Walking rounds for nurse to nurse report?

zambezi, BSN, RN · Mar 10, 2004

I work in CCU--we have a "group report". We all meet in our report room, the day charge rn give us a basic report on each patient in the unit. Takes 5-15 minutes (we are alloted 15). Then we each go and get a more detailed report on our individual patients...usually 1-2 each. I like this format as I know the basics of what is going on in the unit, gtts, reason for admit, etc...

Dinith88 · Mar 10, 2004

My unit does report like Zambezi's. It works very well for us.

Why the switch to the walk-through? Has someone been complaining about finding patients and/or rooms in disarray(sp?)?? Or is this just someones well-meaning (but kinda not very good) idea?

lyndac918 · Mar 10, 2004

I work in CCU--we have a "group report". We all meet in our report room, the day charge rn give us a basic report on each patient in the unit. Takes 5-15 minutes (we are alloted 15). Then we each go and get a more detailed report on our individual patients...usually 1-2 each. I like this format as I know the basics of what is going on in the unit, gtts, reason for admit, etc...

Thanks for your input.

lyndac918 · Mar 10, 2004

My unit does report like Zambezi's. It works very well for us.
Why the switch to the walk-through? Has someone been complaining about finding patients and/or rooms in disarray(sp?)?? Or is this just someones well-meaning (but kinda not very good) idea?

We use to do a taped report which worked fine for both units. Then our VP of nursing thought this type of report would encourage better communication. Of course she has never worked in critical care before. So I modified her idea a bit to make it work. We would do a brief taped report and then the nurses would walk in the rooms and make sure IVs were correct, vent settings were right, etc. I thought it was a fair solution. The staff did it and I was accomplishing what she had asked. But, when I told her what we were doing she said, "No". I want it like I said. I have tried to explain that it is important that we all hear what is going on in the units. I said we are different then the floors, as we do not have a block of patients assigned to us. But, I get no cooperation from her. Its her way or the highway. You were very perceptive in figuring out it was someones well meaning idea. Thanks for your reply.

EmeraldNYL, BSN, RN · Mar 10, 2004

We do the same thing as Zambezi and then we get a taped report on our individual patients.

MizzPrettyPilz · Mar 10, 2004

Walking rounds is when nurses from both on-coming and off-going shifts go room to room with each other visually checking patients together making sure they are safe, and what condition they are in. Also passing along any needed information from the previous shift. Also it depends on the size of your units. And the reason why they switched to this method. Were there several complaints about the condition of the patients or the unit after shift change? This may not be practical if you manage large units. Some ways to make this work is to not be so lengthly with report except the most crucial info. Focus on the source of what caused this method of report to start. Don't backtrack too much. Make staff aware that you are doing report so as to avoid uneeded interruptions. Even the layout of the units is important. And lastly, be prepared to take report. Have a pen and pad to jot notes along the way. Just a few tidbits...:)

Ahhphoey · Mar 10, 2004

I don't work in an ICU setting, but I did have to do walking rounds on a unit I once worked on. It was very time consuming and was not an effective form of report for this particular unit. I think the modification that you made to the traditional walking rounds sounds like a good idea. Too bad the VP doesn't like it. I really dislike when the administrative personnel make all the decisions without the input of those working in the "trenches" because more often that not, they'd have no idea how to function in the roles (i.e.staff nurse) that they make all the rules for; they are often very out of touch with the needs of their staff. Also, why change the protocol for report if the old system is effective?

lyndac918 · Mar 10, 2004

I don't work in an ICU setting, but I did have to do walking rounds on a unit I once worked on. It was very time consuming and was not an effective form of report for this particular unit. I think the modification that you made to the traditional walking rounds sounds like a good idea. Too bad the VP doesn't like it. I really dislike when the administrative personnel make all the decisions without the input of those working in the "trenches" because more often that not, they'd have no idea how to function in the roles (i.e.staff nurse) that they make all the rules for; they are often very out of touch with the needs of their staff. Also, why change the protocol for report if the old system is effective?

VERY WELL WORDED....WE CONSTANTLY HAVE TO CHANGE THINGS BECAUSE SOMEONE HIGHER UP READ "ONE" ARTICLE IN A MAGAZINE. THANK YOU FOR YOUR INPUT.

lyndac918 · Mar 10, 2004

Walking rounds is when nurses from both on-coming and off-going shifts go room to room with each other visually checking patients together making sure they are safe, and what condition they are in. Also passing along any needed information from the previous shift. Also it depends on the size of your units. And the reason why they switched to this method. Were there several complaints about the condition of the patients or the unit after shift change? This may not be practical if you manage large units. Some ways to make this work is to not be so lengthly with report except the most crucial info. Focus on the source of what caused this method of report to start. Don't backtrack too much. Make staff aware that you are doing report so as to avoid uneeded interruptions. Even the layout of the units is important. And lastly, be prepared to take report. Have a pen and pad to jot notes along the way. Just a few tidbits...:)

I dont mind the idea of walking report as much as I hate the idea that we cant revise it to fit our units. We like to hear whats is going on with everyone. Its easier to update a physician if you know what is going on with all the patients if the RN in charge of that patient is off the unit in CT. Our POCTs would sit in on report also. But lately they have fed people that were NPO and didnt get a bath done before a procedure. We are going for Magnet status and I thought Magnet meant the nurses were empowered and had autonomy to make decisions that effect their practice. I talked to a med-surg nurse RN the other day and asked her how walking rounds were going. She asked me if I wanted the truth? I said I did and she said we arent doing them. But according to her manager and director they do them every shift change. My problem is that Im truthful. If you tell the truth, and its not what the VP wants to hear then you are in trouble. I guess i should just sit back and lie like everyone else?

kc ccurn · Mar 14, 2004

We do 1:1 report with the oncoming shift. We do computer charting so when we give report verbally we have the computer in front of us to review the plan of care, vitals, meds, I/O, labs etc. This way we can ask questions of the off going RN, then we go into the pt's room together for a brief once over, neuro check.

Our charge nurse has report with the off going charge nurse. Then towards the beginning of the shift our charge nurse meets with us for "pod" report or individually. Our CCU is broken into 5 pods, 4 have 8 beds, the 5th has 10. This way each nurse has an idea what the other pt's are incase anything comes up and the charge nurse is updated to how the pt's are doing.

We've been doing report this way for over 12 years, it works great!

That's very upsetting that management is so rigid that they won't let a unit make adjustments on things that are individual to each unit. That is micromanagement at it's worst.

lyndac918 · Mar 14, 2004

We do 1:1 report with the oncoming shift. We do computer charting so when we give report verbally we have the computer in front of us to review the plan of care, vitals, meds, I/O, labs etc. This way we can ask questions of the off going RN, then we go into the pt's room together for a brief once over, neuro check.
Our charge nurse has report with the off going charge nurse. Then towards the beginning of the shift our charge nurse meets with us for "pod" report or individually. Our CCU is broken into 5 pods, 4 have 8 beds, the 5th has 10. This way each nurse has an idea what the other pt's are incase anything comes up and the charge nurse is updated to how the pt's are doing.
We've been doing report this way for over 12 years, it works great!
That's very upsetting that management is so rigid that they won't let a unit make adjustments on things that are individual to each unit. That is micromanagement at it's worst.

Thanks KC. I appreciate your response. You are right, I am living in a world of micromanagement.