Bedside report

klone, MSN, RN · Jun 30, 2012

Our hospital has been doing it for over a year. It's been mixed success. Some nurses do true bedside report, and some nurses give report right outside the room and then just go into the room to introduce the oncoming nurse. It's hard because at 7am, a lot of moms are sleeping and don't want to be interrupted. It seems to work better at evening shift. Overall, though, they seem to appreciate being a part of it.

It seems to work much better in L&D than M/B, and it seems like some form of bedside report has always been something we've done in L&D because you have to go in and look at the strip, the IV, etc, so the transition was much easier

Fyreflie · Jun 30, 2012

I've done it in all of my jobs so far--sometimes I've given report outside the room for social issues etc but everything else at the bedside. For postpartum we didn't though--first because of the amount of time it would take, second because of confidentiality with ward beds and third because waking up a mom who has a new baby is bad news! But for L&D I find it works really well and also serves to help the couple understand where their process is and gives them opportunity to ask questions :)

JZ_RN · Jun 30, 2012

I realize that my experience isn't in OB GYN but I'll give my 2 cents as a nurse in with the varied adult population. I'm sure it's slightly different in mother/baby and all of course.

As much as I think the idea of bedside report is good because it can include the patient, which is "patient centered" the focus of it is usually "customer service." Besides, no patient wants to hear "Make sure you get Mrs. Whiny her pain pills right on time or she'll be riding the call light like it's a rodeo bull, or "Mr. Nasty will try to grab and grope you, so watch out, or He refused his bath all day and stinks like the underside of a rotting cow in the sun." Honestly, sometimes nurses need to know things that perhaps are not appropriate to say in front of the patient. And then there's the always present issues with the doctor you need to address but that you don't necessarily want to spend 40 minutes explaining to the patient at that time. And some patients, you go in the room to do report, you're not leaving for 2 more hours 'cause they are constantly begging for attention, unnecessary care (no, your dressing does not in fact need to be changed every 2 hours, it's not saturated and that's not the order I have... ) or wanting something from you, and take up all your time. I'd rather do report and get outta there.

I hope this doesn't come off as "anti-patient" cause they do deserve to be involved in their own care, however, bedside report is more about customer service than patient care in my eyes. A good nurse will talk to the patient anyways, explain things anyways, and provide decent care, without the added time-suck that this can be, and actually give better care. On top of that how many places have all private rooms? Can you say HIPAA violation?

klone, MSN, RN · Jun 30, 2012

On top of that how many places have all private rooms? Can you say HIPAA violation?

Every OB unit I've worked at has had all private rooms, so that has never been an issue.

JZ_RN · Jun 30, 2012

OB is a little different from general hospital floors, I understand that, but no place I have ever worked besides when I did my clinical rotations in OB had all private rooms. Which is why my post was from a general standpoint, not OB. Maybe bedside report works in OB, but I cannot see it working in many other units.

klone, MSN, RN · Jun 30, 2012

OB is a little different from general hospital floors, I understand that, but no place I have ever worked besides when I did my clinical rotations in OB had all private rooms. Which is why my post was from a general standpoint, not OB. Maybe bedside report works in OB, but I cannot see it working in many other units.

I do get that. However, we *are* in the L&D nursing forum, and the OP did specifically ask about how well it works in L&D. :confused:

JZ_RN · Jun 30, 2012

I realized that halfway through my post. I just was interested in letting you guys know about how bedside report can have some downfalls as well. I had one lady in OB, she was positive for lots of icky things. I don't think she'd want to hear "high-risk patient, be extra careful and protect yourself" right in front of her face, but I'm certainly going to pass that on in report to an oncoming nurse.

klone, MSN, RN · Jul 1, 2012

Yeah, there are definitely times when there are certain things you want to say outside of the room before you go in there.

KJM10 · Jul 2, 2012

We typically do more detailed report outside the room, and then introduce the new nurse- go over IV's, and some general things at bedside (like pt wants skin to skin, breast feeding, no epidural, POC etc) I think its difficult to do a detailed report at bedside due to the fact that there are often other people in the patients room. I have found MOST patients have a hard time asking family to step out, even when I suggest they do. So for personal sensitive info we give before we step in room.

Elvish, BSN, DNP, RN, NP · Jul 2, 2012

We do detailed report outside as we have always done, then at the end, we go in and introduce the next nurse and hit the high points (IV, duramorph/PCA, foley, etc.). There is no way in hades I would talk about a pt's swollen bottom or her HIV status in front of anyone but her unless she specifically says I can. And even then it would still feel funny.

rn/writer, RN · Jul 3, 2012

I work postpartum and we do an adapted version that has proved more workable than we first thought it would. We have continued with our old written shift-to-shift reports that we keep in a folder. This allows a look back over the all the shifts since admission and reduces the yakking that goes on with verbal reports. Then, for the bedside part, the off-going nurse introduces the oncoming nurse and we cover the most recent meds, if patients want to be awakened during the night for meds, when babies are due to be fed next, if any after-hours visitors (mostly dads getting off work) are expected. Short and sweet.

The introduction seems to mean something to the patients. And it's a good time to make sure all the bases are covered--prn meds giventaken care of, immunizations addressed, etc.--matters that are much more easily covered when patients are at least somewhat awake.

I don't know if bedside report is a passing fancy or a permanent fixture, but it hasn't been as much of a pain as we feared.