How do your docs do rounds?

[dawngloves]

And how do you give report?

Our docs sit in the middle of the unit and do their rounds and reports. I have suggested we keep the unit closed to parents and visitors at this time, but I'm sure that won't fly. Until we are sued for breech of confidentialitly.

And I never do report in front of a parent, but it seems my co workers have no problem with talking about all their patients next to anyone.

Any suggestions I can fly by my manager?

[Gompers, BSN, RN]

Believe it or not, until about a year ago, my unit let parents stay at the bedside 24/7! Nurse-to-nurse report and rounds were all done in front of the parents. I can't believe they would let parents sit there and overhear everything about everybody's baby! I don't think it was until HIPAA that they closed the unit from 9-12 each morning. Even that three hours was enough to send the parents into a fit, especially those who had been there for a couple of months at the time.

The docs and NNPs do rounds during that 9-12 period, in the middle of the unit. I always wondered why they don't go into the conference room instead, but I guess it's so that the nurses can also be a part of things without leaving their bedsides. Sometimes I wished I worked days instead of nights, so that I could listen in and comment when appropriate, especially if I have a primary with mulitple health problems.

Nurse-to-nurse report still remains a problem. 2-3 times a day we do a unit report in the conference room about all the babies (highlights only) and whatever else might be going on in the unit. But then we go to the bedsides to get report on our patients, and if the parents are there it is often very uncomfortable. Sometimes just hearing their baby's history can send a parent into a tailspin, even though they know it already, because it just sounds so overwhelming. Sometimes they interrupt and start asking questions about meds or feeds, and it's hard to tell them that we will explain later but must give report first. Whenever there is a social issue, we have to either write it down or take the new nurse aside and explain. We shouldn't have to do that! I am really hoping that with our next joint commission visit, we decide to close the unit for at least a half an hour during report times.

[Mimi2RN, ASN, RN]

We have no problem closing the nursery during report. Parents are told about this when the babe is admitted. We have a handout with this info, and also they are told they may be asked to leave if another baby is really sick, while we intubate and put in lines, or we are having a delivery, and we know it's going to be bad. I tell them it's a confidentiality issue.

I have more problem with family members who sit at the bedside for hours, and watch and listen to everything that is going on around them. They soon find out about the babies, and when they talk to parents who have just arrived, and tell them what has been happening, that's trouble!