bedside report

klone, MSN, RN · Mar 15, 2019

On ‎3‎/‎12‎/‎2019 at 10:58 AM, NewEnglandRN16 said:
I personally think a full a handover at the bedside is inappropriate. I do give report outside the room and then go in with the nurse after and do a quick goodbye/introduction. I like to update my board at that time, offer toileting or drink, clarify questions for the patient, check drips, tubes, etc. My manager is fine with this action. I still meet resistance from staff. If they don’t want to come in with me then I go by myself.

IMO, this is EXACTLY how bedside report should be conducted. To me, it's just good patient care, as well as good professional practice (accountability).

Oldmahubbard · Mar 16, 2019

Many many moons ago, back in the day of handwritten records, our hospital tried leaving a clipboard at the bedside. The nurse was to do the documentation right there. It was supposed to streamline the process. No running to the nurse's station for information.

It failed miserably when pts and family members tried to read what was on the clipboard, and didn't understand what they were reading, ie "pt SOB".

HelloWish, ADN, BSN · Mar 16, 2019

I don't like bedside report, as it is disruptive to the patient's rest. However, I did have a patient who we went to the bedside during report and the patient literally had a stroke as we walked in. This patient had been talking a few minutes before when coming back from imaging. So, while I don't think we should do bedside report on every patient. I do think it is important to check in on each patient when you first start shift.

Here.I.Stand, BSN, RN · Mar 16, 2019

The problem I had pre-ICU, was it was impossible to do in 30 minutes. It was an LTACH where we typically had 4-5 pts on days and 6-7 on nocs, and LTAC pts are typically very complex. We routinely had to give/receive the report from 2-3 or more nurses.

It could be challenging to get finished with report in 30 minutes even with all of us at the nurses’ station— let alone if the people you need to talk to are in pt rooms with ANOTHER nurse doing THEIR bedside handoffs.

Personally, it MUST happen within the allotted shift overlap if I am to agree to it. I won’t incur overtime for someone else’s pet priority.

Ruby Vee, BSN · Mar 16, 2019

On 3/12/2019 at 6:14 AM, Mr. Murse said:
So maybe this is just a rant, but oh well.
I'm tired of going into report every morning and seeing that clearly not a single nurse actually wants to do report in the patient's room, but as soon as management comes along they all scurry into the doorway quickly to avoid being chastised.
Don't get me wrong, I totally agree that the oncoming and offgoing nurses should see the patient together at shift change before or after report, but the big push for a full "bedside report" in the past few years, while well-intentioned, is nothing but another nuisance for management to make their nurses resent them just a little bit more.
It's time consuming and unnecessary. Half the time the patient and families don't even want to be woken up anyway.

Am I the only one that thinks bedside report is a flop and a burden and completely fails at what it's intended to accomplish? Let us report how we're comfortable reporting.

You are definitely not the only one who thinks bedside report is a flop and a burden and completely fails at what it's intended to accomplish. Personally, I'm more comfortable reviewing the patient's labs and VS together (or software has a "report sheet") and afterward going in to review the lines, dressings, etc. I realize that isn't politically correct these days. But when you give report in front of a patient you must be careful of jargon, and often stop to answer questions. After several interruptions from patient and family, I tend to lose my train of thought and I'm not sure that I've reported everything I need to.

WeimaranerluvinRN, ADN, RN · Mar 18, 2019

I personally like bedside report if a computer is available in the rooms. Nurses seem to stick to the facts when giving report rather than their opinion of the patient. Also, a good time to check alarms and incontinent patients so there is no he said she said bickering that often occurs. It works best with the 7 to 7 shifts vs the 6 to 6 I feel. No one wants someone tromping around in their room at 530 am to discuss their medical history.

kbrn2002, ADN, RN · Mar 19, 2019

We've tried bedside report in the past and it failed miserably. Now there is a push to do it again for both CNA's and nurses that pretty much all staff have ignored. A big part of the reason it's pretty much ignored is just the logistics of accomplishing this.

I work AM shift at a SNF and when day staff starts there are 3 CNA's that need report from the 1 off going NOC aid on 26 residents. So they all have to follow that CNA around room to room like a gaggle of geese to get the bedside report on the residents they are responsible for. This of course tends to wake them up and doesn't start their day on a very good note. Plus the CNA's don't have an overlap of time in their scheduled shifts to even allow for report time and the off going CNA gets chewed out for not getting out on time.

For nurses it's 1 NOC nurse handing off to 2 nurses on different wings so whichever AM nurse gets stuck with the second round of report has quite a bit of wasted time waiting to get report from the NOC nurse. Not to mention the NOC nurse is done and wants to get the heck out of Dodge instead of giving bedside report on 50+ residents.

