I had the worst experience in a very long time giving report this morning. My unit requires bedside report, which I actually love. Apparently a recent new grad hire hates it. Waited until 15 min into her shift to even try to get report.
She came to room #1. Parked across the hall and silently waited. I called her in, we got started. Shortly into it (I mean, I had just finished saying background info), newbie nurse turns the patient's lights off and leaves the room. I looked up and saw the patient was confused, too. Nurse says the patient was sleeping. Patient denies it, which was obviously more than enough evidence to verify the patient was, in fact, awake.
Finished up (at the bedside), went to #2. I walked in the room thinking she was right behind me. She definitely was NOT. Once again, butt hugged the other side of the hallway, just waiting.
The thing is, not only was today an accreditation visit, but these two patients were extremely complex, both unstable, both with multiple skin "things" going on. #2 had had an RRT called on her a few hours prior. Lots of stuff going on there!
And, bedside is required!
Room #3, she took the lead on introductions, and then actually told the patient we would be leaving the room to do report in the hallway. I stopped her the doorway, told her this patient actually prefers report at the bedside and reminded her that bedside is required on our unit (and management was crawling all over the place tidying things for our horrible, day-destroying visit).
She came back in. Patient #s 3 & 4 were quick and easy, so we were done there quickly.
Personally, I absolutely love bedside reporting. When the situation is inappropriate, I may opt out of it, but I love getting to visualize and verify the patient is alright.
So, me, I vote love it. I also think if you have opposite feelings of the person you're sharing patients with, whichever one of you is giving report should choose location if you are able. If you have had that patient all day long, you know if that patient is appropriate to include.
Hate it. I work in med-surg with six or seven pts. Many of the pts I have are difficult and have psych issues. Then there are the ones who love to talk your ears off and question every...single...thing you do. Then there are the off-going nurses who like to chat with the patient and give you every minute detail of the patient's care/day. It just goes on.
Now, in the ICU, I would want a bedside report. On my unit? I wouldn't get started on my assessments and med passes until 8 with some of the nurses I work with!
I like getting report outside of room and then after, rounding very briefly for the introduction, upsell, checking pt and lines etc. take 2 seconds. But NOOOOO. This is not what they want . they want us to give full report at the bedside. Why?? so said pt can feel like special snowflake?? I dont understand this. Doing it that way, I find it is such a "clean" report, that important stuff gets missed. I mean, its one thing to say " Hi this is Ms Jones , who came in to have her hysterectomy, etc .Straight forward. Not. this is Ms SMith. She is probablly going to pass today, and she is still a full code. She is completely confused, and is is having residuals in her tubefeedings. Or this is ms brown. she is awaiting a bed on the psych unit because she completely delusional . Or what if they are admitted with someting embarrasing.you get the point.
I think its done for the customer service aspect for those who are aox3.
Also gets my goat- " oh while you are in here. I need help to the bathroom. They dont want to hear " wait for the tech. And I guess I wouldnt want to wait either if I had to go, but they prob would have just put their call light on and would have had someone help them that way,if we hadnt already been in there. Now times that by 6 pts.
No wonder report takes so long, then we get berated for taking too long in report.
1. To be woken up at 0300 so your nurses can give report? (part of our hospital works 0300-1500 and 1500-0300).
2. For your entire family to hear about your herpes, chlamydia, gonorrhea, trich, etc?
3. For your entire family to hear about your lady partsl/perineal/labial tear and/or episiotomy and repair?
4. For your partner to discover during bedside report that you have a very well-kept secret case of herpes, chlamydia, gonorrhea, trich, etc?
Regardless of how we tell patients that report goes into all details of their care and history, there is always someone who doesn't really understand what that means until their family (that's glued to the laboring/new mom's side and refuses to leave the room come hell or high water) is standing in on an awkward and formerly private conversation!
