vent. Not sure where that came from, maybe being told that we are now being written up for not having our whiteboards updated at 8am, since DHS is inspecting...pretty sure that's not their thing, insecure assistant nurse manager Mary...but carry on with your OH, SO IMPORTANT JOB...**

    OP - while it's true that it is NOT a violation, please take the rest of my growling with a shrug and a grin. I just had a bad day ;-)

    It's ok. Everyone needs to let off steam. I teach the HIPAA class. At my previous hospital, we were very aware of it and had a phrase we would use if we overheard a patient's identifiable information in an area where it shouldn't have been discussed. "Code White." Not sure where they came up with that phrase, but it seemed to work.
  4. by   trytounderstand
    The patient needs to know exactly what you are saying about them when they are being discussed with another nurse or doctor. There may be things that need to address or questions that the patient has. And in this case they may have overreacted but the other patients have a right to know if they are rooming with a potential hazard to their condition as well. The patient and family members have a right to have the condition and treatment explained to them and this hurry to not give them their right to be heard when they or their insurance are paying that doctor each time they walk in their room is wrong. While the patient appreciates that you are busy they still have the right to know and they still have a right to voice their opinion and to say yes or no. Their healthcare and their body.
  5. by   Here.I.Stand
    Quote from trytounderstand
    The patient needs to know exactly what you are saying about them when they are being discussed with another nurse or doctor. There may be things that need to address or questions that the patient has. And in this case they may have overreacted but the other patients have a right to know if they are rooming with a potential hazard to their condition as well. The patient and family members have a right to have the condition and treatment explained to them and this hurry to not give them their right to be heard when they or their insurance are paying that doctor each time they walk in their room is wrong. While the patient appreciates that you are busy they still have the right to know and they still have a right to voice their opinion and to say yes or no. Their healthcare and their body.
    I don't know about you, but I address questions and explain things to pts/families all day long. It's called teaching.

    I would dispute the point that the roommate has a "right to know" their info. It is always the hospital's practice to isolate or cohort pts whose condition warrants it (such as flu or MDROs.) And I realize that that a roommate hearing report isn't illegal; it is "incidental disclosure." However, the roommate doesn't have "the right" to anyone's history but their own (or their child's.)

    A recent example: trauma pt was pregnant but was planning to abort. I have no idea if her family knew or not -- the only one who has the right to share that is HER.

    Ditto for any other sensitive information.

    My big issue with bedside report -- and I say it every time this comes up -- is that it can't really be done in 30 minutes (not on most floors anyway. I mean it *could possibly* work if pt assignments are always kept consistent between shifts... but who am I kidding? Night shift nearly invariably has more pts per nurse. So Nurse Nancy may be trying to report off on rooms 1, 2, 3, and 4... Well Nurse Nellie is taking rooms 1 and 2, and 5, 6, 7, and 8. Nancy will be reporting to Nellie in two patients, but DRAT she is busy taking report from Nurse Jack on 5 & 6, and from Nurse Jill on 7 and 8. My last floor job was in an LTACH so similar ratios to med-surg, and it was ALWAYS like that with nurses had to give/receive report from 2 or 3 nurses.

    Now throw in that the nurses are in pts' rooms where they need to be sought out. Instead of a centralized area, Nancy has to hunt for Nellie, Jack, and Jill.

    I just don't see how floor nurses can do that in the usual shift overlap of 30 minutes. And I personally am not willing to stay longer than my shift -- at least not for routine matters. It's not like a pt coded during report or any other such deviation from the norm.

    Report that routinely forces overtime is not something that works. If it is that important they should staff accordingly, such as Nancy reporting off to Nellie on 1, 2, 3, and 4; and Jack reporting to Jill on 5, 6, 7, and 8.

