Bedside Reporting- your thoughts

Nurses General Nursing

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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?

Specializes in Emergency, Telemetry, Transplant.

I am a big fan of bedside report if it is implemented correctly--i.e., inservice for nurses, practice sessions, follow up education, etc. Too often, however, it seems when bedside report is implemented, it more administration saying "do this...do it this way. Thanks." (the 'thanks' is optional depending on the attitude of administration that particular half hour).

I worked on one floor that used the aforementioned "report cards" even before bedside report (i.e. for traditional nurse station based report). The cards covered all the basic information (oxygen requirements, lung sounds, heart rate/rhythm, edema, etc. etc.) and had a small section that provided for added notes the nurse could add. They provided a standardized outline for reports and helped to end rambling, 'all over the place' reports...nurses who were the before and after the implementation of such report cards said it saved a ton of time of report and the nurses often went from leaving late to leaving on time.

Specializes in Medical Oncology, Alzheimer/dementia.

It's okay...

I usually give report outside the room, then will go in to meet the patient. That gives me a chance to give/get a decent uninterrupted report, but also include the patient. Lots of times the patient doesn't have anything to add, or is sleeping.

I don't like giving report at the nurses station because it's way too noisy and easy to get sidetracked.

I hate it too, and so do my coworkers. Our managers (who seem to have forgotten their bedside days) think it's a wonderful idea. We just implemented it and I have found that it drags out report, delays my morning routine, and makes me leave late when I so very much want to go home. I like to get report outside the patient's room, then go in and introduce myself and tell them I'm aware of what's going on, the plan of care, dr. so and so will come today, npo status, next time for pain meds, if they need anything, etc. That way, at least I can SEE the patient and make sure the IV is not infiltrated, the room is not dirty, and the patient is STABLE!

I have found that a complete report inside the patient's room is impossible because there is almost always something the off going nurse will need to tell me privately (pain med junkies, if the patient is demanding, Dr. so-and-so ****** off the patient yesterday, etc.) Doing both reports inside and outside just gets me behind!

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.

Only now with a number of bedside reporting in units you have to say "It was a PLEASURE to take care of you!! This is my co-worker (and BFF) Nurse Forget-me-Not. She has her BSN from Blah, Blah University!! She has been a nurse for 2 years and I KNOW she will take EXCEPTIONAL care of you!!"

And forgive the slightly sarcastic edge, however this is EXACTLY what we are to say. Except for the BFF in parenthesis. But make sure your tone reflects your "bond".

And there's even a nifty little card that prompts you should you forget. I have always wanted to say "This is nurse such and so. She and I never work together, so I can not comment on her expertise." And then watch myself lose my job because of it.

They are really, really serious about this concept. And if it is my ultra lucky day, the manager comes along on bedside reporting, just to be sure we are all following the script to the letter.

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.

AH, yes, TCAB....yet another thing made up by people who are not currently, nor been in some time, bedside nurses.

AND when I brought this up in a staff meeting, I was told that re-education was needed ......and then came yet another script of "Let's get up now and use the bathroom. Let me get you some water. I will be back in one hour to round on you again or when your medication is due, whichever comes first".......I kid you not.

TCAB is the latest "special of the day" to attempt to make patients feel like they have a private duty nurse. And mark those surveys accordingly.

On my telemetry/med floor, both the nurses and the aides are required to do bedside reporting. It takes longer and can be a hassle, but I can see the reasoning behind it.

Specializes in Acute Care - Adult, Med Surg, Neuro.

I think I would love bedside report. I have done it a few times, for example -- "Hmm, I KNOW the wound was on the right arm, but now I'm second guessing myself. Let's go take a look." or - "Here's this special drain. Let's go take a look at it and I'll show you how to flush it."

It would also save me from the many times I have entered rooms and the patient is off of the monitor, oxygen tubing disconnected, wound vac hasn't been plugged in and the battery is dead, IV bag is out of fluid, patient is side-ways in bed, bed alarm is off, patient has just arrived on the floor ... etc.

It also includes patients in the report process. So many times I will tell patients "I'm about ready to leave, and I'm going to meet your night nurse and give her a quick update," and the patient will ask - "oh, who are they?" and I won't be able to tell them because I don't even know yet.

Only now with a number of bedside reporting in units you have to say "It was a PLEASURE to take care of you!! This is my co-worker (and BFF) Nurse Forget-me-Not. She has her BSN from Blah, Blah University!! She has been a nurse for 2 years and I KNOW she will take EXCEPTIONAL care of you!!"

And forgive the slightly sarcastic edge, however this is EXACTLY what we are to say. Except for the BFF in parenthesis. But make sure your tone reflects your "bond".

And there's even a nifty little card that prompts you should you forget. I have always wanted to say "This is nurse such and so. She and I never work together, so I can not comment on her expertise." And then watch myself lose my job because of it.

They are really, really serious about this concept. And if it is my ultra lucky day, the manager comes along on bedside reporting, just to be sure we are all following the script to the letter.

We have a script to follow as well during our bedside report. And a couple months ago, they added something new. We have to write on the white board the TIME we will be back to check on them! We do hourly rounding and before we leave the room we have to say, "Is there anything else I can do for you while I have the time?" If not, then we say, "I will be back at such-in-such time to check in on you." And write the time on the board when we will return.

According to management, this is supposed to reduce the amount of call lights. If they need something that can wait a bit, they can look on the board and think, "Oh, Nurse Suzy will be back at 8pm."

This works less often than not. Most patients will call because we aren't there exactly at the time written on the board. They get angry if we are 5 minutes "late".

It just gets frustrating when the higher ups think of more crazy things to add to our routine for "patient satisfaction."

Specializes in CICU.

Thank Heaven for nights and weekends...

I don't do scripts. However, I do like to introduce the oncoming nurse, especially in cases where it will help them to build rapport. Some get a more glowing endorsement than others...

I would be looking for another job if I was forced to endorse the oncoming nurse.

I would be looking for another job if I was forced to endorse the oncoming nurse.

It's crazy because I'm a float nurse and 9 times out of 10 the nurse I'm getting report from doesn't know me at all. They say this script and when they go to say my name they have to ask me my name. So how can I be an outstanding nurse when you don't even know my name. Not saying I'm a bad nurse but don't use all this fluff when you've never met me before. I don't say it. I just introduce them as their next nurse and start going over hanging meds, IV's, lines etc.

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Specializes in NICU.

Ah, yes...'managing up' the oncoming nurse. :sarcastic: Easy to do for our day shift nurses who have been practising for 20+ years. Kind of a joke do to for my shift, night shift. I have the most experience for night shift, with a grand total of 1.5 years. :cheeky: here are only two others with over a year experienced.

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