No nurses on floor during report

  1. I've spoken with my nm regarding my concerns that no nurses are on the floor at shift change. I work 0630-1830. Third shift nurses leave at 0700, when the day shift comes in. Night shift tapes report. Day shift nurses then all go to the report room. No one is on the floor except aides and a unit secretary. Sometimes I'm the only aide. So that makes 2 people on the floor.

    When I talked to the nm I said that since the nurses take turns getting report that those who are not listening to report on their patients can return to the floor until they are called. On more than one occassion I've had to call a code. No floor nurses showed up because where they listen to report there is no speaker for the intercom.

    Oh, and report lasts from 0700-0815, often times longer. Does anyone else see a problem with this? Yes, the nurses are only a few feet away but like I said, they don't hear when codes are called.

    Another bad example: last week had a pt with chest pain and an extensive cardiac history. Put on light and was complaining of severe chest, jaw and arm pain. I interrupted report to let a nurse know. Went back to get vitals. Pt is diaphoretic, soa, and moaning in pain. O2 sat @88%. I can't do anything. The nurse shows up 10 mins later - I kid you not, the pt timed it. In the span of 10 mins I tried to find another nurse but was scared to leave the pt if she became unresponsive. I couldn't find another nurse. I could have paged the NS but she was involved in a code in OB.
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  2. 27 Comments

  3. by   NurseCard
    Yeah, I don't know why the day shift nurses can't take turns listening to report. So the night shift nurses leave while the day shift nurses are in report, leaving no one on the floor. Great.

    When I worked psych and had to tape report on all of the patients, often the day shift would send some of their people out on the floor and have them come back later and listen to report. Psych's a lot different though. Still, does seem like everyone could take turns; doesn't make sense that everyone listen to one long taped report, all at one time.
  4. by   SarasotaRN2b
    Over an hour for report? That is ridiculous. I work as a unit secretary on a cardiac floor. Our nurses work 7-7:30 and usually the last 30 minutes of the shift is when the nurses going off will report on their patients. Also during the shift they will telephone report. When patients call during that last half hour, it would be the off going nurses would have to see the patient. However, unless there is a real emergency (such as the case noted above), I will either have one of the patient care assistants help the patient if it is in their scope or I will ask if it could wait. many nurses will come in about 6:45 so they can listen to phone report and then just get updates from the RN going off.

    Kris
  5. by   cmo421
    Quote from bethin

    When I talked to the nm I said that since the nurses take turns getting report that those who are not listening to report on their patients can return to the floor until they are called. On more than one occassion I've had to call a code. No floor nurses showed up because where they listen to report there is no speaker for the intercom.

    Oh, and report lasts from 0700-0815, often times longer. Does anyone else see a problem with this? Yes, the nurses are only a few feet away but like I said, they don't hear when codes are called.

    Another bad example: last week had a pt with chest pain and an extensive cardiac history. Put on light and was complaining of severe chest, jaw and arm pain. I interrupted report to let a nurse know. Went back to get vitals. Pt is diaphoretic, soa, and moaning in pain. O2 sat @88%. I can't do anything. The nurse shows up 10 mins later - I kid you not, the pt timed it. In the span of 10 mins I tried to find another nurse but was scared to leave the pt if she became unresponsive. I couldn't find another nurse. I could have paged the NS but she was involved in a code in OB.

    First of all nurses in that report room that waited 10 minutes to show up for a pt c/o CP or anything else life threatening,should be reported as also the NM if they where aware. Second, I doubt that all the nurses need to listen to the whole report . They should be in there for what they need to hear and go.The charge nurse is the only one that needs to be in the report the whole time. Nurses can fill each in when they need to cover for breaks etc,,, If I were u,and my NM and or charge nurses did not change policy, each time u where left in an unsafe situation,I would fill out an incident report.Risk management will pick upon it. Over an hour is way to long for pt's to go without at least a quick peek from a licenced person,especially at the change of shifts when so much statistically happens. Be careful how and who u report to, I know it is not acceptable,but many will not be happy with ur opinion. Change is hard for some people. Also,I bet (been there,,,) that much of that time is spent in chit chat. Taped report is really a has been is most areas. Good luck!
  6. by   Alibaba
    Here's me playing devil's advocate for a minute.
    I agree it is absolutely crazy to have no nurses on the floor during report (although I have seen it many times) Where I disagree is those who suggest the day shift nurses not listening to report go on the floor and wait their turn.

    My question to this is; unless there is a real emergency on the floor, who wants to get on the floor without getting report first? Not me. As soon as you hit the floor, and look in on the people, you have established a care contract and can not later say oh.. I wasn't given report.

    My solution (which is done in most places I have worked) is to have the previous shift stay till report is done (and nooooo it should never take 1 hr to get this done). Seems like the fair way to do it.

    That's my 0.02$
  7. by   cmo421
    Quote from Alibaba
    Here's me playing devil's advocate for a minute.
    I agree it is absolutely crazy to have no nurses on the floor during report (although I have seen it many times) Where I disagree is those who suggest the day shift nurses not listening to report go on the floor and wait their turn.

    My question to this is; unless there is a real emergency on the floor, who wants to get on the floor without getting report first? Not me. As soon as you hit the floor, and look in on the people, you have established a care contract and can not later say oh.. I wasn't given report.

