Bedside hand-off/report?

hiddencatRN, BSN, RN · Dec 14, 2011

We're supposed to be doing it but rarely do. I like to be able to refer to the chart when I give report, and not all the rooms have computers at bedside. With the rapid turnover of patients, I find it's easy to get current patients confused with past patients or other patients I'm currently working with when trying to go off the top of my head, especially because by the end of my shift I'm feeling pretty fried and was probably rushing around trying to get things to s decent point for the oncoming shift. And the time of going room to room adds up when you can do it in one spot.

Plus, in some cases I like to be able to give the nurse taking my assignment a heads up if the patient is particularly difficult, and sometimes it's hard to pass on things like "parent states patient had a tactile fever of 98.6" with a straight face.....

I wouldn't mind doing a report away from the patient with a handoff at bedside though. I usually go in to my patients when I get them and introduce myself and tell them I'm taking over their care from the previous nurse.

emtb2rn, BSN, RN, EMT-B · Dec 14, 2011

We've been doing it for a few months. Pts & families really seem to like it. We give the real report at the desk and then go in, say goodby, introduce the oncoming rn and review anything criticalish (new word) like drips & such.

The problem is when we're getting slammed at turnover or as in my case when i come in at 1100, i'm getting report from 3 different rns.

Guest219794 · Dec 14, 2011

Did it for 3 months at a travel job. It was taken seriously, was done well, and was no more time consuming than nsg station report. Patients were well informed, and just the act of summing up critical issues and plan of care in a user friendly form facilitated a good report.

This was done in a high volume, high acuity ER.

Have also done it in facilities in which the nurses were not bought in, there was inadequate training, no supervision, and no enforcement of the rule. In those cases, the nurse who had predicted "this will never work" were right.

My thoughts:

Recpe for success: process is initiated, or at least supported, by respected bedside nurses who have researched the issue, and believe it to be a good practice. These nurses have either done the process with good results, or visited a facility that does.

Typical approach: Administrators or non-clinical nurses impose the process on bedside nurses who are trying to provide good care with limited resources. In this case it will be seen as a hindrance to patient care.

Factor into the above equasion that there will be some degree of negativity. Some nurses are unhappy people, who view anything new and different to be bad. Some nurses are lazy. Unfortunately, this group tends to be vocal.

thelema13 · Dec 15, 2011

Started doing this a few months ago in our ED, pts love it and families do too. They feel as though they are included in their care, plus they are being updated on everything. I usually give bedside report, then I will pull up the chart and report lab/rad results, and review any orders that need to be completed. If family/friends are in room, I always ask pt permission or ask family to leave before blurting out any 'private' info.

Some nurses gripe about it, but I think its great, an easy introduction and a goodbye from the departing nurse is always nice. We're also supposed to do this thing called AIDET- acknowledge, introduce, duration, explanation, and thank-you. It's some PR movement to get more people into the hospital, as if we need more pts. A little impractical at times, and I never tell anyone how long it will take for an XR or lab results because I always end up wrong.

ReWritten · Dec 15, 2011

In a smaller ER. We report at the nurses' station. I think bedside reporting would work in ours, but I don't see any of my coworkers agreeing to it. Plus, the fear of HIPAA violation.

We had AIDET too. What a waste of time, the hospital should've spent money somewhere else (like working equipment) rather than teaching us how to introduce ourselves. And I agree with thelema, I'm not going to put a timeframe on labwork and such. Our lab is worthless and takes forever or screws up, and all that depends how busy we are. I also got scolded for saying "busy" instead I should say "it's a popular time right now". Really? Ok, rant over.

Editorial Team / Moderator · Dec 15, 2011

Yeah, we did AIDET at my old place -- it was a little scripted, but the overall message was good as far as managing patient expectations. When I'm giving a time frame, I usually say "at least" xyz time, but you know how people hear what they want ... LOL

Appreciate the feedback from my fellow ED RNs! (And those of you from other units/areas, but I really needed the ED input. )

VICEDRN, BSN, RN · Jan 2, 2012

We are supposed to do bedside reporting on my unit and we did it on my previous unit as well. I don't really care whether we do it or we don't do it. I don't think it adds anything to the patient's side of the equation in the ER because I always keep my patients informed anyway so they can always recite what they are waiting on and what the next step is for them.

Its a sloppy implementation though. Some nurses do it and some nurses don't. Some of the nurses on the unit think it increases accountability because this way, you can ask the outgoing nurse to do things she didn't do that she should have. This never works. Either the outgoing nurse is lazy or sloppy and not going to do it anyway or it takes me a minute to catch what she didn't do.

As a patient (and before I went to nursing school), I can remember nurses doing bedside reporting when I was on the mother baby unit and I thought it was obnoxious because it interrupted my evening and any conversation that was going on in the room for yet another unnecessary intrusion but that's just me. ;-)