Bedside Report

[Mr. Murse]

I'm wondering if anyone else thinks the incessant push by unit managers to do a "bedside report" is ridiculous (I assume the facilities I work at are not the only ones doing it).

Don't get me wrong, I fully support the idea that both the nurses coming and going should visit each patient together before one leaves, but it's the push to actually do the full report at bedside that's just a good intention gone wrong. On many floors and ICUs the manager intentionally makes a round during shift change to nag and enforce this petty and unnecessary policy.

I understand the intended purpose, I really do, but inevitably bedside reports become unnecessarily long as the patient and family want to chime in about their great uncle who had really bad hemorrhoids or their friend whose cat just had kittens. Even if you manage to keep it on track, bedside report is a waste of everyone's time in my opinion.

Just let the nurses report in the hall or at the desk, then round through every room to visualize the patients, then move on with the day.

I know I'm venting, but surely I'm not the only one annoyed by this?

[NightNerd, MSN, RN]

You are not the only one annoyed by this. My facility is also cracking down on this and it's making me bananas. Bedside report on 6 patients takes a helluva long time, and I'm finding that when I come around at 7 AM to give report, they're not ready to be awake yet and don't acknowledge we're there, let alone participate. By all means, I'll verify code status and drips and bed alarms for everyone before I leave, but it's getting out of hand and I'm sick of hearing about it.

[Tweety, BSN, RN]

The bedside shift report is massively disobeyed by staff on my unit and I'm one of the few that do it.   If we look into the room and the patient is asleep we don't wake them.  It's not really enforced because management doesn't come in that early.  As a charge nurse I've also given up on getting my coworkers to do it.  They can do as they please I won't nag them.  They ignore me anyway.

So no, I'm not annoyed because long ago I surrendered and do what I'm told is policy.  The people that are annoyed by it are the people that aren't doing it even though they are supposed to.  

But yes, sometimes they decide it's time for them to go to the toilet or they want pain medicine or it gets off track and report takes longer especially if it's your first day with a new group.

 

[JBMmom, MSN, NP]

I think that every organization pushes bedside report because they want to improve their Press Ganey scores and make patients feel included in their plan of care. However, as others have pointed out, the impracticality of giving and getting report on 5-7 patients, often from different nurses, in all the patient rooms, is obvious and the time constraints make it nearly impossible. Every report would take well over an hour if that were to truly happen as management intends. 

I try to get into the patient's room during report and I've given report to a few nurses that feel bedside report is the time to get their whole assessment done. They're pulling out their stethoscope, asking patients about their pain levels, just NO. In my view it's a safety sweep to make sure the patient is alive and as well as they can be and then move on. But giving the full report at bedside isn't in the best interests of anyone. 

[CalicoKitty, BSN, MSN, RN]

I am in school. One of my classmates wrote for an assignment last week about the bedside report. It was recommended by the Agency for Healthcare Research and Quality (AHRQ). When looking for a paper, I found one hospital (pediatrics) that includes the physical assessment into the report. They said it prevented people from avoiding rooms until they "looked up" the patient. Plus, getting the assessment done early means that if the shift getes busy at least the assessment was done. Plus, if you look at lines and fluids, can find infiltrates and incorrect rates, etc. But, I hated it. Who wants to wake up at 7am after getting crappy hospital sleep?

[HiddenAngels]

3 hours ago, Mr. Murse said:

I'm wondering if anyone else thinks the incessant push by unit managers to do a "bedside report" is ridiculous (I assume the facilities I work at are not the only ones doing it).

Don't get me wrong, I fully support the idea that both the nurses coming and going should visit each patient together before one leaves, but it's the push to actually do the full report at bedside that's just a good intention gone wrong. On many floors and ICUs the manager intentionally makes a round during shift change to nag and enforce this petty and unnecessary policy.

I understand the intended purpose, I really do, but inevitably bedside reports become unnecessarily long as the patient and family want to chime in about their great uncle who had really bad hemorrhoids or their friend whose cat just had kittens. Even if you manage to keep it on track, bedside report is a waste of everyone's time in my opinion.

Just let the nurses report in the hall or at the desk, then round through every room to visualize the patients, then move on with the day.

