Bed Side Report

nurseprnRN, BSN, RN · Feb 14, 2013

Strongly suggest you go to the OCR.gov (office of civil rights) website that covers HIPAA to see what the law really requires before you start hearing HIPAAchondriasis responses.

brithoover · Feb 14, 2013

The facility I was at started to do bedside reporting. I am personally not a fan if waking my pt up in the morning. I would rather do one on one verbal report to discuss things I may not want to discuss in front of my pt. if my pt then has questions about their care I can sit down with them one on one. Apparently it has been proven that bedside is a positive thing but I don't like it

hopefulwhoop · Feb 15, 2013

My facility has instituted bedside report, as well, but it's really not enforced and most nurses don't comply...unless they're being watched. It's problematic when a pt is in a shared room 'cause you don't want the neighbor hearing their business. I personally don't do it, but I definitely see the advantages--for one, if you miss something in report, the pt can clue you in. I just prefer to give report outside the pt room and then go in with the incoming nurse, introduce myself and leave. And, I don't wake pts up for this--ever. My facility actually prefers that we don't wake up the pt for this purpose.

TheCommuter, BSN, RN · Feb 15, 2013

My workplace recently implemented bedside report. Most of the nurses, including me, dislike it and still give report in a private room unless management is watching us.

HIPAA is not my concern. My problem is, once the patient sees us, we receive a slew of requests and demands that are time-consuming ("Take me to the bathroom!" "Warm my dinner tray." "Get me undressed and put my nightgown on." "Fix me some coffee with two sugars and two creams." "I want a shower now." "Take me outside to smoke.").

If family members are in the room, they see us and have a million time-consuming questions that have no easy answers.

On an understaffed night I will have anywhere from 9 to 12 patients. Bedside report will take one to two hours if the offgoing nurse and I fulfill all of these requests and answer all these questions right then and there, especially if we are short on techs.

When we are understaffed, I secretly hope the patient is too distracted by the TV to ring their call lights. I feel relieved when I see family members leaving the building.

It's not that I do not want to answer questions or attend to these requests. I simply do not have the time to get it all done right when my shift is beginning.

BSNbeauty, BSN, RN · Feb 15, 2013

We have to do bedside report in the ED where I work. My issue is not HIPAA, as the ED rooms are private. However, my issue is the same as commuters, we are constantly interrupted with requests. Sometimes patients want to chime in ( which is fine, however it takes up time).

I think the oncoming nurse should do rounds just to say" Hi, I'm your nurse..., I will be in shortly to do XYZ".

stablesystole · Feb 15, 2013

My workplace recently implemented bedside report. Most of the nurses, including me, dislike it and still give report in a private room unless management is watching us.
HIPAA is not my concern. My problem is, once the patient sees us, we receive a slew of requests and demands that are time-consuming ("Take me to the bathroom!" "Warm my dinner tray." "Get me undressed and put my nightgown on." "Fix me some coffee with two sugars and two creams." "I want a shower now." "Take me outside to smoke.").
If family members are in the room, they see us and have a million time-consuming questions that have no easy answers.
On an understaffed night I will have anywhere from 9 to 12 patients. Bedside report will take one to two hours if the offgoing nurse and I fulfill all of these requests and answer all these questions right then and there, especially if we are short on techs.
When we are understaffed, I secretly hope the patient is too distracted by the TV to ring their call lights. I feel relieved when I see family members leaving the building.
It's not that I do not want to answer questions or attend to these requests. I simply do not have the time to get it all done right when my shift is beginning.

