Bedside Reporting starting Monday :(((

sapphire18 · Dec 5, 2011

We just started this recently also and even though I work icu and only have 1-2 pts to give report on, it honestly doesn't take much more, if any more, time than the old style of giving report did. One plus also for us is that the majority of our pts are confused and/or vented and sedated, so they don't know what's going on anyway.

I did hate the idea of this at first, but it's just like anything else: you get used to it.

HouTx, BSN, MSN, EdD · Dec 5, 2011

You have my sympathies! I know how difficult it is to embark on big change - especially one that will have such an impact on how you are accustomed to organizing your day.

It sounds like there will be some bugs to work out for sure. I have worked with all kinds of report delivery methods.. taped was the absolute worst!!!

The biggest problem I had with bedside reports were how deliver information without upsetting the awake & aware patient - or getting them involved in the conversation. There are some very positive aspects also. For one thing, you will discover that your patient's room & IVs are in much better shape; it is difficult to leave things in a mess if you know that you are going to have to 'face' the oncoming nurse in the midst of it. So, usually no more dry IVs & dirty beds/rooms. It is also a much better process for clarifying any instructions about dressings, drains, etc. Much better to do so while you are both looking at the same thing. We did some patient surveys and found that bedside report was very comforting to them.... apparently one of a patient's worse fears is that the 'new' nurse doesn't know what is going on with them - who knew? It also helps the patient to be more involved in their own care & aware of what is going on; planned trips for lab tests, diet changes, activity limitations, etc.

The 'ticklish' part is how to communicate stuff you may not want the patient to hear ... family is disruptive/difficult, behavioral modification plan to correct bad behavior, etc. You also have to worry about HIPAA - so visitors & extraneous staff have to be contained in a way that they can't overhear confidential details.

Good luck! Make sure you have some extra Advil or headache med of choice. Paste your smile on and remember, there has never been a shift you haven't gotten through yet. You are NURSE!

psu_213, BSN, RN · Dec 5, 2011

I must respetfully disagree with your views on bedside report. The information passed from offgoing to oncoming nurse is much clearing. First, it allows you to take care of simple pt needs while you are in the room (and if it is going to take longer your can tell the pt face to face that you will be back in a half hour). It allows the oncoming nurse to look at the setup for equipement. For example, why is this chest tube not on suction? Finally ia allows 2 nurses a chance to looks at IV gtts/PCAs.

When the unit on which I was working went to bedside report, some oncoming nurses thought it was a chance to complete their assessments while the offgoing nurse just stood there. When you are leaving, don't let this happen, and it does not last any longer that face to face report at the station.

Also, I think that time of commute for the nurses really should not play a role in how report takes place. If that was the principle concern, just to written report, give your cell phone number and leave right when you replacement walks in the door.

As for giving pt's phone numbers, not a good idea. That's why we have call bells, and people at the desk can answer them. I do believe the RN should go to the room (even to deliver a pitcher of water), however there are times when you plain old can't answer the phone (think being gowned in a C diff room).

pale_pilsen · Dec 5, 2011

Personally, once the economy gets better, i'll look for other jobs that is non bedside nursing related. Its jus.t too much on a busy med surg floor

tyvin, BSN, RN · Dec 5, 2011

People are usually resistant to change when it's something they don't understand or agree with. When we did this everyone fought tooth and nail while I embraced it. I ended up actually liking it. It doesn't as take long as sitting report and you get to see first hand if actively dying so and so is really resting comfortably. Give it a chance...if everyone forces bad karma on it well; you'll all end up hating it. The one thing is you got to be prepared when shift change comes. Jump up and go, it will be over before you know it.

NicuGal, MSN, RN · Dec 5, 2011

We have always done this, and while we only have 3-4 patients, we have done it on peds also where we have 4-6 depending on the census. You get used to it and you will find things aren't getting missed as much. On our floors our aides can do blood sugars, so they do that. As for the things that you don't want overheard, we kind of go out to the hall and discuss it as we go to the next patient. There are things that visitors and family members don't need to hear. We have computers in the rooms and in the halls, so that makes things easier.

Give it time. And you have to do it when JCHAO, or whatever it is called now lol, comes around or you will get dinged.

pixie99 · Dec 5, 2011

Bedside report makes zero sense. My patients get very grumpy when they have just been wakened by the aid to check vitals, then get wakened again by me at 7 to listen to their own report. We get punished for having overtime so we have to rush through 6 reports in 30 minutes which is impossible when the patient wants to have some "input". But here is a funny: night nurse Alma was trying to convey to me that the patient, other than a broken leg, was a "negative assessment." Her exact words, in front of the patient, were "she's pretty much been negative all night." To which the outrage patient said "IHAVENOT! I've been very pleasant!" so much for patient satisfaction

LynnLRN · Dec 5, 2011

I love bedside report. I find it is actually quicker than doing report outside the room. You don't talk about your weekend and you don't get off track or talk about non-important things. Plus, you've already seen the patient so it actually helps with prioritizing the day. Like they say you do most of your assessment just by looking at the patient.

One thing we did to help make bed side report go easier is that the aids are to be available to help with patient care and call lights. Plus, all patients are told that we will not give meds, do baths, etc, during report times. Also, when it comes to making assignments the charge nurses really started trying to give most of our patients to 1 or 2 nurses instead of 3-4 different nurses if the patient load was ok.

I guess I'm having hard time understanding why you say it will add 1 hour to your day. Were you not getting report at all prior to this?

Seas · Dec 5, 2011

We are supposed to do bedside report too. But nobody in my floor does it, unless management is there. Most of our rooms are semi-private. Most patients have some visitor(s) with them. Where is HIPPAA while we are talking about the patient in the room? Okay, we can let visitors out for a few minutes, but how about the other patient? Nobody will want their perineal area ulcers heard by their room mate!!

Seas · Dec 5, 2011

I guess I'm having hard time understanding why you say it will add 1 hour to your day. Were you not getting report at all prior to this?

I agree with this question. I can't connect b.s. reporting with having to get up 1 hour earlier. Unless reporting is something new to the floor, it doesn't make sense to me. I shouldn't take an extra hour.

2bTraumaRN2008 · Dec 5, 2011

I love bedside report. I find it is actually quicker than doing report outside the room. You don't talk about your weekend and you don't get off track or talk about non-important things. Plus, you've already seen the patient so it actually helps with prioritizing the day. Like they say you do most of your assessment just by looking at the patient.
One thing we did to help make bed side report go easier is that the aids are to be available to help with patient care and call lights. Plus, all patients are told that we will not give meds, do baths, etc, during report times. Also, when it comes to making assignments the charge nurses really started trying to give most of our patients to 1 or 2 nurses instead of 3-4 different nurses if the patient load was ok.
I guess I'm having hard time understanding why you say it will add 1 hour to your day. Were you not getting report at all prior to this?

I generally get report done in 25 minutes now, so I am leaving at 1910-1915. By the sounds of it, I will not be getting out until 2000 or later. So, instead of getting home at approx. 2015 or so, I'll just be leaving work, or may have just left.