Dreading bedside report with The Interrogator

[sistrmoon]

We are transitioning to bedside report soon as "it shows an increase in both patient and nurse satisfaction"(cue management spin.) I am dreading it in general for many reasons. I think it will be awkward, that it will spawn two reports: the sanitized one in front of the patient and the real one elsewhere, and I don't understand how it isn't a HIPAA violation in our semi private rooms.

However, one thing I'm really dreading is being in front of the patient with my coworker The Interrogator. I have no doubt she will use every opportunity to make me look stupid and herself look Super Nurse to the patient. After all, behavior such as hers stems from insecurity. What's better than chipping away at a fellow nurse in privacy ? Doing it in front of a patient!

Has anyone dealt with this and how did you handle it?

[dudette10, MSN, RN]

However, one thing I'm really dreading is being in front of the patient with my coworker The Interrogator. I have no doubt she will use every opportunity to make me look stupid and herself look Super Nurse to the patient. After all, behavior such as hers stems from insecurity. What's better than chipping away at a fellow nurse in privacy ? Doing it in front of a patient!

Has anyone dealt with this and how did you handle it?

When someone tries to make herself out to be SuperNurse at the expense of another in front of a patient, it usually backfires! It makes SuperNurse wanna be look petty and insecure.

[roser13, ASN, RN]

Please try this: look her right in the eye and say this report needs to be over in five minutes or less because I have places to be today. Be laser focused on telling her about the patient. If she interrupts with some extraneous information or question say I don't interrupt you when you do report and I would appreciate it if you would extend the same courtesy to me.

If you have any kind of rapport with this weirdo, ask to speak to her privately before report and say, I need you to listen and not ask questions when I am trying to give report. It is distracting and putting me into overtime. Take control because these people are running you and they know it.

This. You are not the only one who has one of those in their facility. I knew EXACTLY what you meant as soon as I read your OP. The post quoted above is the only way to deal with a person like that. Even if you are at the bedside when you have to give the response, do it.

Interrogators are bullies and the only thing they respect is running into a brick wall and getting their faces smashed. If you give in at first, you will forever be at their mercy.

ETA: I have to tell you my story. Once I got past my fear of my Interrogator (took a couple of years), I got strong enough to give report as mentioned above. One morning I was giving report on an elderly gentleman who had suffered a stroke while on the floor with us. Patient was still with us (literally and figuratively) and you can bet my report was comprehensive, including I's & O's. Finally, when I stopped speaking, she looks directly at me and says "But how is his turgor?" It completely caught me off guard. I couldn't for the life of me remember what turgor was. I kind of stared like a deer in the headlights, then poof! It came to me, concurrent with the thought "what an idiotic question, given the complete report, including I&O's, that she had just received." I immediately started laughing - just couldn't help it. She stalked away from the bedside and didn't wait to hear about our patient's "turgor." No doubt she spent my entire report trying to think up something to trip me up and was disappointed when I laughed.

[Nurse SMS, MSN, RN]

I absolutely DREADED bedside report when it was announced we were going that route. I was pleasantly surprised at how FAST bedside report is in most cases now. I always start out introducing the patient to the oncoming nurse and stating "I am going to tell him/her everything about your care so that you will know everything we know. However, I do ask you save your questions until the end so that we don't forget anything important." Most of the patients nod and listen eagerly. Some can't help themselves from interrupting but they are more an exception than a rule.

As far as the Interrogator goes, "I'm not finished yet" works. YOu could expand the above statement to include the oncoming nurse if you like. "Nurse Jen is going to hold her questions until I am done so I don't miss anything important and if you would do the same it will help ensure I am thorough". Then Nurse Jen can only look like a dolt for interrupting.

We use Epic for our charting and there is a summary sheet that we pull up and review together during report. Anything not on that summary sheet doesn't really belong in report. If you have your own version of this (or Epic at your place of work), you can simply tell her "I don't know. I'm sure you can find that in the chart" and continue on. If it is something you do cover in your report, the simple "Hang on there Jen. I'm not done yet" should work.

These types need boundaries not only drawn but reinforced. They swiftly learn who they can and can't get away with on this.

[caliotter3]

When we were required to do bedside report, it turned into a situation for two reports, the sanitized bedside report that you mention, as well as the real one, given elsewhere. Then they added the 'include the CNA's' requirement, and that brought forth the third report because there are things that you can not say in front of the CNAs. I believe this 'requirement', if nothing else, is a very effective way to discourage 'nurse to nurse' communication. It is easier to leave out communication than to continually take extra time, often non-compensated, to convey necessary information.

[mariebailey, MSN, RN]

I'm running into the same thing. I'm fresh off orientation. A few nurses seem to think I should have the entire medical record committed to memory for their benefit, & one in particular moans and groans if I give a less than stellar response. I do wish I could come in early to look over the H&P, etc., but assignments are not made until the last minute. After that, I'm running my butt off non-stop, leaving little time for perusing MD documentation.