I know I'm venting, but surely I'm not the only one annoyed by this?
 

You’re def not the only one but I’m on the fence about this. Yes it’s nagging and OMG the great uncle stories (loved that you mentioned that). I’ve been around the block a few times and there are some nurses  I know I can trust their report and their are others that are just absolutely nope, so I’m definitely going bedside. I walked into a patient in full blown sepsis on regular floor at change of shift, I’ve seen bleeding from fem sites, desats,  so I honestly don’t mind this but I agree with you 100% that we should go in greet the patient assess mentation and then go give report quietly by the door.

[HiddenAngels]

23 minutes ago, JBMmom said:

I try to get into the patient's room during report and I've given report to a few nurses that feel bedside report is the time to get their whole assessment done. They're pulling out their stethoscope, asking patients about their pain levels, just NO. In my view it's a safety sweep to make sure the patient is alive and as well as they can be and then move on. But giving the full report at bedside isn't in the best interests of anyone. 

And this, when I’m on days giving report to night nurses  it is a way easier bedside shift report,  but when I’m on nights giving bedside shift to Mrs. Florence Nightingale herself, just stab me in the eye with a rusty paper clip.

[RNperdiem, RN]

This is totally dependent on patient population. Like many nurses, I prefer a report at the nursing station and then a show and tell in the patient room where we sign off PCAs and vasoactive drips.

I am more likely to remember pertinent information when I am in the patient room, but interruptions and sensitive information can be a problem.

[kp2016]

17 hours ago, JBMmom said:

I try to get into the patient's room during report and I've given report to a few nurses that feel bedside report is the time to get their whole assessment done. They're pulling out their stethoscope, asking patients about their pain levels, just NO. In my view it's a safety sweep to make sure the patient is alive and as well as they can be and then move on. But giving the full report at bedside isn't in the best interests of anyone. 

I had an RN do this to me recently. She keep telling me to wait while she started what was clearly her full assessment. I told her "my shift is over and I am leaving, if you would like me to give you report I can do it now, if not you can find all the information in the chart".

 

17 hours ago, CalicoKitty said:

I am in school. One of my classmates wrote for an assignment last week about the bedside report. It was recommended by the Agency for Healthcare Research and Quality (AHRQ). When looking for a paper, I found one hospital (pediatrics) that includes the physical assessment into the report. They said it prevented people from avoiding rooms until they "looked up" the patient. Plus, getting the assessment done early means that if the shift getes busy at least the assessment was done. Plus, if you look at lines and fluids, can find infiltrates and incorrect rates, etc. But, I hated it. Who wants to wake up at 7am after getting crappy hospital sleep?

In theory bedside report sounds like a great idea, probably why it's a bad idea that just won't go away. The reality is it always takes a lot longer than giving handover at the desk and then doing a rapid once over at the beside.

 I'm honestly curious if the hospitals that are enforcing it are paying overtime for the nurses who leave late after handover inevitably took 3 times as long as it should have...... yeah, probably not.

[Lust4life, BSN]

17 hours ago, HiddenAngels said:

And this, when I’m on days giving report to night nurses  it is a way easier bedside shift report,  but when I’m on nights giving bedside shift to Mrs. Florence Nightingale herself, just stab me in the eye with a rusty paper clip.

I think report should be given in a quiet area where you both can sit...and listen! Not where the patient is! Unless the are critical and it's warranted. Otherwise, exactly what you said happens. Which is wrong on the receiving end! They can't pay attention if they are already starting their rounds. The giver is trying to go home, be respectful. 

[HiddenAngels]

On 8/24/2022 at 3:42 AM, kp2016 said:

 I'm honestly curious if the hospitals that are enforcing it are paying overtime for the nurses who leave late after handover inevitably took 3 times as long as it should have...... yeah, probably not.

Yep they are paying the overtime

[HiddenAngels]

3 hours ago, Lust4life said:

I think report should be given in a quiet area where you both can sit...and listen! Not where the patient is! Unless the are critical and it's warranted. Otherwise, exactly what you said happens. Which is wrong on the receiving end! They can't pay attention if they are already starting their rounds. The giver is trying to go home, be respectful. 

Amen! And they be the first one trying to run out the door when their shift is over.