Sample of post-bedside report question panel from peanut gallery:
Bedside reporting – I feel it really is on an individual patient basis. What aggravates me is when our management decides during shift change that this is the perfect time to circulate the unit (before retreating into their offices for the rest of the day, doors shut, blinds drawn) condescendingly asking Are we doing bedside report?†to each pair of nurses they encounter like we are misbehaving children. We are in the hallway – clearly we are NOT doing bedside report!
There is enough micromanaging in nursing, I wish our professional judgement would be trusted sometimes – and sometimes it is just NOT appropriate to do bed side report. Like most comments on this thread I prefer to do report in the hallway and then peak in on the patient to check the basics – breathing, tubes, gtts, bed alarm activated if necessary, ensure patient is not the floor, etc.
I hate it and I feel very strongly that it's a violation of HIPAA when pt's share a room. It's not appropriate to be going over one pt's entire medical history/current admission when the neighbor can hear everything. I do however think it's appropriate to first get report and then go eyeball everyone with the previous shift just to make sure everything is in order.
Bedside? I guess if you want to listen to a bunch of stories, complaints, questions. The patient and family have all day to do that. Professionals need to speak privately,without editing for the patients sake.OF COURSE we share sensitive info that the patient does not need to hear, but is pertinent to the plan of care. . This family involvement thing has gone too far. They don't need to see their family member coded.Why not let them sit in the OR then too during their loved ones CABG? Or maybe have the doctors do all of their consult talks in their room too? Patients understandably have generally have very little knowledge of medicine. Having them listen to report just creates more problems. I think, time allowing, introducing the next nurse and saying goodbye is very professional.
Yeah, we sat on a guys ca dx once because we didn't know the exact type or stage which meant we didn't have POC for it yet. Pretty hard to say "and he's got fungating ca of some sort" in front of a pt and not 1) have the pt start playing 20Q about what a fungating ca is or 2) go leaping over my NPA by revealing a lab result/dx to a pt without his Dr having discussed it first.
But the manager will chase us out of the station, chirping that report needs to be given at bedside, it's for pt safety!
One of my issues: nurses who can't stick to pertinent info and take 10 to 15 minutes on one pt or spend time socializing with the family. This makes me want to scream.
One of my issues: nurses who can't stick to pertinent info and take 10 to 15 minutes on one pt or spend time socializing with the family. This makes me want to scream.
But more socializing with the family = increased customer (oops, how silly of me, I meant patient) satisfaction ratings which somehow magically means better care from the staff and NOT better bonuses or pay bumps for the C-level administration.
Or something like that. They always get a little fuzzy w the details once we get past the more money part.
You nailed it! Hope Managers are following this thread. Maybe family should be allowed in the OR too???
You wait- that is next. a glass room where they can see in and have the conversation pipped in by speaker.
You know, that may not be a bad idea- I bet a lot more docs would have to censor themselves. wouldnt have to hear f bombs from them lol. That could be a win win situation
We have 2 patients to a room so at times it can be invasive. I work nights so at some time before the end of my shift I explain bedside report and ask if it's okay to do in the room, if they want me to kick out friends and family first, and if they'd prefer if I let them sleep. Other than that, I like it because I prefer show-and-tell. It's easier to know if you have a neuro change if you talk to the patient at the beginning of shift. And I've had 3 different occasions where I've called a rapid as soon as I walk into the room and had to transfer the patient to the ICU. One was in DIC and the outgoing nurse somehow didn't think that bleeding from every orifice constituted an emergency.
We use a 1 page printed SBAR and I always update it every shift. I prompt the oncoming nurse to read that as we are walking down the hall into the patient's room. I can usually give report on 5 med-surg patients in 15-20 minutes.
ThePrincessBride, MSN, RN, NP
1 Article; 2,594 Posts
Hate it. I work in med-surg with six or seven pts. Many of the pts I have are difficult and have psych issues. Then there are the ones who love to talk your ears off and question every...single...thing you do. Then there are the off-going nurses who like to chat with the patient and give you every minute detail of the patient's care/day. It just goes on.
Now, in the ICU, I would want a bedside report. On my unit? I wouldn't get started on my assessments and med passes until 8 with some of the nurses I work with!