Bedside Reporting

Specialties Med-Surg

Published

Hello Nurses,

I know nurses are supposed to implement end-of-shift bedside reporting to encourage patients to participate more in their care, but sometimes it seems like it's not always an option due to tired/sleeping patients, fatigued nurses, and the fact that bedside reporting may take too long. This is based on my observation during my current clinical rotation. What are your thoughts on bedside reporting, and do you use any alternatives to it or utilize other methods to involve patient participation?

Specializes in Peds, Neuro, Orthopedics.

I hate bedside report mostly because the patients think it's a fabulous time to ask to be ambulated to the toilet or to ask 50 questions or to tell their life story to the new nurse. This means we can easily add 5-10 minutes to each report.

Can you tell I'm dying to get out of hospital nursing? :wacky:

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Specializes in Med Surg, Specialty.

As a patient I loved bedside report. I found out additional information that I never was told before and it really helped me better understand my condition and plan of care. As a nurse, I think one of the best pieces of bedside reporting is that you get to eyeball your patient and get a clear understanding of what is the norm for them, plus you can look at unusual wounds/etc. Immediate pain needs can be taken care of by offgoing shift instead of being inundated at the start of your shift. If the patient asks a million questions the offgoing nurse can come back to answer them. If the patient needs to go to the bathroom the tech can do it or the offgoing nurse can take care of it after report. The offgoing nurse rounding on the patients prior to shift change can take care of a lot of these issues that people are bringing up. Again, as an oncoming nurse you would be inundated with this if you did not do bedside reporting so I'm not sure why its a bad thing get those things out of the way with the offgoing nurse. If the patient is sleeping we just do report outside of the room, or, if there is sensitive information we do it at the nurse's station. As both a nurse and patient I feel it is really beneficial.

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Bedside reporting... meh. I'm divided.

Sometimes if you're following a nurse who's known to be a ditz, bedside is a Godsend. I've had nurses tell me about IVs that magically switched extremities and locations between report and eyeballing the patient for myself. That patient has a foley in? Uh, no. That patient didn't have a foley in? Uh, no.

On the other, there are times you REALLY don't want to do bedside report. Patient is finally asleep. Or there are sensitive issues that should be discussed AWAY from bediside. "Pt has a history of alcohol, nameyourdrugofchoice abuse", for example. "Pt is HIV positive", but the doctor has not come around to discuss that just yet. "CT scan showed a tumor", also when doctor hasn't been by yet. Patient has family members ready to duke it out with each other over the slightest hint of a problem. Yup, this is when bedside reporting does not work.

As with most things, there are pros and cons. :)

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Specializes in Stepdown, PCCN.
As a patient I loved bedside report. I found out additional information that I never was told before and it really helped me better understand my condition and plan of care. As a nurse, I think one of the best pieces of bedside reporting is that you get to eyeball your patient and get a clear understanding of what is the norm for them, plus you can look at unusual wounds/etc. Immediate pain needs can be taken care of by offgoing shift instead of being inundated at the start of your shift. If the patient asks a million questions the offgoing nurse can come back to answer them. If the patient needs to go to the bathroom the tech can do it or the offgoing nurse can take care of it after report. The offgoing nurse rounding on the patients prior to shift change can take care of a lot of these issues that people are bringing up. Again, as an oncoming nurse you would be inundated with this if you did not do bedside reporting so I'm not sure why its a bad thing get those things out of the way with the offgoing nurse. If the patient is sleeping we just do report outside of the room, or, if there is sensitive information we do it at the nurse's station. As both a nurse and patient I feel it is really beneficial.

In my facility all the tasks you mention fall in the lap of the oncoming nurse. It backs me up even more in the morning.

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Specializes in Med-Surg.
As a patient I loved bedside report. I found out additional information that I never was told before and it really helped me better understand my condition and plan of care. As a nurse, I think one of the best pieces of bedside reporting is that you get to eyeball your patient and get a clear understanding of what is the norm for them, plus you can look at unusual wounds/etc. Immediate pain needs can be taken care of by offgoing shift instead of being inundated at the start of your shift. If the patient asks a million questions the offgoing nurse can come back to answer them. If the patient needs to go to the bathroom the tech can do it or the offgoing nurse can take care of it after report. The offgoing nurse rounding on the patients prior to shift change can take care of a lot of these issues that people are bringing up. Again, as an oncoming nurse you would be inundated with this if you did not do bedside reporting so I'm not sure why its a bad thing get those things out of the way with the offgoing nurse. If the patient is sleeping we just do report outside of the room, or, if there is sensitive information we do it at the nurse's station. As both a nurse and patient I feel it is really beneficial.

Are you in ICU? There is no way anyone in my med surg floor has any time to assess wounds jn bedside report. I would be steaming furious (and it happens) if the oncoming RN wanted to do a skin assessment during bedside. Nope, don't have time for that, do your assessment when I am not in the clock.

If each patient wants XYZ when woken during mandatory bedside report, how is the offgoing RN going to validate her overtime?

I try to respond to reasonable requests from patients during bedside, especially for pain medication. I cannot take two patients to the bathroom at once and medicate two others for pain. I expect the oncoming nurse to assist. Nursing is 24/7. When I receive report, I rarely ask the offgoing nurse to complete such a task. I want to start my shift quickly so I attend to the patients need myself (pain medication, bathroom, ect).