[bebbercorn]

I second the nurses who say that you should give basic facts at the bedside and "You reeeeeally need to know this to make your shift easier" comments to outside of the room. If it is only one nurse giving you the third degree, that's their problem. Sometimes I get thrown off in report after a hectic day of multiple patients, I get it, but if there is a repeat offender, sometimes a "I can't recall the exact details of what I read, but I can show you how to find it in the chart, if you like," will end that kind of behavior.

[tokmom, BSN, RN]

Your floor needs a standard work for your bedside report. We have a report sheet that starts with pt name and room number and ends with barrier to discharge. People know to NOT interrupt the nurse giving report until the end. It works well when people use it the way it is intended.

[martymoose, BSN, RN]

I cant help but wonder sometimes if people do this so they can make sure nothing gets passed on ( as in the " that should have been done on your shift/your time/don't leave me any undone work.)

Explaining that nsg is a 24/7job does nothing.

[martymoose, BSN, RN]

I get it, but if there is a repeat offender, sometimes a "I can't recall the exact details of what I read, but I can show you how to find it in the chart, if you like," will end that kind of behavior.

Oh no it won't......

[amzyRN]

I like bedside reports too. I feel like being in front of patients helps me avoid the interrogation because sometimes the patients have the answers that I don't. You can be honest and say to the next nurse that you don't know the answers and move on from there. A brief SBAR is really all that is necessary. 5 to 7 minutes is usually enough, at least in my specialty.

[avado, BSN]

Is this Bedside Reporting done on an acute care floor with nurse ratio 1:5 or ICUs? I would cringe too if the Interrogator had all FIVE of my patients!

Our Nurse Executive wants us to start doing Bedside but we are so spread out in distance & mixture of patients. I can see it Fail fast..

[cjcsoon2bnp, MSN, RN, NP]

We are transitioning to bedside report soon as "it shows an increase in both patient and nurse satisfaction"(cue management spin.) I am dreading it in general for many reasons. I think it will be awkward, that it will spawn two reports: the sanitized one in front of the patient and the real one elsewhere, and I don't understand how it isn't a HIPAA violation in our semi private rooms.

However, one thing I'm really dreading is being in front of the patient with my coworker The Interrogator. I have no doubt she will use every opportunity to make me look stupid and herself look Super Nurse to the patient. After all, behavior such as hers stems from insecurity. What's better than chipping away at a fellow nurse in privacy ? Doing it in front of a patient!

Has anyone dealt with this and how did you handle it?

To the OP, this particular behavior that you and the other users mention on this thread is passive aggressive and comes from a place of insecurity on the part of "The Interrogator". These individuals know exactly what they are doing and how it makes you feel but will justify it as "ensuring the highest quality of care for the patient", "obtaining a complete and accurate report" and "helping you [the RN giving the report] to elevate your practice". While giving a comprehensive handoff between shifts is the cornerstone of good nursing care, there is a fine line from asking appropriate questions and trying to embarrass your coworker in order to make yourself look better.

In my previous job as a Adult Med/Surg RN we had bedside reporting (with RNs and CNAs) and I really enjoyed it because you are able to do a quick environmental safety check (call bell in reach, O2/suction equipment set up, bed in low position etc.) review IV pumps and flow rates and introduce the oncoming RN to the patient. As the RN giving report I would start off with a pretty generic line that I noticed my coworkers came to adapt as well

RN Handing Off: "Good morning Mrs. Jones, it's the end of my shift and I'm going to be going home now but before I go I want to introduce you to the oncoming nurse and the CNA. This is Carol, she is going to be the nurse taking care of you this morning and this is Jane, she is the CNA taking care of you this morning. I can assure you that your in good hands. I'm going to tell Carol and Jane a little bit about what brought you into the hospital and what has been going on during our shift together. At the very end please let me know if I forgot to mention anything that they need to know and at that point they may have some additional questions for us."

If the patient interrupts you during report I would usually give them a pass once or twice but if it became a pattern I would casually say "Thank you, that's a good point. Do you mind if we come back to that in a minute?".

If the RN or CNA interrupts to ask a question (unless it is to clarify something you just stated) I would nicely say "I will get to that in just a minute but do you mind saving your questions until the end please." If it is about a question that is trivial or not significant for report I would either say "You will have to check the chart or the medical record about that." or "I don't think that is something we need to address at this time."

If you find a particular RN or CNA has a clear pattern of interrupting report for unnecessary questions (and they don't take the hint from your prompts in front of the patient) I would ask to speak to them privately and directly confront the issue. Keep your discussion factual, non-accusatory and focused on the problem behavior and not attacking the individual. Keep in mind that this is likely to be met with resistance and passive aggressive remarks such as: "Well I didn't know you felt that way but I need to ask questions to make sure that I'm getting a good report." or "I'm sorry but I need this essential information to take care of my patient." or "These questions are just helping you to give a better handoff."

If this becoming an ongoing issue between you and a coworker it may involve a conversation with your manager but speaking to the offender directly to address the problem (versus not addressing it and letting it rattle you or making comments to other coworkers about the offender) you will likely find that this behavior will stop. Best of luck to the OP and to other users having the same issue!

!Chris