bedside report/end of shift report role play ideas

NurseCherlove · Feb 17, 2008

If you want formal references, can't help you.

If you want my opinion, here goes...

It SHOULD be done something like the following:

Since most patient charts are located outside of the patients door, nurses should do their report there, looking through the chart together. When report on this patient is done, then the nurses should go into the patient's room together, if for nothing more than the off-going nurse to say good-bye and the on-coming nurse to introduce herself. However, this is also an opportunity to hold the off-going nurse accountable for things that need to be done before she leaves (empty foley bag, put up new IVF bag if about to be empty, give the patient any needed pain meds, etc.). It is also an opportunity to show the on-coming nurse how to perform a procedure not frequently seen (for example, I had a Murphy drip the other night), as well as show the oncoming nurse the status of something she needs to key in on and monitor (fresh post op dressing, pedal pulse and groin site of fresh cardiac cath, etc.).

Now, I specifically said I think it should be done this way b/c I've heard of other nurses saying that they actually give report in the presence of the patient. Personally, I would never do that. There might be some not so good things you want to tell the nurse that the patient does not need to hear (bad test results the MD has yet to discuss, the pt is a PIA, etc.) Also, if it is a roommate style room, obviously HIPPA would be a problem.

Good luck.

hellonurse36 · Feb 17, 2008

I work in an ICU and we do report at the desk and then go into the room for bedside rounds. I agree that bedside report is not approriate...although I will repeat something to the oncoming RN in front of the pt if it is something I told the pt I would pass on. ie. "I just gave Mrs X a lasix pill and she is concerned about incontinence, I told her when she rings her callbell we'll answer quickly to get her a bedpan."

On my bedside rounds I check- dressings, chest tube/drains - both the dressing and the amount/colour of drainage, length of transvenous pacer wires or swans, groin sites if pt has arterial sheath/IABP or had a sheath pulled on that shift, swelling/edema, LOC/responsiveness on a sedated pt or pt with altered LOC.

ALWAYS check your pump set up on any infusions. Make sure the pump is set up for what is hanging - ie. Dopamine 400 mg/250 ml bag hanging but pump is set for 800mg/250 bag! Once you assume care of the pt you are responsible for that error too.

I also review the MARs so I can ask the day shift RN about any unsigned meds - did they give them and forget to sign them off or did they forget to give them.

Also, if family is at the bedside of a very sick pt or one that is comfort care (withdrawing on a DNR pt), I make sure I ease the transition to a new nurse with them as well. ie for a really sick pt: "Mr Z's wife will be sleeping in the waiting room or at hotel ABC and the ph number is in the chart, I told her that we'd let her if anything happened and keep her up to date on things." For a comfort care pt I make sure the family knows that they can stay at the bedside and that we are there for them as well, reinforce to not hesitate to let us know if there is anything we can do for them. I think for many families shift change is a stressful time. If they've built a rapport with the nurse and have gained confidence in the care their loved one is receiving, they worry about who is coming on next and how things will go.

Hope this helps,

Terri

Greenville, NC

Blee O'Myacin, BSN, RN · Feb 17, 2008

Hi, I'm new to Allnurses.
I'm a nursing student working a leadership project about implementing the bedside report procedure as a standardized process. One of the teaching methods I was asked to help out with is a role play scenario for the bedside report. Does anyone have any ides of where I could find resources to help with designing a role play activity? --Or somewhere I might be able to see some examples to help give me a reference base. I'm having a hard time finding information and would be extremely grateful if anyone knows any resources out there to help. Thanks!

The issue I have with bedside report is if the patient is AAO in the slightest, they may feel like we are discussing the patient as if they weren't there. Not a good feeling to have at all. And I have a peeve about being interrupted during report by anyone other than the nurse I am giving report to! It is not the time for patient questions. A smooth handoff to me would be a system by system report privately and then going to the bedside to ease handoff, check drips -etc. Kind of the best of both worlds. That would work in a student exercise. In "real life", assignments get split from shift to shift, so unless you are giving your entire patient load to only one nurse, then report will take forever!

Blee

lpnstudentin2010, LPN · Feb 17, 2008

The issue I have with bedside report is if the patient is AAO in the slightest they may feel like we are discussing the patient as if they weren't there. Not a good feeling to have at all. [/quote']
Ya it feel so weird to have one medical professional talk to another with you right there. One of my docs has done this twice recently and it feels SO weird. I was sitting there and she was on the phone talking to another of my docs.

Blee O'Myacin, BSN, RN · Feb 18, 2008

Ya it feel so weird to have one medical professional talk to another with you right there. One of my docs has done this twice recently and it feels SO weird. I was sitting there and she was on the phone talking to another of my docs.

Or when they dictate your case into the phone in front of you, that's weird as well.

Blee

jjjoy, LPN · Feb 18, 2008

I just love nursing school leadership assignments.. (sarcasm!). Let's ask an RN student who has never worked as an RN to design a role play to teach others how to do something he/she has never done themselves... huh?!?!

This is one of my pet peeves with putting so much emphasis on "leadership" in basic nursing education. With the way nursing education works these days, the new RN still has so much to learn their first year on the job, that it's a little unrealistic to expect them to also function as leaders. Since nursing is a practice and demands practical experience to be competent, it would seem best to make sure the nurses "walk before they run" and prove their competence as practicing nurses before training them in how to lead other nurses.

There are general leadership skills that transfer across fields. Being able to put together a role play for training purposes is one. But to be able to put together an effective role play about bedside reporting without personal experience would require substantial observation of that kind of reporting and feedback from those with experience... not just having one imagine what it might be like. *sigh*

Wouldn't it be more effective to have the school teach the students the various different ways of giving report? That way they can ensure that all of the students are getting the same guidance and not whatever variable quality of information that the students present as their project.

Well, not very helpful for you as a student... but if you think this is an awkward assignment, you're not alone. You've just gotta get through it. : )