Bedside Reporting starting Monday :(((

[2bTraumaRN2008]

So, we are starting this on Monday, and the "general" census is that most aren't happy and lots aren't even doing it at my facility.

I'm not sure what to expect, but I don't think I like what I'm hearing based on feedback from other floors.

For me personally, I have a problem taking 1 hour or more to give report, especially since I drive 1hour plus to and from work, and get up at 0330 to get ready for work. So, now I'll be loosing another hour of sleep on the days where I work back to back to back????? And, FYI - most of our nurses commute 45 minutes or more!! NOT FAIR!!

Another issue I have is fingersticks....we can barely get them done now before breakfast comes, and now the pt's will be done eating breakfast before we can even get in there to do their FS...that makes alot of sense.

The one plus I do see is: LOTS of our pt's are confused, so that will make things real simple....I wonder if I can just request to have all to confused pt's from now on, or the self cares who just come in for a simple cellulits that don't have an ounce of history...And to top things off, we are going tele in January...

And, we are to give our pt's our numbers from our personal hand held phones so they can call us if needed. We can barely handle all the calls that come in now from CT, Xray, Endo, Dr.s, Lab, etc, etc....

We also have to sometimes give report to 3-4 nurses, what do you do about this?? I sure hope they can do a better job at assignments.

I think maybe it's time to move into a M-F office job....

I look forward to reading/getting feedback from those who have been doing it for some time now, please!!

Thanks for letting me VENT!!!

[psu_213, BSN, RN]

I can't believe how many people here are in favor of bedside report. It's obviously something thought up by a person who's never touched a real patient. I guess for ICU it's ok, but I work nights on a med tele floor with a lot of psych patients and legal holds. The rest of our patients are usually totals on isolation and/or frequent fliers with q3h pain meds. We have had bedside report around for about 2 years now.

Where I worked the bedside shift report idea was spearheaded by 2 nurses (not managers, APNs, etc...."regular" nurses on the unit) who worked on the cardiothoracic surgery stepdown unit, where there was a 5-7 pt load on nights, 4-5 on days. After all their work on the project, their unit implemented it, they got to present their results at a national conference, and the idea was implemented through the hospital (a 1200 bed facility). These 2 nurses helped to train more nurses and those nurses then introduced to all the other units of the hospital. The also realized it would only worked if all the staff was educated about bedside report before it was implemented. You could not just say "start doing this on Monday." Every nurse was educated in how to do it to prevent pts from dominating the nurses' time, how to properly talk to pts and handle their requests (such as 'I need water right now!'), and the proper etiquette for the oncoming and offgoing nurse (so that bedside report didn't take any longer than the old style of report). Despite reservations from the rest of the staff, including myself, bedside report was a big success. When I left this job, my new hospital would not implement bedside report. Let's just say that it was obvious that the quality of information passed on from shift to shift was way lower than it had been with bedside report. There is no doubt in my mind that bedside report is superior to traditional report if bedside report is done right, including proper education of staff before implementation of bedside report. The group on here is well educated and, overall, a group of good nurses. I "can't believe" that there aren't more of these nurses who don't see the benefit of bedside report. Look beyond PG scores!

[dr.lecter]

My sympathy!

[anotherone, BSN, RN]

another terrible idea bs report is..... what about reporting hiv status, hep c, the visitors WILL NOT LEAVE they already dont leave for other things when they should. ohh that is right, i should call security/supervisor and waste MORE TIME waiting for them. what about reporting, "patient frequent flyer , yells and screams if dilaudid 4mg is not brought in q 1 hr", " pt most likely has cancer, doesn't know it yet, "pt non compliant, "family calls every 20mins", pt can use the bathroom but insists on bedpan, holding urinal" other nonsence. do i have to waste more of my time and give the nurse the "real report" away from the patient and then a scripted one infront of the patient? both nurses willb e written up for not getting the bath done right there , they were just after all standing there, two of them. ........................

[JBudd, MSN]

We discuss the pt and report at the desk first, then just go around and intro the next nurse to the pt. Can see everything you need to see in just a few minutes, and the oncoming nurse is already primed for what to expect in the room.

Was pretty glad we did bedside last month, the off going nurse left a total mess in every room. The minute we walked in he started grabbing old/dirty linens and trash and cleaning up the room.

[Do-over, ASN, RN]

We are switching to bed side reporting, and I am actually looking forward to it. We use a tape recorder now, and it takes forever.

[DookieMeisterRN]

Honestly if you're rounding on your patients in the last hour or so of your shift and let them know it will be change of shift there should be no reason why report is being interrupted for bathroom, med or water requests. If a patient is sleeping we don't wake him/her but do safety and pca/gtt co-signs quietly in the room and share information at the pt doorway. Same goes for patients with sensitive information or a shared room.

