Bedside Report

[nynursey_]

This week, the instutition in which I work will be rolling out bedside report, a change that will largely impact nursing care (I'll decline to comment whether positively or negatively--that's the purpose of this post).

So I ask you all this: bedside report; friend or foe?

Discuss!

[Guest03/15/15, BSN, RN]

Question. What happens if a patient makes rude, threatening, or whatever obnoxious comments by instant messaging their nurse? Any repercussions ?

[ixchel]

Question. What happens if a patient makes rude, threatening, or whatever obnoxious comments by instant messaging their nurse? Any repercussions ?

You just have to set boundaries. I'm not sure rudeness is any different in writing than it is spoken. Threats are different, though, in my opinion. Without knowing whether they intend to follow through, your safety could be in jeopardy. I'd involve the charge nurse and maybe security, depending on the level of danger the patient might pose. If I got a death threat and believed it entirely possible the person would follow through, that might be police-worthy. Idk. That's tricky.

I did some reading on violence toward hospital employees for school and it's sad that this is part of our job. In no other industry would a single person get away with this, and yet, in hospitals, it's just part of the job.

[Here.I.Stand, BSN, RN]

Question. What happens if a patient makes rude, threatening, or whatever obnoxious comments by instant messaging their nurse? Any repercussions ?

What happens is that they've just eliminated pt-said/nurse-said. They've created electronic proof of any threats against the nurse. Better than a verbal threat, right?

As for what happens if a pt makes a threat against a nurse, then law enforcement needs to get involved. Making terroristic threats is a crime, and receiving them is not part of any job description.

Rude/obnoxious comments should be dealt with same as if they said it to your face. I'll tell someone straight-up when they are speaking inappropriately to me, but however works for you.

[dudette10, MSN, RN]

Oh, please NO to the MyChart Bedside! Maybe I'd go for it if they can page their doctors directly...then see how long the idea lasts!

[mariebailey, MSN, RN]

You know that the person who came up with this are not direct care staff! I can see the purpose of MyChart, but not the messaging feature. It will be abused and staff will be pushed for time even more. On their website it says "overdue upgrade from the call light. Instead of pushing the call light to ask for a drink or a blanket, just send a message to your nurse"....

That's crazy. I feel sorry for your 90 year old patients who aren't computer literate and can barely lift their fingers to hit the call button.

[SeattleJess]

We are expected to do bedside report at our hospital, there are signs at nursing stations stating that managers are checking for compliance, but none of my preceptors have ever done bedside report the 3 months that I have been there- including managers that were working the floor that I was orientating with. We give report at the nurses station and then go meet the patients, check the lines, write on the white board but do not give report in the room. I do not like the bedside report because of the reasons already mentioned.

Now my hospital is going to be implementing MyChart Bedside. They will be passing out computers to patients where it will display their most recent vitals, when their meds are due, who their doctors are, and plans for the day. Guess what else? Messaging, where they can message their nurses. I'm sorry but I don't have time to text message my patients!

Oi vey... you are making me not want to graduate.

[CamillusRN, BSN]

Oh good lord! What next???????

I'm guessing a "FitBit" type of bracelet that vibrates and buzzes every time a patient demands something. And a touch screen with a menu of available PRN's, snacks, and customizeable meals for the patient to order from. And a 15-minute-delivery-or-the-product-is-free guarantee. How will we pay for this, you ask? The nursing staff will be charged rent for the break room, chairs, computer screens, and parking space.

[Anonymous865]

That's crazy. I feel sorry for your 90 year old patients who aren't computer literate and can barely lift their fingers to hit the call button.

As a patient I like the idea of My Chart Bedside. It would make me MORE independent. Instead of having to ask the nurse what my labs were and how do they compare to yesterdays labs, I could just look If I forgot the name of the abx that I'm getting, I could look instead of bugging the nurse

As far as elderly patients not being computer literate you might be surprised. My 93 yo uncle is very computer literate building complex excel files to analyze and track stocks, sending emails, posting on facebook to reconnect with old school friends, etc. My 83 yo dad is very computer literate - setting up his own wireless home network, doing excel, word, email, etc. The senior generation I know is pretty computer savy.

As a patient I would love the ability to text my nurse. About the only time I called the nurse was to request pain med. I'd always call and ask that the nurse bring my pain med when it was convenient or when she was coming this way. I always called when the pain was starting to come back but before it became excruciating. As long as I got the pill in the next 30-45 minutes, I'd be fine. I'm pretty sure that when the request was passed on to my nurse it was passed on as Room 1203 needs her pain meds now, because the nurse always brought them in minutes. If I texted, I could say pain beginning to return. Can you bring pain med when it's convenient.

I think most people see test messaging as something that gets answered at the receivers convenience. If you want an immediate response, you phone someone. Maybe patients would understand that the nurse will respond to text messages as her duties permit.

[flyersfan88]

It's difficult for me to take it seriously when your only basis for comparison is nursing school clinical.

I really don't care if you take me seriously or not. I just feel bad that you're so stubborn to change you can't see any good in it...even though you have people that do it every day listing some positives. I just can't believe it's THAT big of a crappy issue.

[sistrmoon, BSN, RN]

I'm guessing a "FitBit" type of bracelet that vibrates and buzzes every time a patient demands something. And a touch screen with a menu of available PRN's, snacks, and customizeable meals for the patient to order from. And a 15-minute-delivery-or-the-product-is-free guarantee. How will we pay for this, you ask? The nursing staff will be charged rent for the break room, chairs, computer screens, and parking space.

Vibrates and buzzes? No! Electric shock. That'll get us moving and our satisfaction scores through the roof!

[sistrmoon, BSN, RN]

Well, I looked through the material last night, and it addressed all my big concerns. We are not to wake sleeping patients unless they have specifically asked to be awakened for report. It's not a HIPAA violation as it is necessary communication in the course of our duties( we are to ask the patient if visitors can stay during report.) It specifically said not to put the other nurse on the spot in front of the patient( I doubt that will prevent it but since it is addressed in the material, I can point at it later when my coworker starts being obnoxious.) and I guess the goal is to sanitize report, to "keep it clean" instead of gossipy.

The scripts are atrocious though! They want us to say, "this is your RN so and so and I've worked with her 6 years. You'll be in great care!" What if a nurse is brand new? "I've worked with Nurse So and So for 2 days."

I also wasn't happy that they bashed night shift in the training materials example. "Have you ever come on shift and found that night shift had left a bunch of full urinals around and the room a mess? This will hold them accountable!" We get enough of the "night shift does nothing" attitude without that.

[RNKay]

Friend. We do bedside report where I work and I love it. It allows the nurses to check the patient/lines/any skin issues during report so I think of it as a 2 in 1 type deal. Sometimes I even do a quick head to toe while I'm getting report.

Secondly, if something is wrong- i.e. the patient is sitting in poop, IVs beeping because the bag is empty, etc, the nurse giving report has the opportunity to assist in fixing those things before she leaves and the same goes for every shift change.