Bedside shift report w/ emergency department

[bsnursing]

Does anyone else do bedside shift report with your emergency department? Meaning you, the RN/LPN: goes to the emergency department and receives verbal report about your patient from ED RN then you transfers your patient to your unit?

If you do, what are your thoughts? What are your procedures?

If you don't, I'd still appreciate your thoughts about it.

[sunnysideup24]

That would be nice, but I don't see it being practical in our hospital... it would take 15 minutes just to make the walk over to the ED. Our ED calls to give verbal report, which is all we need 90% of the time

[benmca13]

We just talk on the phone and a tech brings them up. How a floor nurse finds the time to go get their patient enough to make it a hospital thing is beyond me! You must have awesome ratios!!!!

[Esme12, ASN, BSN, RN]

Hummm...I worked at a facility that did this with ICU patients and it worked well. Why would the floor nurse need to come to the ED? While it's a nice thing for both parties and the patient I can't see it being practical for the floor nurses.

[bsnursing]

Our ratios are 5:1 on days and 6:1 on nights, I would not call that an awesome ratio especially having to make time to pick up patients from the ED while having to perform the necessary tasks on the floor also. The purpose of this -as management has described- is supposedly to improve patient's wait time, familiarize the patient with the nurse before arriving to the floor, and lastly so the floor nurse can physically see the patient before they arrive to the floor and determine if the patient is fit for the floor . I've been finding that the patients wait time has increased. And shouldn't the admitting doctors and ER staff be best to determine if the patient should be sent to a certain floor or another?

[tokmom, BSN, RN]

Yes, we implemented it over a year ago and it has sustained nicely, but we do it a bit differently. A nurse on the floor knows when they are up for the next admit, and when it is looking like a possibility the supervisor chooses a bed, etc. The staff nurse prints a summary of the ED visit. Once the patient is coming to the floor, the ED nurse does an all broadcast, and how the person moves, so we know what to have with us at the time of admission, such as more people, slider, etc..The Ed nurse then gives us report on the person, IN the room with the patient. If the person is messy, they help clean them up unless it's really involved, then it is highly frowned upon because no patient should be sitting in sopping wet sheets. The entire process takes less than 10 min off the floor. Sometimes ED tries to buck the protocol and we will bend if they are slammed, but it has worked well for us.

[rnmi2004]

I can see how it would be feasible in a small hospital. Many hospitals have inpatient floors too far away from ER to make this work. And what happens if the floor nurse decides the patient isn't appropriate for transfer?

[classicdame, MSN, EdD]

we found it difficult for the nurse in ED and the floor nurse to both be available to the phone at the same time. We created a report sheet, and now the MD or nurse in ED fills it out and faxes it to the floor. If there are still questions, the nurses then try to make personal contact.

[Lola Lou, BSN]

At my facility the ED nurse brings the pt to the floor and gives report to the receiving nurse.

[turnforthenurse, MSN, NP]

some nurses will do that...we will bring the pt up from the ED and then do bedside report on the unit. I personally have no problem with it (ED RN here) and as someone mentioned it can be difficult to get both the ED nurse and floor nurse on he phone at the same time. Some nurses will refuse bedside report, though, so then I just have to keep calling the floor and hope I can get ahold of them. If not, we go up the chain of command and speak with the charge RN or the nursing supervisor.

[bebbercorn]

If someone has a really complicated skin issue or something like this, I'll let the floor nurse know and ask her if she wants to do a head to toe with me. Otherwise, I agree with other posters in that it's too hard to get us together at one time.