Worst information given in shift report!!! - page 4
What has been some of the worst information you've ever been given during shift report on your patients? Don't you just hate hearing "i don't know" or "i'm not really sure" when it comes to essential... Read More
Oct 23, '05Quote from southernlpnBut, sometimes that is all there is to say. I work three nights (weekends) in row and report off to the same dayshift nurse two days in a row. If there is no change and they had a good day, I am fully satisfied with "everybody's fine." I always give a good report the first day on everyone's condition, but the next day we just hit the highlights.My pet peeve about report in LTC is the nurse who just says "everybody's fine" and expects that to work.
We also ask each other if they know the patinet, if they do, we don't have to give the whole H&P, giving us more time for the patients we don't know.
It also helps when you are able to work with the same people and you know what they want in report.
And I really don't care that they had a cat when they were five...I would like to know, and know how to look up myself, what they do/did for a living. That information is gold!
Oct 23, '05I think my worst report for me happened during my Med-Surg I rotation this summer. The reporting nurse wanted to launch into a tirade about an argument she had with a patient's family member. My preceptor handled it beautifully--after about only 1 minute of this, she interrupted, saying "Yes, but the patient???" The reporting nurse then started supplying pertinent details....
Here's been another observation--don't let your opinion of a patient be colored by the info given by the reporting nurse. I had one who told me that my patient liked to keep the side rail down on one side of his bed so that he could pee from lying down into his bedside commode. She told me this with a look of utter disgust on her face. So, when I went into his room and saw garbage scattered all over the floor, I immediately assumed that he was a slob. However, when I stopped and thought about it, I realized two things: 1) the only garbage can this patient had was located across the room, so he couldn't throw anything in it, and 2) he was used to being very independent, was too weak to make it to the bedside commode by himself, and was too proud to ask for help.
When I moved the garbage can within reach, the garbage somehow wound up in the correct place (note to myself: Duh!), and when I had an honest conversation with him why it was important that I assist him to the restroom (I gladly offered to help him across the room to the restroom instead of insisting he use the bedside commode) and that I was happy to do so, he always let me know when he needed help!
Quote from AMARTIN1What has been some of the worst information you've ever been given during shift report on your patients? Don't you just hate hearing "i don't know" or "i'm not really sure" when it comes to essential information like last BM, last BS on a diabetic patient or I & O's (especially on surgical patients)?
Oct 23, '05When I give report I am concise and to the point. I expect to receive it in the same manner.... I do not care about your love life or lack thereof. I do not want to hear about your family...brother, sister, mother, father, hubby, child's drinking problem, drug problem, etc. I don't like having to wait on report while you change clothes so you can go drinking, bar hopping, etc. I don't want to clean up your dinner trash, old coffee cups, scrap paper , that you leave all over the nurses station either!!!
I really get upset when I get this...
Her: Well, Mr. So & So Removed his foley, has been a no void since 12 noon, and his vitals have been really funny, he is pale and he doesn't seem right....he's got a temp...
Me: did you cath him? ....
Her: well, no I was hoping he'd pee
Me: He hasn't voided in 11 hrs? Did you call the doc? Give him tylenol?
Her: hmmm, well I was kinda busy...and Dr. X is just so rude and unpleasant...
and we were out of tylenol and I did not have time to ask pharmacy to bring it up...
OH, I just want to scream.... Lazy? Stoopid? Thoughtless half-wit? spineless?
Then I go and assess the patient and he is in bad shape and we can add Urosepsis to his Dx.
That, my friends.... Makes me so angry.... Especially when other nurses tell me she is on line ordering crap rather then attending to the needs of the patient... or leaving a bunch of crap that i have to do, because the off going nurse is too freaking lazy....
I just thought I'd mention it.... lol.... It happened to me last nite....
Oct 23, '05I received report that a patient was "brain dead". Mind you I work med-surg, not Neuro Intensive Care where they do donor cases on brain dead people. I kept my mouth shut, knowing she probably meant "permanent vegetative state" from a head injury.
I assess the patient, and yes, he's severely brain damaged, but opened eyes, nodded yes and no to simple questions, moved his right side and obeyed commands. Didn't look brain dead to me.
Oct 23, '05The worst??? "This patient is doing fine." I walk into the room 15 minutes later and find him Cheyne-Stoking!
