Bedside report

[martymoose, BSN, RN]

I know there are many posts on this subject. We were just told we WILL be doing this under no uncertain terms. We have semi private rooms. We have dementia pts,confused people , psych pts, drug seekers, etc now. How is bedside report going to help them feel like a special snowflake when they arent even able to participate in the report, yet their room mate probably will know more about them then they do.

Are all hospitals going to this crap, or is it just "magnet" ones? More like opposing magnet.

oh, and when iI read prev. posts that " oh we just give the abbreviated versions in front of the pt ( so i guess they can feel all warm and cozy inside that we chose to include them in their" plan of care , lol), we have also been told NO- we will the the WHOLE report in the rooms- there are not to be any nurses out at the nursing stations sitting down. And we will also be having senior management personel following us around and critiquing our reports.

Gee, if I wanted to become an actor, I would have gone to school for that.

Any thoughts??

[martymoose, BSN, RN]

Oh, and to further the rant, why is itt NURSES are responsible for the hcaps crap??? why arent the Doctors in with this special report??

How bout housekeeping, dietary, labs services, radiology ,physical therapy etc etc etc???? Why are WE responsible for their crap??? Why are we responsible for ED messing up, and we have to clean it up??? Why are WE responsible for the drugseeker not getting their fix from the MD??

[MunoRN, RN]

Long ago, the full report at bedside had a short run as a fad. For the most part, it's been accepted that this limits the ability for staff to effectively transfer important information, in other words it makes for a less safe handoff (interruptions, less access to patient data, etc). So for a while now, groups such as the Joint Commission have been pushing to morph this into "safety checks", in which checks are done, such as double checking drips, wounds, etc, along with review of the plan with the patient. The Joint commission actually defines "safe handoff" as being free from disruptions such as patients and family, and the importance of having direct access to the chart and/or computer and that this portion of report should not take place in the room.

Management likes the idea of a full bedside report, because they hope it may improve patient satisfaction, which it might, the problem is that the report the patient is so pleased they've been included in on, isn't actually an adequate or safe report.

It's a difficult situation for Nursing staff. Really, it's your license and therefore you, not administration, is responsible for ensuring that you're not intentionally making report less safe. At the same time though, administration has no obligation to support your patient safety requirements. Years ago when we started this in my facility, we tried for a few days and then said as a group that this wasn't safe or effective and we were going back to the old way, the advantage of being part of a large group of "rogue" nurses.

[mappers]

MunoRn, do you have documentation for what you're saying? I find it interesting as management likes to say that evidence shows bedside reporting as superior.

[Sun0408, ASN, RN]

Call me dumb here but wouldn't bedside report in a NON private room be a big HIPAA violation?? We do bedside report but all our rooms are private, at report time we ask the family/friends/visitors to step out. They know this ahead of time and we have had no issues. In the am the pts are generally still asleep and we do not wake them.

[martymoose, BSN, RN]

Of course management likes this idea- they've been brainwashed by studor that this raises pt satisfaction scores.

Let's put each and everyone of ourselves in that situation of pt listening to two nurses drone over a report that is basically being read and edited on the fly so they hear only the good stuff, and are given the opportunity to " participate" in their care.

Ok, as if the nurses have any ability to make their stay at Hotel de Hospitale any better. It's all the other services that can ruin a person's view of their Hotel stay. Pt hates MD. How am I going to change that . Food sucks,which Dr. ordered,How are we changing that? etc. Or like I said before- pt so demented they don't know you are in the room.

I've received press gainey surveys, as I have been on the pt side of things many times. The nurse care aspect is maybe 1/100th of the report. The other 99% of things to be rated on are what people can complain about.

My only point is, that bedside report is NOT going to make pt satisfaction scores go up.

And in the effort of sugar coating report, SOMETHING will get missed, which also equals NOT SAFE REPORT.

[martymoose, BSN, RN]

Call me dumb here but wouldn't bedside report in a NON private room be a big HIPAA violation?? We do bedside report but all our rooms are private, at report time we ask the family/friends/visitors to step out. They know this ahead of time and we have had no issues. In the am the pts are generally still asleep and we do not wake them.

Well, for one, since we have no restraints on visiting hours,or especially giving report at 3 pm, there ARE many family members around . Just think how awkward it would be if the family members were just behind you at the nurse desk where we used to give report. Don't forget, In the name of pt satisfaction, there are no boundaries anymore- People get to do what they want- they get mad if we ask them to leave for the sake of another.

It's one thing if the other room mate says ok, I dont mind, but guess what, I would be that room mate that DOES mind- does that mean you will wheel out the other bed so you can give report??

[anotherone, BSN, RN]

It is compete bs. you do not get a good report ever! i go in and read the charts and hope for the best. most of the staff refuses to do it and by night shift less management is around. why dont the doctors keep pts informed? they shoukd have the primary responsibility as they dictate the plan of care!!!!! including tests etc. and i have always told my pts about their plan of care . this is ridiculous . report should ve for the nurse not for the pt anything else is garbage to me

[anotherone, BSN, RN]

yes things get missed with the fake sugar coated reports all the time.

[Orange Tree]

We do reports at the nursing station and then go see the patient (our bedside report). I was told patients in semi-private rooms have no expectation of privacy, so it's OK to gab in front of the roommate. I can see that being true in a limited way, but only in a limited way. I do like to show the oncoming nurse surgical sites, colostomies, IV sites, etc. Bedside "report" does help with accountability, IMO.

[buytheshoes11, MSN, RN]

We have private rooms on my floor, but I always do report outside of the room before going in with the AM nurse. If the patient is awake I like to say bye and introduce the on-coming nurse, and to ask if the patient has any questions/needs something at the moment. Typically, the patient is sleeping, and I see no point in waking up the patient one last time in order to give a bedside report. This is just my opinion though.

[martymoose, BSN, RN]

^^ We actually have been doing this all along for the most part- give report, then go "meet " the pt , check rhythm, lines etc. THAT is not acceptable anymore. We're told ALL in the room- not at the station, not outside the pt door, etc. I should copy the paper that they gave us from studor ( stupor??) that tells us how to script the report. Like how to re word that the pt is a drugseeker, or how they are non compliant of whatever- it is reworded in a "special snowflake " way.

I was so disgusted with the paper I left it in my locker.

So unbelievable. I only hope it will be a short lived fad, but we were told by our new manager this will not be an option. And her being new ( new to floor, not new to mgmt) she will dig her heels in in an effort to look favorable to her higher ups.

Really. I think this is the last straw. I was was 4 classes away from finishing the BSN, thinking I might find a better job. Market here doesnt look favorable for anything beyond what I am doing now. I'm going to take that money I would have spent, and go backk for coding or something. Something BEHIND the scenes.

I feel sorry for my fellow nurses.