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
ARE YOU SERIOUS?!?!? if we lived in a vacuum without extraneous variables sure! why not?!?!?! this plays out like a skit in one of those HR/PC videos...next ladies and gents... this is how we go about handling a code (enter the calm, cool and collected nurses).
meanwhile in realtime, nurse handing off realizes that she/he is running out of time and has three other nurses to give report to and just spent 20 minutes battling it out with family, patient and new nurse... meanwhile trying to execute this script... oy... save it...
stand your ground, give a report as best your can and address the passive aggressive attitude.
Yeah, that's the problem is she will repeatedly interrupt with detailed questions trying to trip me up. I am filled with dread. Maybe the "I'm not finished yet" would work.
I hear you. You might have to embarrass HER in front of the patient, by saying "We should talk about this outside the room, please" or "Let's not take up any more of Mrs Jones' time, we'll talk out in the hall . . ."
The Interrogator fears most WHAT she's doing to you -- humiliation. For some reason I'll never understand, this 'type' believes in slapping you before you slap them. The Interrogator EXPECTS someone, somewhere, to want to attack them. Their bluster is 100% 'offense is the best defense'
Sometimes they don't realize how they are coming across, and others could care less if they 'hurt your wittle teensy feewings". Not sure which version The Interrogator is. The above advice about being very efficient and task oriented during the report will give you the sense of being 'in control', and frankly, you ARE in control (or should be) when you give report.
You are GIVING report. Not having report extracted without anesthesia.
We transitioned to bedside report several years ago, and it was a bit weird, we didn't really know how to do it at first (kind of like sex lol), we fumbled around and eventually everyone got into a 'groove'.
Our manager, for a while, would sneak around the unit during report and 'bust' people exchanging report outside the patient's room. Eventually she stopped doing that, I think she realized it is not appropriate or even safe for the patient for two nurses to say everything at the bedside.
The 'groove' we got into was this; we'd stand outside the patient's room and briefly run down the sbar, and then we'd go into the room and she'd introduce me to the patient, tell me a few more things and engage the patient in the conversation, and we'd check the lines, etc. Standing there gawking at one another while the patient wonders what in the HECK you're on about will happen at first, but you'll develop your 'groove', too. It is a better way to give report, and it shouldn't, but does, infer to certain types of nurses that the two of you are having some kind of competition. You don't have to put up with that, and if you have to tell The Interrogator, in so many words, to shut the heck up in front of a patient, well, it will probably be the last time.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I given bedside report for most of my career. I too have faced the interrogator. You are correct that their behavior is motivated by insecurity.
I have learned to give report exactly the same way every time starting with history, diagnosis, head to toe assessment by body system and so on. I created a report sheet that I could use I added to during my shift. I no longer use it having long since memorized every aspect of it.
I don't tolerate interruptions for anything other than a patient emergency. Neither the nurse manager, doctors, nor the RN receiving report dare ever interrupt me. If the nurse interrupts me I shut them down immediately. How I do it depends on the nurse. A new nurse who may not be sure of herself and maybe nervous will get a gentle reminder that I am still giving my report and she should just wait and see if her questions get answered and that she will have an opportunity to ask questions when I am finished. If the RN is an old battle ax who interrupts me just to trip me up or to show how great a nurse she is will get "I need you to shut up and listen until I am finished with my report, you may ask questions when I have completed my report". In severe cases I will throw in "I need you to shut the F bomb up" that usually shocks them into silence. Be very firm.
Any doctor who tries to interrupt my report for anything other than an immediate patient need will be quickly put in their place.
Use or create a report sheet that has everything you need to pass on in report. Keep it near during your shift and add to it as needed. Adjust it when you find it is lacking something until you get it right.
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..
5-6 for us on nights. We often have to give report to 2 or more day shift nurses too!
Also, I wanted to mention that we already do change of shift bedside rounds. So we already check in with the patient, look at fluids/tubing/etc. Just not report.
This nurse actually has less experience than me but is in school for NP. But this attitude existed when she was a nursing assistant. She would shame the nurses and laugh about it. She also just seems angry at night shift in general. She's made comments that we don't do anything/haven't even seen our patients all night.
I'll try what you're saying. I am seriously so miserable even on my off days that I'm considering moving on from this position. I feel like that's letting her win though, and it won't change her behavior toward other nurses.
Management wanted us to do this too. It lasted less than a week. Patients do not want to be harassed each shift, sometimes they have visitors etc. if I was a patient I would refuse bedside report.
Management wanted us to do this too. It lasted less than a week. Patients do not want to be harassed each shift, sometimes they have visitors etc. if I was a patient I would refuse bedside report.
Yeah, you know I work nights and many of the patients are sleeping at both 11p and 7a. Are we waking them up for bedside report all these times? Seems like that would cause a decrease in satisfaction.
I too dread giving report to several interrogators on my floor. They annoy me with questions that are irrelevant to Pt's current dx or POC. We use a standardized Care Team Rounding form that has SBAR and pertinent data listed on it that I update in red ink during my shift. I agree some are trying to make sure no work is left from my shift for,them to complete, some are lazy and don't want to look up labs or test results and others want to micro manage every detail.
JMCP
83 Posts
lol! "I'm not finished!" (angry face, regain composer and back to happy nurse)... one crazy act like that and that nurse will never bother you again!