Oct 23, '05Quote from southernlpnEXACTLY! Then we come to find out Mrs. Worth is in the hospital, Mr. Fowth threw up after every meal as soon as he got back to his room, and Miss Everstein died last night.My pet peeve about report in LTC is the nurse who just says "everybody's fine" and expects that to work.
Oct 23, '05Quote from GompersI once got report from a nurse who forgot to tell me that the baby had an extra digit on her hand that had been "tied off" a few days before. I had no clue, and nothing was written on the patient care summary either. So there I am, unwrapping the baby, and caught a glimpse of something black in her hand. I jumped so fast that I banged my arms on the isolette portholes and scared the heck out of anyone within ten feet of me! The shape of the digit, the black-purple color of it, and the black sutures that were tied and then snipped to look like two little antennae...I thought the kid was holding a cockroach!
Gompers I know exactly what you mean. I once had a baby that was about 2 weeks old by the time I had her. Up until that point NO ONE had noticed kiddo had webbed toes on one foot.
Oct 23, '05The worst report I ever got was from a nurse that reported that her patient was new mom who had just delievered her second baby, had had a full term infant that died of sids and had one miscarriage. As the charge nurse, I assigned this patient to one of the other nurses who went in to do discharge teaching and came out furious! Apparently in the course of doing discharge teaching she tried to be very sensitive of the fact that the patient had had a baby die of sids when it was three days old, when she got to the baby care stuff she was very careful to go over the back to sleep and no second hand smoke stuff, then acknowledged that the patient may be very nervous in taking this baby home since her last baby had died. The patient got a very confused look on her face and said, "This is my first baby, I had a miscarriage but I have never had a baby that died." As it turns out, no one on the unit that day had ever had a baby that died of sids, we have no idea where she got this info. She was notorious for giving incorrect reports, like saying that her patients had been medicated at a certain time when they had actually been medicated several hours prior, or that babies were breastfeeding well when in fact they were bottlefeeding, or were in the NICU and had never attempted breastfeeding, but this was probably the worst bit of misinformation that she ever gave. As you may have guessed, she no longer works with us!
Oct 23, '05Quote from AMARTIN1Yes! Thank you! I'm at the 1/2 way point in nursing school right now, and so far we have not been taught a darned thing about giving report (what to include/not include, how to be concise yet thorough, how to organize it), and I'm wondering if/when they will cover it. Certainly I haven't *heard* any reports I would want to emulate (nothing remotely like KaroSnowQueen's example). And with some clinical instructors, pre-conference can regularly run well past report, so we don't even get the bad examples then ;-)Thanks for all the feedback. As a new nurse ... <snip>
Oct 24, '05I was told in report one morning that one of my patients had come in during the night with a fractured tibia and that the doc tried to do an ORIF in the ER but was unsuccessful, so he will probably try to do a closed reduction in the OR today. In addition to this I was told about another patient who had an abd wound vac and a wound on his thigh where they had removed skin to try to graft to the abd wound. No problem there right? Except when I asked how he got the abd wound she said she didn't know she hadn't asked him.
Oct 24, '05I hate to say it, but if your course is ANYTHING like mine was, you will NOT get any instruction. Insead you will have to figure it out by yourself, and endure the sighs, and caustic remarks to your face and behind your back, of the other, more experienced nurses. I still make mistakes, don't gossip and I really try not to be ugly, but I might leave something out. If I do I call from my cell.
Oct 25, '05have a nurse where i work staff that got upset that i didn't include every minor detail (bm's and sugars, etc. are written on the paper i turn over to her but she needed to hear them) and complained about inadequate report...but when i began giving detailed ones she'd leaf through a magazine or such rather than listen.....btw--i also work agency and please any of you out there who deal with us don't get all bent out of shape if it's our first time in a building and you don't get every last detail on someone--we can only tell you what we were told by the tired nurses leaving and rushing through report and what we saw...which first time in a new ltf trying to identify people w/out armbands is usually like "they're breathing here's the vitals i got no complaints from 'em". we're more concerned with right meds/right pt and keep 'em alive and we have no clue who these people are excepting what we wrote down during the shift! (i've been given reports at new places before that only say to "watch so-and-so...bye" and have no clue about any other pts health problems or who to crush meds for, etc--please give relevant info on all pts to us!). and lastly, as a former weekend opt. person...update weekenders on new developments that happened through the week! may be old news to you but they don't like finding out at 9 that the iv atb that the weekender didn't know the last-room pt was on was to be hung at 7!