We now have a hospital wide standardized report form which helps speed it up a lot, only reporting in hand off the exceptions and pertinent info, history, etc.

For all those of you who hate it, propose change and come up with better ways to trial on your unit. Use all that negative attitude/energy and make changes to improve your practice. It amazes me how some will expend so much energy into making sure a new process won't work and go out of their way to help it fail before even giving it a fair chance. IMHO if you refuse to actively participate to seek a decent solution you're part of the problem and I'm so happy I don't have to work beside you.

[psu_213, BSN, RN]

For all those of you who hate it, propose change and come up with better ways to trial on your unit. Use all that negative attitude/energy and make changes to improve your practice. It amazes me how some will expend so much energy into making sure a new process won't work and go out of their way to help it fail before even giving it a fair chance. IMHO if you refuse to actively participate to seek a decent solution you're part of the problem and I'm so happy I don't have to work beside you.

Amen to that (esp. the section in bold). Be educated in how to do it correctly. Use it correctly. And try it...try and make is successful. If it doe not work, then fine, go with something else. I've seen it improve pt care if done correctly. Until you try it, you have no right to call it the stupidest idea ever....

[psu_213, BSN, RN]

another terrible idea bs report is..... what about reporting hiv status, hep c, the visitors WILL NOT LEAVE they already dont leave for other things when they should. ohh that is right, i should call security/supervisor and waste MORE TIME waiting for them. what about reporting, "patient frequent flyer , yells and screams if dilaudid 4mg is not brought in q 1 hr", " pt most likely has cancer, doesn't know it yet, "pt non compliant, "family calls every 20mins", pt can use the bathroom but insists on bedpan, holding urinal" other nonsence. do i have to waste more of my time and give the nurse the "real report" away from the patient and then a scripted one infront of the patient? both nurses willb e written up for not getting the bath done right there , they were just after all standing there, two of them. ........................

Not every piece of information about a pt is shared while at the bedside. That is why staff education is a must before starting bedside report...and no, I don't mean a 5 minute talk or a poster board. Real education the involves situations you will encounter, role playing, etc.

[BittyBabyGrower, MSN, RN]

Bedside report is better for all involved....how many times have you gone in and seen your patients and there are like a 100 things wrong or not done...this cuts this way down. Also, if you have information that is truly confidential, take it out in the hall....common sense should be used. Any questions you have are answered by the off going nurse. It is really about patient safety. We have a letter that we give all families on admission that explain that when the nurses are reporting off it is important to try not to interrupt them. When parents do interrupt us for something not important we ask them,nicely, to please wait until we are done giving report and we will get to whatever it is they need. If they are a "problem family" that constantly is interrupting we give report either at another computer terminal or in the hall or conference room, and then come back and go over lines etc.

We have 6 patients in a room with each bed being able to have 3 visitors, so you can imagine the chaos sometimes. But it does work once you iron out the kinks. Our whole hospital, not just the ICU's went to this 2 years ago and after an initial OMG time the kinks got ironed out and it works great. But everyone is right, you have to have education and inservices on it. And people will learn how to stream line their report.

[Fribblet]

How to end this in 3 easy steps:

1. Just say in front of the patient everything you'd normally say in report.

2. Watch complaints skyrocket and patient satisfaction scores plumet.

3. LOL in break room.

Optional step 4:

Have another job lined up.

[BluegrassRN]

Our pt satisfaction scores have increased dramatically after implementing bedside report.

I love it. No longer do I have to listen to the offgoing nurse go on and on about things that I can look up in the computer. I need to know the plan of care, and the highlights. Everything else is unnecessary.

Our pts say they feel like they know what's going on with their care, and they like seeing their off-going and on-coming nurses communicate. We always ask at the end "Did that cover everything important? Do you have anything else you want to discuss?" and I've had multiple pts tell me they really appreciate that we're asking their opinion and including them in the discussion.

We ask visitors to step out during report, by the way. Also, anything that we can't discuss in front of the pt, we state briefly at the desk.

This has virtually eliminated issues like pts complaining that their nurse didn't do anything for them all day, rooms that are trashed, pts complaining that there is no communication and that they don't know what's going on, and mistakes like the wrong IV fluids hanging (that's one thing we double check at each bedside report). Since we started this, I haven't left late once. I'm out of report by 7:15 AND I've seen and done a quick visual check on all my patients, and I know that they don't need anything right now. Our docs like it because they say the nurses know more about the pts (no more phone calls from the docs early in the shift, asking about something, and the nurse replying "well, I haven't even seen that pt yet, for example).

[esrun00]

We started bedside reporting a month ago and most of us now love it. It goes much quicker with less chit/chat. As nurses we don't seem to like change, but this really isn't as bad as you think. Give it a chance.