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?

[monkeybug]

It's just another thing that is thought up by those way away from patient care that actually makes more work for the nurse. We were specifically told that we should NOT be doing two reports, one 'real' one and then the one for show. We should do a complete report at bedside. Let's look at maternity. You go in and ask the laboring mom if she would prefer everyone to step out. She says no, because if she says yes then the family will wonder what she is hiding. So boyfriend's mom and her mom are both there as you begin report: "This is a 23 yo G2P0,one elective AB 3 years ago." And there we have the first problem. No one knows she's a G2, they all think she's a G1. But let's continue. "She's GBS negative, Rh postive, Rubella Immune, and positive for HSV and HPV." Whoa nelly! Significant other didn't know about the warts and the herpes! Okay, put that fire and and resume. By the time you are done everyone is upset.

I think it puts patients in a terrible position. Yes, they can ask for a private report, but that does tend to clue family in that there is something they may not know, and it makes them curious, so I have had patients refuse private report and then all hell breaks loose.

[RNewbie]

It's just another thing that is thought up by those way away from patient care that actually makes more work for the nurse. We were specifically told that we should NOT be doing two reports, one 'real' one and then the one for show. We should do a complete report at bedside. Let's look at maternity. You go in and ask the laboring mom if she would prefer everyone to step out. She says no, because if she says yes then the family will wonder what she is hiding. So boyfriend's mom and her mom are both there as you begin report: "This is a 23 yo G2P0,one elective AB 3 years ago." And there we have the first problem. No one knows she's a G2, they all think she's a G1. But let's continue. "She's GBS negative, Rh postive, Rubella Immune, and positive for HSV and HPV." Whoa nelly! Significant other didn't know about the warts and the herpes! Okay, put that fire and and resume. By the time you are done everyone is upset.

I think it puts patients in a terrible position. Yes, they can ask for a private report, but that does tend to clue family in that there is something they may not know, and it makes them curious, so I have had patients refuse private report and then all hell breaks loose.

Totally agree. I'm all for making rounds with an introduction and laying eyes on the pt, but full report of all kinds of sensitive health info only causes more problems.

[PinkNBlue, BSN, RN]

We do it and it annoys me when people don't want to go and meet the patient. I will still go if i'm coming on shift and the outgoing nurse doesn't want to go into the patient's room. I'll go and introduce myself, put my name and phone ext on the board in the room in case they need to get ahold of me before I get in to assess them. It's courtesy and takes 5 minutes. If the incoming nurse doesn't want to go into the room, I also still go into the room to say good bye and let them know I'm leaving.

[RNsRWe, ASN, RN]

I'm out of hospital nursing for about 16 months, but I saw this tried twice in five years. Both times went down in flames.

Management thought it would be more efficient, information would be transferred more accurately, etc etc. Reality was it took LONGER because of the questions and interruptions of patients and family. You can't exactly walk out of the room when you know the patient requires assistance to the bathroom, or personal hygiene attention---and there's no CNA in sight. So you stop and the two RNs are giving the care, slowing down report. And don't forget the 75 questions the family has that must be answered right then. So.....even slower report.

Privacy issues were a real problem, as has been mentioned in the thread previously.

Report really WAS sketchy and had to be "filled in" in the hallway anyway, as the patient sometimes was not aware of the result of a dx test but the oncoming nurse needed to know. Or needed to know what it was the patient knew and didn't know, etc.

Bottom line was we went back to nurse-to-nurse or nurse-to-charge-to-nurse report (or both, in conference room) within a week the first time and probably all of three days the next.

[evolvingrn, BSN, RN]

I'm out of hospital nursing for about 16 months, but I saw this tried twice in five years. Both times went down in flames.

Management thought it would be more efficient, information would be transferred more accurately, etc etc. Reality was it took LONGER because of the questions and interruptions of patients and family. You can't exactly walk out of the room when you know the patient requires assistance to the bathroom, or personal hygiene attention---and there's no CNA in sight. So you stop and the two RNs are giving the care, slowing down report. And don't forget the 75 questions the family has that must be answered right then. So.....even slower report.

Privacy issues were a real problem, as has been mentioned in the thread previously.

Report really WAS sketchy and had to be "filled in" in the hallway anyway, as the patient sometimes was not aware of the result of a dx test but the oncoming nurse needed to know. Or needed to know what it was the patient knew and didn't know, etc.

Bottom line was we went back to nurse-to-nurse or nurse-to-charge-to-nurse report (or both, in conference room) within a week the first time and probably all of three days the next.

It does take longer but it's safer and pts love it. We catch a lot of mistakes and its a great way to hold lazier nurses accountable without being mean.....they know we have to look at every line and if its overdo. ......it will be acknowledged by both on check off. Like pp. I had a pt that was almost dead and was found in bedside report....the night nurse just assumed they were sleeping....they instead were almost dead. I credit that to saving their life