Bedside hand-off/report?

sapphire18 · Dec 12, 2011

This isn't specific to ER, but here is a recent, lengthy thread on this topic: https://allnurses.com/general-nursing-discussion/bedside-reporting-starting-649839.html

SoldierNurse22, BSN, RN · Dec 12, 2011

I've seen this done a few times at my hospital. Usually it's when you're working an 8 hour shift. There's one nurse in particular that does it. But it's a very touchy practice. There are some things that you really shouldn't say in front of your patient (example: one of my patients that day was bipolar and had been more bipolar than normal over the course of the prior shift), but by and large, if you do it right (ie, involve the patient in the report instead of just standing there talking about them, which I've seen done), I think it's a really useful tool.

AJPV · Dec 13, 2011

I'm just graduating from school now. It's interesting that in school and in our NCLEX review material, they are now discouraging bedside reporting (especially when other patients/people are within hearing distance). As a tech, I have noticed a couple interesting situations where "roommates" obviously overheard things that they shouldn't have.

Palliative Care, DNP · Dec 13, 2011

Personally, we do it but you can not give a full accurate report at the bedside. HIPPA prevents a lot from being said especially when there is family in the room. They may not be aware of every ailment the patient has. You also can not share the patient is demanding or has behavioral issues etc. :twocents:

Telelizard · Dec 13, 2011

At my hospital, its a rule. We must do bedside report every single time. If there is sensitive information, we discuss it at the nurse's station. We ask the pt if its okay that we do report in front of family, etc. I believe they did a survey where the patient stated they felt they were more involved in their care and informed of their condition when bedside report was done.

AngelicDarkness · Dec 13, 2011

My history with this topic is that we did report at the desks, and then went to bedsides to introduce the oncoming nurse, and the oncoming nurse would read the leaving nurse the hospital bracelet code number and full name. It was great for helping decrease errors:)

jnndub · Dec 13, 2011

We do this at our hospital here. We report admit Dx, pertinent Hx and any sensitive info like psych/social or CPS involvement outside the room and then walk in and do a focused minimal report; this is so and so and they will be your nurse tonight, show any drains/wounds, check out IV site, ask about pain, update (if any) about doc orders your basic plan of care. It takes about 5 mins unless it's a freq flier with multiple concerns. All are happy and you're less likely to have call bells going off at COS if you already addressed any needs. Furthermore, if your pts are heavy you've already seen them and your basic assessment on priorities of care and their status is taken care of. Especially if you have admits waiting or lots of meds to get on top of. Good luck to the implementation!

JeskaRN2011 · Dec 13, 2011

Our hospital does bedside hand off, but report is given first outside of the room. Then the nurse leaving goes in each patients room and says goodbye and introduces the nurse coming on. I really like it and the patients seem to too.

StrwbryblndRN · Dec 13, 2011

I like the idea. But it has been implemented before but unfortunately it did not go over well. Not the nurses but the patients. I work 7p-7a. Many pt's have dementia, some have diagnoses that have not been stated to the pt yet.

Plus you may have the pt for multiple nights and they do not like to hear over and over what is going wrong with them.

It can work for some patients but overall it is too much. I take on 6 pt's at night. Plus at one time we were doing bedside and private reporting off. That was horrible.

However I do agree that if there is a total pt that it is a good idea to take that time and turn them, listen to lung sounds posteriorly (not easy when everyone else is busy) and make sure they are not sitting in poop. All this while you are reporting.

What we are doing now is introducing the the oncoming nurse to the pt. Works well. You can figure out who needs to be seen first and if there need anything when you come back.

I am very open to new ideas. But this one did not do well for us.

Editorial Team / Moderator · Dec 13, 2011

I'm talking about bedside handoff/report in the ER, specifically, which we all know is not really much like other units. Obviously sensitive information isn't discussed in front of the patient -- it's more to introduce the oncoming nurse and let the patient know what's pending, etc., and it's with the patient's permission that anything is discussed in front of anyone else. There was a great article in JEN that I found about bedside handoff/report that addressed many of these issues, but I was curious about implementation in the ER setting and how ER nurses felt about it.

Thanks for your contributions! :)

etaoinshrdluRN · Dec 14, 2011

Been doing bedside report for almost a year, and it's the rule in my hospital. I love it. The reports are concise, the pt. feels he is more involved, and anything sensitive (work in psych) can be done at the nurses' station. I appreciate laying eyes on my patient and even establishing a rapport, and getting some aspects of the assessment done. Privacy is seldom an issue; the pt. is asked to come with us to a private spot. Some don't even think that is necessary. Any time a patient is awake, we must do bedside report . . . the exception being someone who is experiencing s loss of control or who is too agitated to handle it.