    My solution (which is done in most places I have worked) is to have the previous shift stay till report is done (and nooooo it should never take 1 hr to get this done). Seems like the fair way to do it.

    That's my 0.02$


    So if u walked on the floor,no report,walked by a room and the pt was blue and gasping ,u would say hold on ,let me get report first? Licenced professionals do not need a full report to assess an emergency situation. Many small things can be done before getting report. Even if the nurses just sat and reviewed charts while waiting,at least they would be accessable! I am not saying ,give meds,or answer questions,etc,,,,I am saying provide a safe enviorment for pt's. I have said to many a pt or family, "I do not know the answer to that,I have to get report,but I will get back to u shortly" .Many union facilities have set 8/12 hr days, no over lapping of shifts,and changing that will take eons. Changing the mind set of a few nurses should not take all that long.
  8. by   CarVsTree
    I know this is a problem everywhere. I believe on my floor they used to tape report, but it was just not successful. We are trauma and the injuries, dressing changes, etc are just too extensive.... Anyway, fortunately for us, we are not all in the back room getting report. There are some nurses in the front "server" and some in the back. Some in the break room as well. In addition, we have good nurses who would not ignore a pt. in distress report or not. I'm sorry this has happened to you.

    I agree with other posters who said you need to report the RN who took 10 minutes to get there. I assume you told her the sao2 was 88% or did you find that out after. Either way, 10 minutes is not acceptable. I think a meeting to rectify this dangerous situation is in order.

    I have a question, if report is taped why is it not taped earlier. Why aren't the night shift RN's manning the floor while the day shift RN's are getting report. The whole thing sounds hokey.
  9. by   Alibaba
    Quote from cmo421
    So if u walked on the floor,no report,walked by a room and the pt was blue and gasping ,u would say hold on ,let me get report first? Licenced professionals do not need a full report to assess an emergency situation. Many small things can be done before getting report. Even if the nurses just sat and reviewed charts while waiting,at least they would be accessable! I am not saying ,give meds,or answer questions,etc,,,,I am saying provide a safe enviorment for pt's. I have said to many a pt or family, "I do not know the answer to that,I have to get report,but I will get back to u shortly" .Many union facilities have set 8/12 hr days, no over lapping of shifts,and changing that will take eons. Changing the mind set of a few nurses should not take all that long.
    Please re-read the second paragraph of my post. I believe I addressed your concern about emergencies (and yes a blue pt gasping for breath is an emergency in my book)
  10. by   PRESLA
    ]Speaking for night and day shifts, in which I have worked both, I have to say day shift farts around longer in the morning before they start work then when they are ready to leave at night. They have to make their coffee catch up on the news and talk. Night shift has their problems to don't get me wrong, but I always wanted to get my stuff done before the patient was ready for bed. In the facilities that I have worked in they did away c taping report a long time ago because that makes everyone sit at the conference table waiting for there assignment report to be given taking WAY, Way toooo long. Keep up the good work aides don't get enough glory and they should. Keep on you NM and pull together and make changes it can and has been done c this situation.

    Lisa
  11. by   Spidey's mom
    The nurses leaving took turns giving report and the nurses coming on all listened to report on all the patients. So, one nurse is giving report and the others are on the floor.

    This seems simple to me . . .

    Why do all the off-going nurses have to be in the same room at the same time? They don't need to hear report. They are leaving.

    steph
  12. by   cmo421
    Quote from Alibaba
    Please re-read the second paragraph of my post. I believe I addressed your concern about emergencies (and yes a blue pt gasping for breath is an emergency in my book)

    I am sorry,but I did read it,and I still do not agree that u need report to man the floor. I know u would not walk by a pt in an emergency,but a pt care contract? Come on. I am just one of those nurses who hit the floor running.( or I was) You need to get report to accomplish your day and for safety. But a few minutes to cover each other without all the in's and out's is perfectly safe and doable. You have to work with what u have and that is an 8 hr day. No one is going to pay OT for shift report. So either establish a shift that covers report(630-1430,1430-2230,2230-0630) or work with what u have. We used to do team years ago,8 hr shifts, side a listened,side b covered and visa versa. Charge people heard the whole floor,if a question arose,someone peeked into report and asked. Sorry,did not mean to get u angry,just believe in working as a team and independent thinking.
  13. by   ICRN2008
    I am wondering why report is still being taped. The new standard from the Joint Commission is a person-to-person verbal report with an opportunity to review the orders together so that the nurse coming on can ask questions. Are hospitals not abiding by this rule?
  14. by   RN1989
    Report should never take this long. Obviously someone is either talking too long or giving redundant info that can be found on a kardex. You can read the kardex while you are taking report. Report from the offgoing shift should consist of what is pertinent for that pt for that shift. You do no need to read every piece of information written on a kardex. This is usually the reason I have found taped reports to be ridiculously long.

    If the nurses are unsure of what they should be including in report, then they need education in priorities, time management, continuity of care and how to give a report.

    And why in the world are nurses leaving before report is finished? That is totally inappropriate. If your unit wants to tape report, fine. But NO ONE should leave until the oncoming shift has listened to the tape and then had the opportunity to ask the off going shift if there are any updates/changes that occured between taping and listening to the tape. I have seen nurses that started taping report at 3 am. A lot can happen between 3 and 7 am!

    IMO - the nurses on your unit are unprofessional by starting this practice and then allowing this to go on. They are asking for a lawsuit!

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