Just time wise this model isn't tenable in the LTC setting. This recent push to resume it was a knee jerk reaction by our DON following a particularly bad NOC shift with multiple falls in a 12 hour time span. Not a single time has the bedside report actually happened and I doubt it will. I also doubt if our DON will push on it as she's a smart one and knows how intrusive to residents it is and how time consuming for the staff it would be.

Mavnurse17, BSN, RN · Apr 29, 2019

I realize this post is about a month old, but I wanted to offer my !!

I work community health now, but I spent about a year out of RN school at a very large university teaching hospital.

One of the "straws that broke the camel's back" was administrators on my unit instituting a very intensive bedside reporting practice. We'd been doing bedside reporting for years, but not like how they were going to make it.

To begin, nurses were audited EVERY shift by an administrator. Our names were put into a cup and if we were drawn during shift huddle, an admin followed us to each room and observed the report. We were docked 'points' if we didn't do/say everything 100%. We were not allowed to share any information outside of the room. Our new report sheets had a literal highlighted script we had to follow, and we were docked if we didn't. We had to basically do a head to toe assessment in the room, as well as verify lines and drips (which actually I'm 100% for). I worked on a cardiac step-down unit, and some of our patients were very medically fragile/bedbound/had multiple lines/tubes/drains we were to verify with the oncoming shift (we were even docked if we didn't check to make sure there was a green curos cap on the hub on a foley catheter). We had 3-4 patients, so now report took about an hour total!! Admin told us that them auditing our reports wouldn't be punitive, and they weren't, but still imagine having a difficult shift and then having to be 'perfect' for these audits.

To make matters worse, we had to do an entire bedside report (no 'updates') even if the same nurse was back 12 hours later ?

Oh, and here's the kicker--- after this had started and nurses were leaving later because of the increase in time it took to report off, management started griping about incremental OT

JKL33 · Apr 29, 2019

3 hours ago, Mavnurse17 said:
To begin, nurses were audited EVERY shift by an administrator. Our names were put into a cup and if we were drawn during shift huddle, an admin followed us to each room and observed the report.

"It's so cool that you're doing this! Pick me!" ?

[Oh, I did 20 things wrong?] "Ok cool, thank you! This is so helpful!" ????

tammymize · Sep 5, 2019

On 3/12/2019 at 6:14 AM, Mr. Murse said:
So maybe this is just a rant, but oh well.
I'm tired of going into report every morning and seeing that clearly not a single nurse actually wants to do report in the patient's room, but as soon as management comes along they all scurry into the doorway quickly to avoid being chastised.
Don't get me wrong, I totally agree that the oncoming and offgoing nurses should see the patient together at shift change before or after report, but the big push for a full "bedside report" in the past few years, while well-intentioned, is nothing but another nuisance for management to make their nurses resent them just a little bit more.
It's time consuming and unnecessary. Half the time the patient and families don't even want to be woken up anyway.

Am I the only one that thinks bedside report is a flop and a burden and completely fails at what it's intended to accomplish? Let us report how we're comfortable reporting.

No, you aren’t the only one. But I foresee a bigger problem. Asking for consent from the patient in front of the family is worrisome! It was brought to my attention from a patient that felt like she couldn’t say “no, don’t speak in front of my family”. Where I work we don’t ask for consent - how big of an issue is this?

tammymize · Sep 5, 2019

On 3/12/2019 at 10:03 PM, Kallie3006 said:
But how else would you learn of the patient's sister's ex husband's 2nd cousin's niece figured out the patient really has congenital insensitivity to pain with anhidrosis, because the patient didn't feel anything when a skillet fell on the patient's prosthetic foot and she googled the symptoms?

Bwahahaha very good question!! If family wasn’t going to slow you down or the patient will remarks that he finds funny... then here take these 2 nursing students with you and a new employee!! That’ll for sure speed you up!!

**canoehead, BSN, RN** · Sep 6, 2019

On ‎3‎/‎16‎/‎2019 at 8:20 AM, Oldmahubbard said:
Many many moons ago, back in the day of handwritten records, our hospital tried leaving a clipboard at the bedside. The nurse was to do the documentation right there. It was supposed to streamline the process. No running to the nurse's station for information.
It failed miserably when pts and family members tried to read what was on the clipboard, and didn't understand what they were reading, ie "pt SOB".

I remember that fad. I also remember "pain is what the patient says it is" and medicating to just shy of resp arrest.

Nursing is very faddy, everyone gets on board and shames those that question the newest trend, then we all swing in the other direction ten years later. Bedside report has it's pros, but it's never going to replace 1-1 talking between nurses.