Bedside Reporting- your thoughts

[SailorMoonRN]

My facility recently implemented bedside reporting. Sensitive information is given away from the patient. Once in the patient room, the report is more of a discussion of the plan of care. While I like this part, there are features I do not like and do not feel are safe.

When a patient is admitted, an 8 1/2 by 11 inch report sheet (made of card stock) is completed by the admitting nurse. This report sheet is passed from shift to shift until the patient is discharged so the report is no longer my own.

1. Nurses no longer are writing their own report and are reading the hand written report from another nurse. We are discouraged from using our old single piece of paper report sheet.

2. Report is written in erasable ink. Anything needing updating is erased and re-written using the same sheet.

3. Since we have a 6 patient to one nurse ratio, we also have a report card from every patient which means you either carry a clipboard (which a lot of nurses don't like to do) or leave at the nurses station. They are too thick to carry in your pocket.

4. I feel things get missed or aren't updated because everyone is too busy.

5. How much can you really remember from your 30 minute report on 6 patients? In nursing school if you went to a lecture, you wrote things down. You would never listen to something (for say 30 minutes) and not write something.

Management is behind this 100%

What are your thoughts?

[Spidey's mom, ADN, BSN, RN]

I don't like it. Pure and simple.

[VANurse2010]

I prefer the report at the desk, round on everyone afterward with the oncoming nurse approach. True bedside reporting is ridiculous.

[Spidey's mom, ADN, BSN, RN]

We do report in our break room. Of course we are a small hospital. Show up at 0445 a.m. and one nurse comes off the floor to report while the other nurse is on the floor with the patients. Then they switch. Then they get to go home. And we start our day.

I'd prefer to get report before seeing the patient. When we round, we usually round WITH our CNA and get vitals and I do my full assessment then.

Seems like a waste of time to be in the room with the patient just getting information from the previous shift when I could be doing an assessment.

[loriangel14, RN]

Bedisde reporting may be effective is say, an ICU setting but on most floors it is a terrible idea.

[LightMyFire]

We also are supposed to do bedside report but usually do it at the desk and then round. Some of the nurses want to go in though and that makes report take a long time as some oncoming nurses will try to start an assessment right then.

[Do-over, ASN, RN]

I like it in ICU in theory AND in practice. Checking lines, drains, drips, mental status, vent settings, etc. together is important. Including family is important. Helping the oncoming nurse establish rapport with the family is important. Not that the last two points are important on the floor, things are just usually less intense (for lack of a better word).

On the floor it is simply impractical - UNLESS you are getting all your patients from one nurse. Which never happens.

[ukjenn231]

i find that report goes a lot quicker. because the off going nurse does not want to talk forever about the patient in front of them. i can visualize the patient, i meet them up front so then i don't feel bad 2 hours later when i was running around like crazy and haven't made it into my 7th patient's room. of course, i can survive on a very minimal report, and i know some nurses that prefer a *much* more thorough one so they don't like it. i will read my orders, my H&P and talk to my patient if i need more info...

i still like to write my own report sheet though. i have floated to floors that have these pencil-written "report sheets" and i found things are often left off or incorrect, and i'm trying to decipher if it's important to know about this CXR result from 18 days ago.

[jadelpn, LPN, EMT-B]

Sounds like the card-ex system from many years ago. Only now one has to carry the card-ex with them.

Bedside reporting is a huge push in my area as well. The patient is usually less than thrilled to have people in their room discussing them at 11pm. I think more effective is a report, then rounding. When one does an assessment then is the time to discuss plans for the day if it is day. Most patient's plan of care at night is sleeping as soundly and pain free as feasible.

ICU is different, as with all the bells, wires, and drips you have to eyeball that to be sure that you are aware of what is happening with the patient.

[Penelope_Pitstop, BSN, RN]

Bedisde reporting may be effective is say, an ICU setting but on most floors it is a terrible idea.

I was a floor nurse, now I'm in ICU. I've done bedside in both areas, and I think it works very well in the ICU setting...especially on sicker patients.

[turnforthenurse, MSN, NP]

This sounds sort of like having a kardex that they used to have years ago...why exactly are you discouraged from keeping your own report sheets?

I loathed bedside report. Unless I was in ICU or in stepdown with some a very sick patient where things needed to be verified at the bedside (such as looking at the lines, the rate the drips are set at, maybe looking at a wound or something) we did report at the nurses station. After report we would then go to the rooms and introduce ourselves and have the off-going RN say goodbye to the patient and let them know that we are taking over.

[GundeRN]

Hate this idea. Right now there is talk of going to this at our hospital, Right now we have something called TCAB transforming care at the bedside so they got all these portable computers we are supposed to sit at right outside the rooms and no more nurses station. We give report at our computers and even this is terrible because on a busy morning you get interrupted so many times it is impossible to finish report in a timely manner. We start at 7am and once I didn't get finished with report until 8:30 because no one can seem to recognize that we are in the middle of report. Patients, family, even other staff seem to think we are just having a gab session. Sometimes I will be getting report from someone who will tell people they will have to wait a few minutes so we can finish report, but other times the outgoing nurse will jump up and answer every little request. It drives me crazy. I can just see bedside report turning into report, toilet, help brush teeth, open breakfast trays, ect. What a disaster that would be.