Bedside Reporting starting Monday :(((

[2bTraumaRN2008]

So, we are starting this on Monday, and the "general" census is that most aren't happy and lots aren't even doing it at my facility.

I'm not sure what to expect, but I don't think I like what I'm hearing based on feedback from other floors.

For me personally, I have a problem taking 1 hour or more to give report, especially since I drive 1hour plus to and from work, and get up at 0330 to get ready for work. So, now I'll be loosing another hour of sleep on the days where I work back to back to back????? And, FYI - most of our nurses commute 45 minutes or more!! NOT FAIR!!

Another issue I have is fingersticks....we can barely get them done now before breakfast comes, and now the pt's will be done eating breakfast before we can even get in there to do their FS...that makes alot of sense.

The one plus I do see is: LOTS of our pt's are confused, so that will make things real simple....I wonder if I can just request to have all to confused pt's from now on, or the self cares who just come in for a simple cellulits that don't have an ounce of history...And to top things off, we are going tele in January...

And, we are to give our pt's our numbers from our personal hand held phones so they can call us if needed. We can barely handle all the calls that come in now from CT, Xray, Endo, Dr.s, Lab, etc, etc....

We also have to sometimes give report to 3-4 nurses, what do you do about this?? I sure hope they can do a better job at assignments.

I think maybe it's time to move into a M-F office job....

I look forward to reading/getting feedback from those who have been doing it for some time now, please!!

Thanks for letting me VENT!!!

[UpinawayRN]

I think the complaints about it prolonging assessments are generally due to acutally being in the room, and pt reallizing that they need/want a dozen different things while someone is there, does actually hold up a report. Not to mention, the "could you plug my charger in, get me some ice water, turn me. etc.. it really does lead to a longer report. Honestly. Report should be given at desk, then, quick intro to next nurse comming on at bedside. Of course ANY conversation with pt is going to prolong report.

[ReggaeRN]

Where I worked the bedside shift report idea was spearheaded by 2 nurses (not managers, APNs, etc...."regular" nurses on the unit) who worked on the cardiothoracic surgery stepdown unit, where there was a 5-7 pt load on nights, 4-5 on days. After all their work on the project, their unit implemented it, they got to present their results at a national conference, and the idea was implemented through the hospital (a 1200 bed facility). These 2 nurses helped to train more nurses and those nurses then introduced to all the other units of the hospital. The also realized it would only worked if all the staff was educated about bedside report before it was implemented. You could not just say "start doing this on Monday." Every nurse was educated in how to do it to prevent pts from dominating the nurses' time, how to properly talk to pts and handle their requests (such as 'I need water right now!'), and the proper etiquette for the oncoming and offgoing nurse (so that bedside report didn't take any longer than the old style of report). Despite reservations from the rest of the staff, including myself, bedside report was a big success. When I left this job, my new hospital would not implement bedside report. Let's just say that it was obvious that the quality of information passed on from shift to shift was way lower than it had been with bedside report. There is no doubt in my mind that bedside report is superior to traditional report if bedside report is done right, including proper education of staff before implementation of bedside report. The group on here is well educated and, overall, a group of good nurses. I "can't believe" that there aren't more of these nurses who don't see the benefit of bedside report. Look beyond PG scores!

PSU 213, is there any way you can help me to get in touch with the individual(s) that developed the process AND education for the bedside handoff? I am wanting to implement this in our facility, but when we attempted to do so in the ED, the negative scenario you described is exactly what happened (we were emailed a "good article" about bedside handoff and told "We will start this _this date_"). Needless to say, I have only left the ED for a leadership role a few weeks ago and since we started "bedside handoff" a year ago, I can count on one hand the nurses who still use it. We need this house-wide and I am desperate to speak with someone who has successfully implemented it! Any help you can offer is GREATLY appreciated.

[Bonnie RN,CPN]

Many of my peers thought the bedside shift report would mean getting out late. What I found is bedside sift report reduces the stress at the beginning of my shift. The oncoming and off going nurse work together to resolve issues. My day starts out much better. The scripting takes time and practice. Learning to change the wordage when explaining the patients day. Example:

thought- He was on the call bell every 5 minutes for pain med!

verbalize He did not have very good pain control today. These are the things we tried help with the pain.

[melbe77]

how about when you have 8-12 patients and have to give two different nurses report... seems time consuming and a hipaa violation if there is more than one patient to a room.. i'm sorry but pulling a curtain does not mean it is a sound proof wall..

[BluegrassRN]

how about when you have 8-12 patients and have to give two different nurses report... seems time consuming and a hipaa violation if there is more than one patient to a room.. i'm sorry but pulling a curtain does not mean it is a sound proof wall..

Bedside report takes us less time than the old face-to-face-at-the-desk report.

If we have more than one pt in a room, we just do a brief intro, check bands and IVFs, and ask the pt if they need anything at the moment. The full report then takes place at the desk.

I typically have 5 pts I report off on in the morning, and give report to 3-5 nurses. Not a problem there. 8-12 pts seems like a lot to care for; but I don't see how bedside report would be longer than face to face report.

[StarryEyed, RN]

Why do we need to check and recheck, and recheck PCA's and Heparin drips over and over again. These are already checked by 2 nurses when they are hung, bag changed, rates changed, etc. So why does the nurse I'm giving report to need to "check" it with me again when it has been checked throughout the day by 2 nurses?

Because things can still get missed even on a double check. I was getting report for a pt w/a PCA, was handed a copy of the order and the pain documentation flowsheet and noticed that both nurses that had signed off on the order had missed that the order also included a continuous infusion rate. I caught it and we added it and clarified everything. What if a calculation was off on a Heparin drip?

Also with dressings, it's one thing to hear from the offgoing nurse that the dressing is clean, dry and intact, then you see that it's soiled or even soaked. It's another to go into the room have the nurse show you what it looks like then you definitely know what's a change from the start of your shift instead of just the last time the offgoing nurse looked at it.

[Piglet08]

well, a little venting is okay. But it's probably better to approach this from a problem-solving viewpoint.

For example, are you telling me there is NO WAY to resolve the blood glucose checking problem? Maybe the person passing the trays can be responsible for checking sugars? Or if that's not allowed in your facility, perhaps the offgoing nurses will need to be responsible for checking them before report.

And I'm dealing with the same change at my workplace, just started a thread here about it, as a matter of fact. I don't much like it at this point. But I will learn how to make it work. I might even learn to appreciate whatever benefits it offers. Hang in there. The only thing that stays the same is that things change.