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Frequency of rounds

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by Non_nurse Non_nurse (New Member) New Member

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I'm curious to know what the standard policy on nursing rounds are. When my wife was in recovery room post delivery we had nurses coming in to check on us constantly. In that circumstance it felt like overkill since all she wanted to do was sleep after a 37 hour labor. On the other end of the spectrum, my 3 year old was admitted into hospital for a GI issue and we felt abandoned. There have been times when we haven’t had a nurse come into our room to check on us for over 5 hours. In this case, we would welcome more frequent contact for a variety of reasons. Does this seem normal - having such infrequent check-ins? 

thanks ( for clarification I’m not a nurse)

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

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It varies by facility, but generally most want 1-2 hour rounding.  Unfortunately, many times, because of staffing ratios and any emergent situations or admissions, this may stretch out longer.   5 hours does seem excessive, but again, I don't know this facilities particulars.  Call the hospital and ask to speak to patient relations, they can help with the child situation and get some answers.  

As far as the delivery, they are there constantly as hemorrhaging and other postpartum issues are very time sensitive. They have specific time guidelines for L&D and mom and baby areas, and generally are better staffed as well.

Beyond that, per Terms of Service, really can't offer much else as it borders on legal advice, which is a no-no here

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kp2016 has 20 years experience.

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I have been a nurse for a long time, a patient once or twice and the family member many times. Any time you have questions about the care or perceived  lack of care you or a family member is receiving you need to calmly and politely talk to the appropriate staff ASAP. 

Waiting until after the fact doesn’t help the patient and frankly it’s impossible to give an accurate answer on if the care was appropriate or not without access to the entire clinical picture. Please don’t take this as a criticism of you. Just understand well meaning people without access to the entire picture can’t help you and could easily get it very wrong if they tried. 

If your really concerned contact the facilities patient advocate and ask to speak with them and going forward if you are concerned about the care say so immediately.

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Meriwhen is a ASN, BSN, RN and specializes in Psych ICU, addictions.

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Come to a psych unit and you'll see our faces every 15 minutes 24/7, whether you want to or not 🙂

Seriously, it depends on the facility's policy, the specific unit's policy, as well as the acuity of the specific patient.  So it can vary.  More acute/seriously ill patients, more frequent rounding.  Though call lights are there for a reason, and a patient/parent should not hesitate to use them if they feel staff assistance is needed.

As others have said, if you have concerns about the rounding, then you should contact the patient advocate/relations department of the facility.  Also, don't wait until after discharge to voice those concerns.  The most effective way to get concerns addressed is for staff to address them ASAP, while the patient is actually still a patient.  But we can't address concerns if they are not brought to our attention.

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On 7/7/2019 at 7:14 PM, Non_nurse said:

There have been times when we haven’t had a nurse come into our room to check on us for over 5 hours.

The likelihood of your nurse being overloaded with duties and responsibilities is quite high in a hospital setting in 2019. [There will always be the possibility of the absolutely neglectful/lazy nurse - - but that is by far not the most likely thing that affected your scenario].

There is an overall mentality within healthcare corporations (business people) that nurses can absorb an infinite amount of duties and directives, and somehow do justice to it all - - but mostly what these corporations are concerned about is their liability and the technicalities required in order to be able to maximize their billings and ultimately their profits (whether they are for-profit or not-for-profit).

I hope you will keep these basic ideas in mind when discussing this with those responsible, which I agree you should do.

One of my family members had a harmful episode while hospitalized that required additional intervention because of someone's actions. Because I am a nurse, the whole thing could easily be traced directly to poor treatment of nurses and removal of their decision-making abilities. When I addressed this with administration, that is basically the only angle that I pressed with them because I knew it to be the truth.

Just my perspective.

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Hospitals have different policies regarding rounding.  In addition,  the circumstances on the unit (of which you would not be aware of) have a direct impact on rounding frequency.  Priorities have to be set, the most needy come first.  A nurse can't be everywhere at once and patients have trouble realizing that nurses must take care of other patients too.  If you felt concern at the time then that was the time to see about it.

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amoLucia specializes in LTC.

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This may just be my own perspective but it seems that nurses may slip into the impression that when a family is present, they provide 'extra eyes' and would most likely come out to the nurse to report anything amiss.

With all that nurses have to do, it's like having someone else to help lighten the load. Shouldn't be that way, but it does help staff manage assignments.

I believe this to be true particularly if the pt is more on the stable end, whereas if the pt is more unstable/serious, the observations/roundings occur more freq.

Just my observation.

Kind of like when nurses are pts themselves, other HC practitioners tend to keep instructions or other important information as short as poss, because after all , 'we're nurses, and we should already know it'.

No, I don't know it already and I really would appreciate some info, like you would if I wasn't a nurse.

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humerusRN has 7 years experience.

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On 7/11/2019 at 4:40 PM, amoLucia said:

This may just be my own perspective but it seems that nurses may slip into the impression that when a family is present, they provide 'extra eyes' and would most likely come out to the nurse to report anything amiss.

 

Family is usually present in pediatrics, and I can't imagine not rounding on a patient for 5 hours! Our policy is every hour, and PRN. You see my face every hour - even if you are an "easy" kid with a great family. Even if my round is just ducking my head in, seeing the kid is asleep, and I mime you a thumbs up sign. 🙂 It is easy to overlook the stable kids when you have a busy assignment, and I can't speak for the hospital where you were at OP - but I work inpatient peds at a Children's hospital, and my patient load is usually 3/4 kids, 5 on a bad day. If I am busy with a super sick kid, I will have a charge RN or a teammate check in on my other kids. It's just the right thing to do.

Never hesitate to call out when you need something, even if it's just to see the RN's face and get the thumbs up that everything is OK!

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GroovyOwl has 4 years experience as a MSN, RN and specializes in Geriatrics.

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At my facility, rounds are actually put into the electronic patient file and we have to chart it every two hours during day shift and every hour during the night. It's one of the items that we cannot chart early or even 30 minutes late. Did you miss charting at 2PM? Well you better chart at 4PM explaining why and how. 

Check-ups don't have to be all elaborate; they can be really quick, like when you're rounding prior to med pass or when it's time to install the patients properly for eating. When a patient requires constant vigilance (for whatever reason), we put them in the observation room that's right across from the nurses station. They'll get walked by the most and anyone on the team can keep an eye on them.

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