This mostly nails it. Bedside shift report takes at an unrealistically optimistic minimum, twice at long. Then you have to consider the cross shift relationship on your unit. If you have to deal with one shift being disrespectful/poorly disciplined and chronically showing up late or jacking around in the break room before hitting the floor, then you're an hour late clocking out to boot. Then you get the inquisition as to why the patients are complaining about being woken up all the time.

jadelpn, LPN, EMT-B · Feb 15, 2013

My workplace recently implemented bedside report. Most of the nurses, including me, dislike it and still give report in a private room unless management is watching us.
HIPAA is not my concern. My problem is, once the patient sees us, we receive a slew of requests and demands that are time-consuming ("Take me to the bathroom!" "Warm my dinner tray." "Get me undressed and put my nightgown on." "Fix me some coffee with two sugars and two creams." "I want a shower now." "Take me outside to smoke.").
If family members are in the room, they see us and have a million time-consuming questions that have no easy answers.
On an understaffed night I will have anywhere from 9 to 12 patients. Bedside report will take one to two hours if the offgoing nurse and I fulfill all of these requests and answer all these questions right then and there, especially if we are short on techs.
When we are understaffed, I secretly hope the patient is too distracted by the TV to ring their call lights. I feel relieved when I see family members leaving the building.
It's not that I do not want to answer questions or attend to these requests. I simply do not have the time to get it all done right when my shift is beginning.

This is why I don't like bedside reporting. Or bedside charting. Management seems to think we need to learn to "set limits". Uhm, ya. Right.

RNperdiem, RN · Feb 15, 2013

It depends on your setting.

In ICU, a bedside can be easier if the patient is intubated, sedated and has a complicated set of drains. It is easier to show than to tell some things.

Bedside report is one of those things that sounds good in theory, is imposed upon nurses from above, and we find ways to make it work(subvert the requirements).

Meriwhen, ASN, BSN, MSN, RN · Feb 15, 2013

I thank God every day that bedside reporting will never come to my setting. Not just because of the potential running amok of HIPAA, but because bedside reporting just wouldn't work in psych settings. Imagine how it talking about a patient's delusions in front of said delusional patient, giving report in front of a paranoid patient, talking about the drug-seeking behaviors of the ETOH admission, or discussing a borderline personality diagnosis in a patient who is in denial about it or worse--hasn't even been told about the diagnosis yet.

The patients are not just going to lie there meekly and nod in agreement. No, bedside report could potentially get pretty ugly pretty fast :)

dawnv368 · Feb 15, 2013

I work on a psychiatric unit and bedside shift report was recently made a requirement for us . We only do it once a day, from days to evenings. It's actually worked better than anyone expected. Not only does it give my patients a way to know who their oncoming staff is, it also gives them the chance to ask questions and it gives staff the chance to pass on any information that a patient may try to use to split staff. It's has practically eliminated all staff splitting from shift to shift. As far as addressing negative behaviours in front of the patient we do it in a matter of fact way. Pt did this, this and this earlier but after seclusion, or prns or whatever intervention they were able to turn things around. It allows our patients to reflect on thier behavior as normal when stated matter of factly and not as something to be ashamed of. Which we all know those with mental health issues have enough shame. As far as our more psychotic or paranoid patients all we do introduce the oncoming staff, ask if they have questions and complete report outside their room. And we never wake a patient for report. We just do it outside their room. It has provided a much smoother transition between shifts for staff and patients. Staff are more punctual as well because report has to start on time and if they're late they have to go back and get report on their patient's from someone when reports over. None of us wanted to do bedside shift report and thought it was stupid in the psychiatric setting but I'm happy to report we were wrong. If you give it a chance and work out the kinks it really is a good thing.

RainMom · Feb 15, 2013

I don't mind bedside rounding for the most part. I try to do a final round myself on all my pts about 30-45 minutes before so that hopefully any last minute requests or potty trips are taken care of. We peek in & if the pt appears to be sleeping/dozing, we just do report outside the door. Any sensitive info is given out of pt's hearing.

Actually, come to think of it, I give report at the bedside in the AM, but I receive report in the evening at the desk, usually because most pts are trying to get to sleep plus no managers around. Comparing the two, I think I usually am able to get through report in the AM faster than when I receive it at the desk in the evening. Evening RNs often seem to add a bit more chit chat, but the AM RNs are usually chomping at the bit, ready to go. (There's one RN that hardly waits [or wants] to even hear report; you have to chase her down.)