Bedside Report

The only thing you can change is your own attitude. Report should be based on objective information and the client's goals, not the caregiver's judgements. A person who is adjusting to living with quadriplegia is learning to cope with frustration and grief at the loss of their independence, expressing anger is a normal response to their situation. Directing his own care to prevent secondary complications, is not micro-managing, it is self preservation.

The only thing you can change is your own attitude. Report should be based on objective information and the client's goals, not the caregiver's judgements. A person who is adjusting to living with quadriplegia is learning to cope with frustration and grief at the loss of their independence, expressing anger is a normal response to their situation. Directing his own care to prevent secondary complications, is not micro-managing, it is self preservation.

I understand and agree with everything you are saying... which is why its important to pass along his emotional well being to the next nurse. Yes it is a struggle and a re learning situation for him, but when his days are better... we report a good day... when his days are worse we report bad days. My question is how do you report the negative and be political correct at the same time.

Would it be possible to give the bulk of the shift report at the bedside, and either before or after bedside report, discreetly share information about more sensitive info like mood/behavior? I agree with the PP cautioning against injecting caregiver's judgements into report, but also see value in sharing objective & subjective info about mood/demeanor, which can provide useful data regarding coping and adjustment to new challenges.

If the pt was "cranky" or "snappy" you don't have to say those words to the on-coming nurse.

The pt isn't a child who you are babysitting.

If this is a newly quad, you report good and bad days... In a professional manor

Don't set the on coming nurse with a bias of how the patient will behave with them.

Pt tolerated repositioning well

Pt did not tolerate well

Pt was able to direct cares today....

Unable to direct cares today

If you had a bad day or were in a bad mood how would you want your nurses to discuss your information

Bedside reporting is very popular in the hospital setting and even on our difficult pt with challenging social situations there are ways to share that information

A quick "not a good day" before going into his room should suffice.

Does the on coming nurse need to know all the details regarding the pts temper tantrum over his TV remote 4 hrs ago? How will that change/affect the care that nurse will provide?

Have you taken care of many new quads? They need to grieve and accept their new body and way of life that can take years and part of the grieving process is anger at a loss of total control of their life and their body.

I understand and agree with everything you are saying... which is why its important to pass along his emotional well being to the next nurse. Yes it is a struggle and a re learning situation for him, but when his days are better... we report a good day... when his days are worse we report bad days. My question is how do you report the negative and be political correct at the same time.

Is he currently having caregivers in his home 24 hours? Many people find 24 hour caregiving is very intrusive to their privacy and they prefer having gaps in their service, for example one caregiver comes in the morning, the next comes at lunch and the next comes for HS. In this arrangement the client is responsible for reporting or passing along pertinent information regarding any changes or concerns in their care. If his goal is to have more privacy and wean off 24 hour services, he can start by giving report now.

Most clients do not want to discuss their mood with every caregiver, they are more comfortable discussing their feelings with the caregivers with whom they have developed rapport and when they truly are in control of directing their own care, they do not give a self report of their mood to every caregiver that comes into their home.

We give a heads up, or off the record report about those uncomfy matters right outside the door, beforee giving the official bedside report

I would have a weekly team conference to discuss apporaches to caring for this patient and in bedside report I would include what types of things helped mediate patient's comfort ie how he likes the tv managed or positioning with pillows or how his food is prepared and provided. And I'd include him in the conversation.

I like this...

NO, I have not taken care go ANY new quads... this a learning and adjustment period for me as well. I do understand the process in which he is adjusting.

this is good advice thank you.

Yes, this is a good idea. The bulk of the information and then meet her in the brake room to tell you simply that is was a bad day. thank you..

Is he currently having caregivers in his home 24 hours? Many people find 24 hour caregiving is very intrusive to their privacy and they prefer having gaps in their service, for example one caregiver comes in the morning, the next comes at lunch and the next comes for HS. In this arrangement the client is responsible for reporting or passing along pertinent information regarding any changes or concerns in their care. If his goal is to have more privacy and wean off 24 hour services, he can start by giving report now.

Most clients do not want to discuss their mood with every caregiver, they are more comfortable discussing their feelings with the caregivers with whom they have developed rapport and when they truly are in control of directing their own care, they do not give a self report of their mood to every caregiver that comes into their home.

Yes, he had 24 hour care in his home. 3 shifts, 3 different nurses a day, 7 of us total. He cannot function without 24 hour care, his prognosis is dependent upon this fact. He is a C4 quad with autonomic Dysreflexia. His wife is a doctor and opened their own home health company with him as their sole client. This is a very wealthy couple who can afford the care. I have been in some facilities that don't have the amount of equipment as this man does.

I would have a weekly team conference to discuss apporaches to caring for this patient and in bedside report I would include what types of things helped mediate patient's comfort ie how he likes the tv managed or positioning with pillows or how his food is prepared and provided. And I'd include him in the conversation.

I agree. One issue i have brought up to our nurse manager is his lack of communication with the nurses. Its a problem. He like to play telephone with us (you know, he tells AM nurse something to pass on to PM nurse to pass on to me the NOC nurse; PM nurse will say "Craig wants to tell you..." as I'm standing right beside him) he does it with all of us.