Bedside Reporting

Ruby Vee, BSN · Apr 17, 2007

bedside reporting works pretty well in the icu, generally, but i can see where it would be a problem on the floors where you have more patients to get report on and more nurses to get report from. in the units i've worked on, we herd the family out of the unit about half an hour before report starts to allow the offgoing shift time to finish up, and visiting hours restart about half an hour after shift change to allow the oncoming shift time to do quick assessments. we generally try to keep our voices low enough that the patient neither hears nor feels compelled to participate -- which means acronyms and verbal shorthand isn't as frightening threatening to the patient. when i've had difficulty with it is when the other nurse deliberatey draws the patient in, or when they allow the family to linger at the bedside during report. every acronym gets challenged and with the constant interruptions information gets missed.

angel's RN · Apr 17, 2007

Here's my two cents worth :twocents: -

Our facility has "walking rounds" or "bedside reporting". I work in CCU, and we also have open vistation. This presents a BIG problem in my opinion. We try to ask visitors to wait in the waiting room during report and original assessment, but do they comply? Noooooo!!!! Sometimes we have to give information about the patient that he/she doesn't know, or that the family or visitor doesn't have any business knowing. My director is trying to redo the visiting hours, but for now, ANYONE, no matter the age, yes, 4-5 years old CAN come into the CCU/ICU and see the patient!!:smackingf I have had kids wearing those skating shoes and they were skating up and down the hallway!!! But back to the subject-------

What benifit can you see giving report in front of family ans visitors? I agree that both shifts need to look at \dressings, IV's ect., but can't that be done AFTER report? If I were a patient, I really don't think that I would care for the nurses discussing me and my problems in front of everyone in the room!!!!

's RN

jjjoy, LPN · Apr 17, 2007

angel's RN - it sounds more like your unit need to revisit it's visitation policies regardless of the type of report given. It's always frustrating when the valid concerns of nurses are dismissed by the policy-makers!!!

SweetOldWorld, BSN, RN · Apr 17, 2007

What benifit can you see giving report in front of family ans visitors? I agree that both shifts need to look at \dressings, IV's ect., but can't that be done AFTER report? If I were a patient, I really don't think that I would care for the nurses discussing me and my problems in front of everyone in the room!!!!
's RN

I haven't run into that problem yet. I ask visitors to step out for a few minutes and they are generally very cooperative. Or the patient will speak up and say it's okay for them to stay. Anything of a sensitive nature gets discussed outside the patient's room. Time to put on your assertive shoes and ask the visitors to step out!

As for using medical terminology or acronyms or whatever, we were told not to do so. We are supposed to include the patient in the report in language they can understand. And in my experience, it's been a beneficial practice. The patients really like it. It gives me a chance to clarify things right then and there. On the worksheet, I will see "history of DVT" or other information, and I can ask the patient about it. I had a patient who was post-op hysterectomy with a history of DVT, and I asked her right then if they'd put a hormone patch on in recovery. The answer was no. That might have gotten lost in the shuffle of a busy shift otherwise. Those little patches are hard to see because they are tiny and clear, and the PACU nurses sometimes forget to chart them, or doctors forget to order them. I learn some really useful important stuff that isn't in the chart. And the patient feels confident that the nurses understand their condition. I get it straight from the patient, rather than getting the blank-eyed look from the off-going nurse who hasn't had time to dig into the chart all shift. It helps me prioritize my tasks right at the beginning of the shift.

When we started doing bedside reporting, we were told that change of shift is one of the most dangerous times for patients. Sometimes a patient will go for a couple of hours without being seen by a nurse. We try not to let that happen, but let's be honest... it happens. I think bedside reporting is primarily for safety! It increases communication between staff, family, and patients. And things don't get dropped or missed as often.

In an ideal world, we as professional nurses would do all these things anyway, eyeball our patients at the beginning of the shift, look up all the pertinent stuff in the chart, etc. But in the real world, things happen, and we don't have time to do all we'd like to do. I've found beside reporting actually saves me time. Change isn't easy, but I've noticed that most of the nurses who were resistant to doing bedside reporting now insist on doing it. If done properly, it's very beneficial. And if I were a patient, I'd want to have that opportunity to discuss my care and assess whether my nurses knew their stuff.

angel's RN · Apr 18, 2007

Dear SweetOldWorld,

I have tried the assertive thing, but I guess people don't take me serious. For example, last night. After the "visitor's please exit...." anouncement, I checked for visitors. I saw that one room still had someone in the room, so I went to close the door--thought that might provide a BIT of privacy. The visitor asked what I was doing, and after I explained about report, and that if visitors do stay in the room, we close the door for report. She promply said that the visitors had gone, it was just her with the patient.:smackingf I guess-- well, never mind what I guess. :twocents: Just my two cents worth. I still don't like it, but Grandma always said that I won't like everything in life and love, and BOY!!!! was she right!

's RN

ICURNDENVER · Nov 5, 2010

Bedside reporting is a terrible idea. There is NO privacy for patients in double room. With the economy and healthcare reform, hospitals have tightened the belt on incrimental overtime. How are we supposed to give report on 4+ patients at the bedside? Often time we report off to 2-4 different people! And what about all the rest of the nurses posting in here that they have 8 patients. How are they going to give report in 30 mins at the bedside? Probably not a very good report. Hopefully there is some kind of written report on each patient.

tazzyjo · Aug 16, 2012

Our facility is making it mandatory and I still find it is a pain in the ass and a HIPPA violation. We have very sick patients but we also allow visitors 24/7 and that makes it even more difficult. I have received the worst reports from nurses now since we started doing this they are short on useful content because no one will say much and it seems to be more for show than anything else. I prefer the information at the desk do a meet and greet to go over dressings, tubes, IV's and plan for the day, but not the whole report. I find it takes way to long at the bedside when the patients and family start asking questions that have nothing to do with the report and they don't take no for an answer when you tell them you will be back to discuss this when you are finished report. It's even worse if you have a different nurse for each of your patients. I have refused to do it and my manager understand that but says I need to be careful for the higher ups are now rounding to make sure we are doing it. I've just continued to be defiant and don't care if they don't like it. There has to be a better alternative. I like to look up my labs when we talk and at the chart so I can make sure nothing has been missed, now I can't and it takes me even longer to get back to the room.