Bedside report

[aem31]

My facility does it, or we are supposed to. Nobody on my unit gives bedside report. Everyone hates the idea of it.

The problems I see with it:

1. Especially for nights going into day shift: Often we have friends or family members sleep in room with the patient. This in itself could bring up a few issues. To begin with, there is potential for HIPAA violation. Or as a coworker mentioned, you now have these other family/friend ears listening in, and the potential for drama that could bring with the twisting of what was said and misunderstandings. If the patient doesn't want the person rooming in to hear report (which would probably be quite unusual) then you would have to fully rouse said individual and escort them out of room so report could commence, further delaying report and probably leaving for some unhappy kicked-out-of room-folks.

2. I think most of us feel uncomfortable with what to say in report in front of the patient. Obviously we can all think of things that would be awkward to discuss. Does that then mean you have two reports given? One that is prettied up for patient and then "the real deal" outside the room?

3. Interruptions. I see lots of interruptions happening in this scenario.

4. Fear of accidentally slipping some diagnosis or result that the patient was not yet privy to.

Benefits would include less gossip and judgmental tidbits mixed in with report. Probably a more streamline fashion of giving report. The patient is involved and can ask questions (which is also a con as I mentioned above-interruptions).

Do you give bedside report? Do you like it? Hate it?

[liveyourlife747]

We give bedside reports. Upon admission a pt goes through questions about bedside report: do they want to be woken up and do they care if others are in the room. If they are sleeping at 7am report, we step into the hallway outside of the door to give report. If they are awake we go in.

I enjoy it, 1. I get to see my pt at the start of shift. 2. There seems to be less drama during report giving, although little "tidbits" about the pt still are stated in the hall. 3. Pts feel more involved with care.

I don't like the interruptions, but the pcts are there for those needs... Usually....

[DoeRN]

I like bedside reporting. I'm an internal travel nurse so I never know what I'm walking into.

I usually give the dx and other info like that right outside the room. I go in and I introduce the next nurse and we go over a quick care plan for the day, look at IV fluids, other IV meds, any other lines, wounds etc. And making sure the leaving nurse did everything they were suppose to or if I need to do something. And most important making sure the patient is ok. If there are family or friends sleeping I have no problems kicking people out the room for report. I always ask if I can speak in front of family and friends anyway. It doesn't take any longer now at least for me when I give report. Because I go in before my shift ends to make sure the patient is ok, pain controlled, cleaned, used the bathroom.

And to tell them that I will bring the next nurse in for shift report. This way it can go much quicker.

The main reason I like bdsr is because on 2 occasions I worked an extra shift and found my patient unresponsive. Nothing like starting your shift coding a patient. And who knows how long they were like that.

When I was in management I made sure staff did bdsr even when the hospital didn't require it. Some staff complained but I told them my reasons and some evidence based research on why it was a good thing and they agreed. They still do it on that floor and I don't work there anymore.

[dudette10, MSN, RN]

It's just being implemented where I work, and it's difficult getting all of us to comply. I was on the fence about it, and I didn't push the other nurses to do so. Now, I'm starting to.

From other threads, there are two ways to do it: 1) give a nearly full report at bedside with sensitive info outside the room (the way mgmt wants it done) and 2) give full report outside the room and do a quick once-over of the patient in the room (the way that newly-implemented bedside report usually goes).

I am becoming more and more inclined to do it the proper way because most of my assessment is done in those few minutes at bedside. You get 75% of your assessment data just by eyeballing the patient and exchanging a few words. In most cases, doing it the abbreviated way actually takes longer, too.

As for interruptions and addressing needs, those are usually minimal. If the patient asks for something, I note it, tell the oncoming nurse and patient that I'll take care of it as soon as report is done, then collect everything the patients asked for and make deliveries before clocking out. Usually toileting needs aren't an issue because the techs rounded on everyone within an hour of shift change. If there is a toileting need, it's done immediately with two sets of hands!

[Gold_SJ]

Its seen as the gold standard and being implemented across the state here.

^.^;; To be honest though...I can't stand it.

I admit it can take people different lengths of time to adapt to change and that's probably me.

But in a kids ward I feel it just makes parents edgy and kids stress. Plus I personally would hate a group of people standing there discussing me in a shared four bay ward.

It would make more sense (To me) just to implement a round after shift to check on your patients.

Of course I understand patients feeling involved in the care process, checking med charts, lines, allowing questions, meeting patients, assessment.

So many good things

But I find there's more discomfort, forced to do a second report later about private issues. Father not allowed entry / Department of child safety etc. And I feel the lack of privacy is wrong.

XD This is just my personal opinion I can certainly see the benefits but you asked how we felt. I think nursing wise either way is good if you're prudent and assess your patient and their charts on commencement of shift.

Evidence based practice however says it's safer to have bedside handover... well from what I'm aware of anyway.

So I'm guessing we'll be stuck with it.

[rksgray13]

It's ok to a point. We asked the visitors to step out to give the patient an "out" from making the visitor feel shut out. We didn't dicuss anything that wasn't obvious. We dicussed the plan and what happedned that day. We also asked the patient if they had any comments after. Out side the room we gave more info on the way to the next room. Plus we had those print out sheets with dx, iv and setting, wounds and location, precautions, allergies, etc. We didn't discuss these. It made report go by alot quicker and informing oncoming nurse that I didn't care about the goosip and non pertinent info. Personally, I think report went quicker plus the patient knew when shift change actually was and who the next nurse was. I always checked charts and history if I wanted to know more info.

[Do-over, ASN, RN]

Honestly, I have learned to really like it. Its been a tough sell, but it does hold the off-going shift accountable for the state of the patient and the room. Plus, if the patient needs to be cleaned up or repositioned - there are two of you and you can get it handled immediately.

I have had very few issues with interruptions, etc. and, I think it is the fastest way.

The worst part is having to coerce your co-workers into getting up and walking into the room with you...

[anotherone, BSN, RN]

i do not like it, cant stand it actually! the reports are worse. i prefer to just do report outside of the room then ongoing and offgoing nurse can both go see the pt quickly! maybe check drips/pcas. i should t have to waste time with two reports and hate doing that. most of our pts have some sott of sensitive information.

[liveyourlife747]

After my event yesterday, I am so glad for bedside report! We found a pt in a full code blue. If we hadn't gone into his room, I wonder how long he would have gone before someone attended to him. Another RAT call was called today around shift change during report as well. I am a full on believer of bedside report!

[RNperdiem, RN]

If I am giving report to a new nurse or someone floating, I will do part of the report at the bedside.

Sometimes in SICU, if the patient has a complicated maze of surgical drains or unusual dressings, it is just easier to do the show-and-tell presentation.

A lot of people are visual learners, so it is easier to show the IV's, show the traction etc.

[Caffeine_IV]

I like walking rounds where you simply introduce the next shift. I prefer to get report at the nursing station.

However we do bedside reporting. Always seem to get patients that want to ask 15 questions or make multiple requests during bedside report that prolongs the end of shift.

[aem31]

I'm now kind of wanting to do BS report. Initially, I felt apprehensive about it but I think some great valid points in favor of Bs report have been made. I really like the idea of seeing the patient and doing a quick assessment right there. And being able to hold the off going nurse accountable or have them perhaps explain why xyz wasn't done, I think would be helpful. Not to mention having an extra set of hands to situate the patient or to catch something big, like a code.

My group seems so leery of it. I mentioned to one nurse I was reporting to that maybe we should go do BS report because the DON has been cracking down on us about it and she had just walked by looking none to happy that people were still giving report at the nurses station. She was adamant that we were going to give report right there at the nurses station.

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