Only exception is questions about plans of care. I am night shift and if these questions come up during report then day shift is more qualified to answer.

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Specializes in Med Surg, Specialty.
In my facility all the tasks you mention fall in the lap of the oncoming nurse. It backs me up even more in the morning.

That really stinks. In my hospital its the norm that the offgoing nurse round prior to giving report so that these issues don't pop up. If they haven't and there's an immediate need such as pain, the offgoing nurse always volunteers to get it right away. I've never had an offgoing nurse not offer to do that, and I always do the same when I'm leaving shift. Its just not fair for the patient to have to wait 20+ minutes for the oncoming nurse to finish report and get settled before they can get the pain medicine for them. Regarding bathroom requests, these can almost always wait for the tech, and, our techs round before shift change as well to try to catch all of these as much as possible.

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Specializes in Med Surg, Specialty.
Are you in ICU? There is no way anyone in my med surg floor has any time to assess wounds jn bedside report. I would be steaming furious (and it happens) if the oncoming RN wanted to do a skin assessment during bedside. Nope, don't have time for that, do your assessment when I am not in the clock.
That's why I wrote unusual wounds, I'm definitely not referring to your daily skin assessment ;)

If each patient wants XYZ when woken during mandatory bedside report, how is the offgoing RN going to validate her overtime?
We don't wake patients. I could see how that would be a problem if we had to. I'm referring to things that can be easily taken care of during a round before shift change. Especially when it comes to pain, patients should not have to wait 20+ minutes for the oncoming nurse to finish report and get settled before they can be medicated. That's not fair to the patient or oncoming nurse. This is similar to how the ER should medicate patients for pain before sending them up to the floor.

I try to respond to reasonable requests from patients during bedside, especially for pain medication. I cannot take two patients to the bathroom at once and medicate two others for pain.
right, which is why patients who need the bathroom should wait for the techs, and why the techs are supposed to round before shift change to catch these.
I expect the oncoming nurse to assist. Nursing is 24/7. When I receive report, I rarely ask the offgoing nurse to complete such a task. I want to start my shift quickly so I attend to the patients need myself (pain medication, bathroom, ect).
Yes, nursing is 24/7 for passing along non urgent tasks such as an IV change, tubing/dressing change, or a late order they couldn't get to such as blood transfusion. However I expect the patient to not have urgent matters like pain when I come on shift. When you consider that an oral pain medicine will take 30-45 minutes to start working, why make the patient wait any longer than they have to? Its professional courtesy that an offgoing nurse will make sure the patient is properly medicated before handing off.

Only exception is questions about plans of care. I am night shift and if these questions come up during report then day shift is more qualified to answer.

Which is fine. This isn't an urgent issue and it definitely can be either nurse that answers it. I was just thinking if a patient is super anxious and asking a ton of questions then as professional courtesy I'd stay as the offgoing nurse, as I feel its my duty that patients should be somewhat OK before I pass them along to the next nurse.
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At my facility we are supposed to do a bedside report but management is okay with us exchanging most information away from the patients and then doing walking rounds to get a visualize on everyone and make the transfer official. During the last hour of my shift I remind patients that I'll be leaving soon and see if there is anything they need. This gets a lot of tasks out of the way and helps prepare them for the change in staff.

Also, if I can, I try to make sure that no PRN meds fall due during the oncoming nurse's first hour and this helps to cut down on the hecticness.

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I worked at a facility for 2 years where bedside reporting was mandatory. Honestly, I think bedside reporting allowed me to know the most about my patient and their care. Also helped to keep patients involved in their care. Patients won't mind being woken up for report when they realize it's the normal practice. We had Patients who would actually get upset if they realize bedside report didn't happen for some odd reason.

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Specializes in Peds, Neuro, Orthopedics.
Regarding bathroom requests, these can almost always wait for the tech, and, our techs round before shift change as well to try to catch all of these as much as possible.

Must be nice. We only have 1 tech for 15-18 rooms. S/he can't get everyone to the bathroom before report, so the patient asks during report and it means I get to stay later.

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Specializes in Med Surg, Specialty.
Must be nice. We only have 1 tech for 15-18 rooms. S/he can't get everyone to the bathroom before report, so the patient asks during report and it means I get to stay later.

Our techs generally have 8-10 patients day shift, while the nurse has 6 days and 7-8 nights. If the tech can't start their pre shift rounds earlier, then there are several other options. The offgoing nurse can help with bathroom issues during their pre shift rounds. Or if it is asked during shift change, the offgoing nurse can do it after report or the patient can wait for the oncoming tech to get to them. Find what works best for your floor. It is not set in stone that the oncoming nurse must take care of shift change bathroom requests.

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Specializes in Med/Surg, Gyn, Pospartum & Psych.

I still prefer a quick report outside the patient room and then a quick good-bye/hello in front of the patient to make the change smooth and address any questions that might need to be address by the nurse going off shift. This is also when I address pain & nausea needs and whoever has the most time can meet the immediate ones.

The one real upside is that lateral violence during handoff is less of an issue when handoff is done in front of the patient. Less eye rolling and sarcastic statements when the patient is a witness and is fond of the nurse that is leaving. And if you do forget which arm the IV is in, you just ask the patient who sticks it out and shows you.

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