painful reports

[Beatlefan, BSN]

Hello fellow nurses. I have been an intermediate care nurse for 7 years- work on a very busy floor. I originally pursued nursing in my early '30s after having my kids. The nurse that I knew growing up were all very wonderful women (it was the '70s), who always had great senses of humor, and just were a joy to be around. They seemed to "get it". I aspired to be like them. Nursing seemed to have something of everything, and was a great opportunity to give to others, and also receive good things.

I have found in my time as a nursing student and also as a nurse, that my view was probably naïve. Most of the people I have encountered in my field are not very self-actualized, professionals who are great to be around.

My biggest complaint is what I have to go through at the shift report/hand-off. When I am reporting off to co-workers, I encounter some of the ugliest behavior in the form of passive-aggressiveness, eye-rolling, questioning, fixating on something that is beyond my control, quizzing me on something that I may not know the answer to- you get it.

I try to tweak my reports and individualize to the nurse I am handing off to, but sometimes, there is just no pleasing certain people.

I get that it isn't fun to leave our families and come in to work. I get that shift work is hard, and nursing is also hard work. I just don't understand why we are so horrible to each other. I also observe by listening to some of these co-workers talk about themselves, that I'm dealing with big egos. I love what I do- the patients are great. Just a little difficult to deal with the immature, too much ego or lack thereof in the co-workers. Can anyone offer how I can improve myself? Ways to make this easier?

[classicdame, MSN, EdD]

Be upfront with that person and state "I see by the expression on your face you dod not like my report. What, exactly, were you expecting to hear?" Another thing, if you go by the SBAR you have given a full report. Stay away from he said-she said stuff. You have have to guide them by asking more open ended questions.

[Been there,done that, ASN, RN]

Most of your post is an attempt to rationalize their behavior.Think you know the answer to passive- aggressive behavior, it's assertiveness.

You've started a pattern with your attempts to"tweak my reports and individualize to the nurse I am handing off to" and trying to please these difficult personalities.

That's why it's going to be so sweeeet.. when you start looking them in the eye, asking them why they are rolling their eyes,

why are they asking you a question that does not pertain to report ( direct them to find it in the chart if it's so important).

or " I don't know why Dr. Joe Blow stopped the Valium.. call him and ask him".

You get the drift.. stop letting them walk all over you. The SBAR approach idea is excellent. Give your SBAR, do not allow questions until you are finished.. repeat the above until no pain is felt.

[nrsang97, BSN, RN]

SBAR! Ask them to leave questions till the end. I am doing a paper on hand off for my RN-BSN class. This is some of the reasons that make hand off so difficult, the constant interruption to what you're trying to say.

[chiandre]

My biggest complaint is what I have to go through at the shift report/hand-off. When I am reporting off to co-workers, I encounter some of the ugliest behavior in the form of passive-aggressiveness, eye-rolling, questioning, fixating on something that is beyond my control, quizzing me on something that I may not know the answer to- you get it.

I try to tweak my reports and individualize to the nurse I am handing off to, but sometimes, there is just no pleasing certain people.

I get that it isn't fun to leave our families and come in to work. I get that shift work is hard, and nursing is also hard work. I just don't understand why we are so horrible to each other. I also observe by listening to some of these co-workers talk about themselves, that I'm dealing with big egos. I love what I do- the patients are great. Just a little difficult to deal with the immature, too much ego or lack thereof in the co-workers. Can anyone offer how I can improve myself? Ways to make this easier?

It is not you, it is them!

People use transference to transfer their negative feelings to others. When they feel insignificant, they will try to harass somebody with the intention of destroying that person's self-worth.

Unfortunately, people who not sure of themselves or lack self-esteem will talk about themselves and make up things about their lives. This helps them to feel important.

Next time somebody interrupts your report with irrelevant question, throw the question back to them. If they insist on interrupting you, calmly tell them that the question is not pertinent at this time. This will do two things – The interrupter will either leave you alone or they will throw a temper tantrum. Pity them!

Use SBAR, read avidly, practice prudently and ignore immature, pompous and egotistical distractions.

[bluenurse85]

I would second everything Chiandre wrote. Some of the nurses I work with make me feel like I'm back in clinical pre-conference, when instructors seemed to deliberately mess you up. I realize now that was to instill critical thinking. These nurses asking questions like that I think either don't know & don't want to admit it or try to feel superior to the person giving report. They'll challenge every single thing you say & expect you to read MD's, other nurses', or other people's minds. Or they'll ask totally irrelevant questions & roll their eyes because I don't know the answer. The best ones are the ones who keep asking you to repeat the same thing so they can fill out their own little pre-printed report sheets. This got so bad one time that I suggested if the nurse couldn't keep up, she could take report on plain paper & fill out her own little cheat sheet later. She backed down & haven't had a single problem with her since.

[poppycat, ADN, BSN]

Many years ago, I worked at a hospital where we tape recorded report. We almost always got out on time because report wasn't constantly interrupted for nonsense.

Report in my current job is mostly chit chat. I work in PDN with a fairly stable patient so there isn't much to report from day to day.

[delphine22]

Bedside report is awesome for killing idle chit chat (from the nurses).

[duskyjewel]

Every time they roll their eyes, stop and say, "Oh, I'm sorry, do you have something in your eye? Can I get you a tissue?" Every time. Even if it doesn't help much, their exasperation when you do that for say, the fifth or sixth time in one report, will be entertaining.

I agree bedside report would likely put a damper on most of that ridiculousness, because they know if they do that in front of patients, they'll be in trouble.

[Been there,done that, ASN, RN]

Bedside report is awesome for killing idle chit chat (from the nurses).

Bedside report is not the answer. Bedside report is merely a PR stunt to put on a show for the patients. For one thing, it is never considered a complete report as there are many issues that cannot be discussed in the patient's room. There is always another private discussion between the nurses.

[Been there,done that, ASN, RN]

Every time they roll their eyes, stop and say, "Oh, I'm sorry, do you have something in your eye? Can I get you a tissue?" Every time. Even if it doesn't help much, their exasperation when you do that for say, the fifth or sixth time in one report, will be entertaining.

I agree bedside report would likely put a damper on most of that ridiculousness, because they know if they do that in front of patients, they'll be in trouble.

This is a discussion as to how professionals communicate. It allows the off-going nurse to communicate with the on-coming nurse about the patient's case.

It will be a cold day in Hades before a CNA gives me advice on how to give/get report.

[LadyFree28, BSN, LPN, RN]

SBAR, SBAR, SBAR.

It always comes back to this.

I agree with BTDT; STOP "tailoring" your reports to the nurses; just the facts, or other time for anything else.