    But who am I kidding? The day that night shifters get 4 pts is the day that hell will freeze over.
  6. by   JadedCPN
    I've got nothing positive to say about bedside report, for many of the reasons that other people have already mentioned. However, bedside safety checks at shift change are more than okay in my book. Big difference though.
  7. by   StrwbryblndRN
    I love bedside report. I only had to do it in private rooms so another pt overhearing was not an issue. But a few key things need to be considered when doing report.
    *The use of layman's terms. Bedside report is useless if the pt does not understand what you are saying.
    *Be aware of dx that has not been relayed to the pt. I made that mistake the hard way.
    *Not all information should be shared at the bedside. EX: The pt with a history of mental instabilities may not react well when it is brought up in front of them. Or the confused pt who does not think they are confused may get agitated at hearing it. These are not always the case but may want to be considered if a pt has a history of anxiety.
    Each pt is different and sensitivities need to be taken into consideration.
    I found bedside report faster. Iv lines and PCA are observed during report which help catch errors. Catching pt changes at shift change helps too.
  8. by   scout mom
    When I was a bedside nurse, I hated bedside report. I totally agree with giving report and then going in together to check wounds, lines, meds, etc... but not full report at beside. As a patient, I feel the same way. Within a week, I was a patient in 3 hospitals (2 transfers to hospitals with higher levels of care) and not one of the hospitals routinely did bedside report. At the last hospital (a large teaching hospital), I'm not sure if ICU did bedside report, because I don't remember much about the ICU, but the Cardiac Care floor did not. & my husband & I were perfectly ok with that. Give report, then come in to check on me, answer any quick questions & introduce the oncoming staff. That's all you need IMO. If I have more in depth questions, I can talk to the RN or Dr later not during shift change.


    & you sure as heck better not wake me up so that I am "involved" in bedside report. Especially when I just got to sleep after being woken up multiple times. But maybe that's just me...
    Last edit by scout mom on Apr 17 : Reason: Edited to add
  9. by   Rocknurse
    I don't like bedside report because when working in the ICU and picking up complicated patients, I'd rather sit down at a desk so I can comfortably write down my report. I write everything down by system so I can refer to it during the day and like to look at orders and labs as I go. I don't like having to stand in a room getting bombarded with questions while trying to formulate my plan for the shift. I'd rather get report first then go in and check all the drips, dressing etc and say hi to the patient afterwards and answer any of their questions then. Plus, it's probably the only time I'll get to properly sit for the next 12 hours. Interruptions = poor report = things getting missed
    Last edit by Rocknurse on Apr 18
  10. by   brownbook
    I don't know when bedside reporting came into fashion.

    I graduated in 1984 had never heard of it. Never did it. I had worked/floated med/surg, peds, ICU, rehab, for many years, never did bedside reporting. Until once I floated to the skilled nursing facility that was part of our acute care hospital. I was getting report and I could not figure out what the nurse was doing? We kept going from patient to patient....finally I realized they did bedside reporting there! She made a point of assuring me the continuous feeding bags were full.

    It seems sad that the main reason it is necessary or liked is because the nurse you follow leaves IV bags dry or patients soiled, bloody dressings, etc. I seldom had this issue with co-workers, but I imagine if I frequently followed a nurse who left the patients in a mess I would tell her next time I worked with her and talk to the charge nurse if it was a chronic thing.

    As another nurse noted updating the patient and family about the patient's plan of care should be taking place anytime they are awake, aware, asking questions. It doesn't seem that during bedside report is a good time, I can't imagine how you would have time to stop report to the oncoming nurse and start answering questions from them?
  11. by   NurseSpeedy
    Quote from Apples&Oranges

    **Wow, that was a major vent. Not sure where that came from, maybe being told that we are now being written up for not having our whiteboards updated at 8am, since DHS is inspecting...pretty sure that's not their thing, insecure assistant nurse manager Mary...but carry on with your OH, SO IMPORTANT JOB...**
    Oh don't even get me started on the darn white boards! We've got the same thing, along with what exact wording we can and cannot use, which seems to change at any given time. Oh, and then there's the huge push to write which med was given when and when it can be given again on the board....oh, wait....not everyone wants to broadcast to their roomate and their visitors every medication they are taking on a PRN basis....so now discuss this with the patient and check which day it is to see which policy we will be following from 8-10am, 10am-12pm, etc, etc...regarding what info to include on the holy board and what words are white board approved at any given time.

close