Published May 15, 2007
rnanm
29 Posts
hi everyone
i have been busy with finals but want to ask how many of you are reverting back to bedside report at the change of shift? with jcaho confidentiality laws in place how do we manage this very private information being passed from one nurse to another without others hearing everything?
also i find it difficult because the patients start asking for help to the bathroom, a drink of water or something for pain. it is also very time consuming which results in ot pay for the off going nurses.
i would appreciate input from any of you that are going through this type of report in 2007.
love and laughs
jjjoy, LPN
2,801 Posts
This issue has been addressed before. You can do a *search* to find previous threads. You can see there are varied opinions on it and experiences with it. Here are a few threads:
https://allnurses.com/forums/f8/bedside-face-face-shift-report-175915.htm
https://allnurses.com/forums/f8/bedside-reporting-218551.html
https://allnurses.com/forums/f8/report-pts-room-218907.html
In regard to privacy concerns, this is copied from the DHHS website in regard to HIPAA:
The Department, in its July 6 guidance, clarified that the Privacy Rule is not intended to impede customary and necessary health care communications or practices, nor to require that all risk of incidental use or disclosure be eliminated to satisfy its standards.
ntysesf
1 Post
the hospital I work at just started doing this, and I highly disagree with it! I think it violates HIPPA, is time consuming and in a large way offesive to me as an RN. What our hospital says, is that the off going nurse is to introduce the oncoming nurse to the patient, we are also to point out where the IVs are, dressings and foleys! Now I dont know about others, but in my first year of nursing we learned to introduce ourselves to our patients, and any nurse who is handing out meds and not introducing themselves should be ashamed. Next unless you are an a floor that your patient has mulitple lines with meds that are being titrated, I dont need anyone to show me where my IVs are or where my foley is! I know my time could be spent doing a lot more than introducing a nurse to the patient that has a name tag on!!! I dont get the rational behind it and would love someone to point out a different aspect of this because, its to the point where I feel like i'm on some hidden camera show being punked!! I just feel that stupid doing it!...
kelisehunter
27 Posts
I don't think it's stupid by any means. If you've ever been a patient in a hospital you know that you may be confused and with nurses changing every 12 hours or so, the patient doesn't know who his/her nurse ever is. So I think the introduction of the next nurse is really helpful for the patient. I don't agree with the OP saying that the patient tends to start asking for help or medications and that can make the turnover much more difficult. It may be time consuming, but I personally feel that it is much more thorough. Just my opinion.
the hospital I work at just started doing this, and I highly disagree with it! I think it violates HIPPA,
as another noted, one needn't be overly concerned about others incidentally overhearing patient information.
is time consuming
how much time it takes depends on how it's done
and in a large way offesive to me as an RN. What our hospital says, is that the off going nurse is to introduce the oncoming nurse to the patient, we are also to point out where the IVs are, dressings and foleys! Now I dont know about others, but in my first year of nursing we learned to introduce ourselves to our patients, and any nurse who is handing out meds and not introducing themselves should be ashamed. Next unless you are an a floor that your patient has mulitple lines with meds that are being titrated, I dont need anyone to show me where my IVs are or where my foley is! I know my time could be spent doing a lot more than introducing a nurse to the patient that has a name tag on!!!
How many times have you gotten report that didn't mention the patient had a foley when they did or vice versa? Have you ever only later discovered that the off-going nurse forgot the mention that, by the way, the patient is missing their left foot? Or that the patient is doing fine but when you look in on them, they look like hell? Or some other incorrect or missed information? If you're both right there looking at the patient, certain things can be better clarified.
Finally, if the off-going nurse introduces the oncoming nurse, the patient is assured that you two have actually talked to each other and you, as the off-going nurse, know that the patient has some idea of who is taking over your care. While you have no control over what happens after you leave, if the following nurse isn't as attentive as you were, the patient won't be wondering if you had had a chance to review their situation with the oncoming nurse. The patient won't have to wonder if the oncoming nurse already knows important info like that they're a vegetarian or that they have a test scheduled for 9a. Of course, the oncoming nurse should know these things, but it can be reassuring for the patients.
ERRNTraveler, RN
672 Posts
I dont need anyone to show me where my IVs are or where my foley is!
hehe... Thank god, because if a nurse needs someone to show her where the Foley is, she's got some serious problems....
NRSKarenRN, BSN, RN
10 Articles; 18,926 Posts
as another noted, one needn't be overly concerned about others incidentally overhearing patient information. how much time it takes depends on how it's doneHow many times have you gotten report that didn't mention the patient had a foley when they did or vice versa? Have you ever only later discovered that the off-going nurse forgot the mention that, by the way, the patient is missing their left foot? Or that the patient is doing fine but when you look in on them, they look like hell? Or some other incorrect or missed information? If you're both right there looking at the patient, certain things can be better clarified. Finally, if the off-going nurse introduces the oncoming nurse, the patient is assured that you two have actually talked to each other and you, as the off-going nurse, know that the patient has some idea of who is taking over your care. While you have no control over what happens after you leave, if the following nurse isn't as attentive as you were, the patient won't be wondering if you had had a chance to review their situation with the oncoming nurse. The patient won't have to wonder if the oncoming nurse already knows important info like that they're a vegetarian or that they have a test scheduled for 9a. Of course, the oncoming nurse should know these things, but it can be reassuring for the patients.
I actually preferred bedside report when we started it in 1980....much better than garbled tape recorder or report from indiferent nurse. My eye could immediately take in who's IV bag was low, missing suction canister, bedside was a mess, or astma pt who's face is ashen grey despite nebs and good blood gases--- one look told me was gonna crump and my priority patient post report. For thoose nurses who "forgot" I+ O's, that full foley bag was emptied before they left too. I could take in more info in a snapshot eye view of pt/room than could obtain from any other report mechanism and record on my paper brain report sheet issues to be addressed.
Most private info: pathology came back lung CA, attending on way in to discuss; cast due to being hit by spouse, HIV+ status was reported OUTSIDE patients room in hallway if no visitors or at nursing station. Nervous patients seemed to relax some when introduced to next nurse...who returned with that box of klenex and fresh water pitcher.
All this helpful when prioritizing care for 6-12 patients. When I worked 12/12 WE , Sunday report might only take 5 minutes this way too, Took getting used to but is still way handoff of care is done 25+ years latter this hospital.
Faeriewand, ASN, RN
1,800 Posts
I've seen patients roll their eyes and turn their head the other way when they are being talked about. I personally would hate it if I were a pt.