Adult nurses- please weigh in on bedside rounding!

[enzati]

Hi everyone!

I am a pediatric nurse wanting to present and write about the great strides our area has made in physician/nurse bedside rounding. However, I've had several docs tell me that bedside rounding is not a priority in the adult world! In my literature and web searches, I've been able to find only that general consensus is that it should be occurring and giving a lot of great evidence for why - but cannot find evidence that it actually IS occurring. I'd love to get input from those of you who work with adults in all various specialties to see what the trend actually IS. Thanks SO much for your valuable time and help!!

Jaime

Columbus, Ohio

[imintrouble, BSN, RN]

We do hourly rounding. The requests by pts during those rounds are generally not r/t their illness. Usually warm blanket, more water, help me turn, pick up my remote, cover me up, the room's too cold, close the blinds, bring me a wash cloth, turn off the light, put my head up......

If the pt has an issue with their condition they'll use the light.

The hourly rounding is simply to boost survey scores.

[VANurse2010]

And those doctors who say it's not a priority are the ones who get mad when they're paged even though they didn't update you on the plan... Whatever.

[Here.I.Stand, BSN, RN]

I'm not sure what the current norm in med-surg and other floors are, but in my ICU there are at least 3 bedside rounds a day. (I say at least 3 b/c I've never worked 3-11). The primary service's residents round towards the end of night shift around 0500, and then a couple hours later w/ the rest of the service. Then around 0900, there is bedside IDT rounding--includes RN, case manager, primary and consulting MDs, PharmD, RT, RD.

[imintrouble, BSN, RN]

Oops....not nurse rounding.

Don't I feel silly:sarcastic:

[wanderlust99]

Physician/RN rounding or rounding with the whole team...I see in some ICUs, but surprisingly not all. And it is usually not at the bedside. Many times it will be right outside the door. I've worked at many hospitals so I've seen it done all sorts of ways. It was actually at a smaller 200 bed community hospital where the RN would present the patient to the MD, the social worker, etc.. and the MD would ask us questions and our thoughts. It was a real learning experience and I enjoyed it. But I will be honest, that was an exception to most facilities I've worked at.

I'm not a floor nurse but have floated to the floors and tele many many times and have never seen physician/RN rounding on patients and certainly not at bedside. One facility I worked at the case manager would do rounds with us, but that's it. I remember being floated to tele once and seeing the MD enter the room, so I followed so I could listen in. He looked at me like what are you doing here? Can I help you? Sometimes the doc will find you and ask you questions but honestly that is rare in my experience. They will usually just come in, put in some orders and not even address the RN.

[nichefinder]

I am strictly a night nurse, so I rarely.. actually never saw a real rounding. Most of pt requests are done via phone by me asking the doc for something, and guarantee you I am not calling a doc at 0200 so pt can get laxative.

To be frank, I think that physician rounding is not that important in med/surg like it is in ICU, NICU, peds, etc. Most of the times, the requests are pretty stupid like "can you increase my morphine?" or "I am having diarrhea, can you d/c my colace" and I have to remind them they can refuse meds... duh. I can't blame physicians for being led to believe that med/surg pts are most of times waste of their time; well I hate working at med/surg floor after all, so I might be blowing off the importance of individual pt's wishes to get as much pain meds and alprazolams they need.

[Lev, MSN, RN, NP]

I work on a 40 bed General Surgery and Orthopedic Unit at a community hospital. Our bedside rounding takes places after giving report to the oncoming nurse. The oncoming nurses is introduced and the white board is updated with the nurse and tech's names. Things that may come up in bedside rounding includes: patient comfort - get me water or blanket, next dose of pain medicine, and plan of care - such as scheduled procedures. If something was mentioned in report that needs to be seen - such as her urine is really concentrated or her IV may not last much longer- it can be seen during beside report. Just this morning I noticed that my patient appeared to have a facial droop. I was able to ask the nigh shift RN about this during beside report. Then, during bedside report at the end of this shift, the nurse I gave report to asked me about the facial droop too!

[loriangel14, RN]

We don't do bedside doctor/nurse rounding of any kind.

[Fiona59]

Our residents round at the crack of dawn. Yup, the best time to see a patient, when they are half asleep.

Our surgeons? Maybe once a week.

It's operate, sleep over, go home, go for follow up visit.

[Dranger]

We do team rounding every morning in front of the patient (MD,RN,MSW,PT/OT)

[bostonrnbsn]

I also participate in multidisciplinary rounds once a day (usually sometime between 9-11am) with charge RN, bedside RN, case manager, MD, physical therapy, and a pharmacist at the patient's bedside.