Communication between nurses and aids

[pitt34]

I work on a med/surg unit and I am really frustrated with the lack of communication between nurses and aids. When new orders are constantly being put it on patient's throughout the day these orders aren't being relayed to the aids. I have also found how terrible report is between the aids. I often hear them say "they are a turn and reposition every 2 hours and they are incontinent" and move on to the next patient. These aids have no idea what is going on with these patients and what needs to be done for the day.

How do you guys communicate with your aids?

How could we improve this end of shift report between aids?

[Vespertinas]

Do they have a standardized communication sheet that covers common basics like: mobility/fall risk, surgical site, central lines, drains, oxygen, VS freqency, diet, fingersticks, continence, misc (daily weights, strict I+O)?

If so, I've seen aides update each other according to these sheets and I've also seen aides get report both from the prior shift AND confirming with RNs.

This is something that I've seen works only when management mandates it. Otherwise you're not going to force everyone to change how they give/receive report. The best I've done in that situation is to give a brief verbal summary when I can catch the aide in the patient's room. That way, if they are not writing it down, the information can stick better by visualizing the patient during my description.

Sometimes they have so many patients to care for that "turn q2h and incontinent" is all they can squeeze into their shift for each patient.

[caliotter3]

One place where I worked instituted the practice of the nursing assistants being present for shift to shift report that occurred between the nurses instead of waiting to receive their separate report from their respective nurses. The nurses did not like this because it put a damper on nurse to nurse communication.

[classicdame, MSN, EdD]

actually I see nurses who also reduce their "work" to just tasks. Perhaps the aides are tasking only, because no one is asking their input on anything or showing them the respect they deserve. Nurses will react the same way when they feel their contributions are not being validated. We then resort to just "doing the job". Consider ways your staff can work together to improve communications. Make it a focus for the unit with posters, etc and really listen to one another. Might improve day/night shift communications as well, or even communications with other depts/disciplines. Good observation on your part!

[ShantheRN, BSN, RN]

I didn't think aides could delegate to each other? Not sure if that's just Ohio or my hospital specifically. All of our PCAs have to get report from the nurse. We've also implemented delegation tools where we set up a time to check in with them as the shift progresses. Granted this usually doesn't work - who can plan for that? - but I make sure I'm in constant communication with them. It makes things a lot easier. When we get a PCA from float pool or another floor, it can be awkward because our floor is busy and they may be used to just hanging out on a computer somewhere. That goes away quickly. They might not like me, but I get my point across :)

Now that I think about it, when I was in assisted living/LTC we never received any type of report from nursing. Everything was from aide to aide. We had so many patients it never would've worked. But in acute care, where things are constantly changing, that's just not possible.

The delegation worksheet is a wonderful tool. Every PCA goes to their nurses and we tell them how often VS, weights, UAs, stool samples, etc need to be done. When I was a PCA it was invaluable. I didn't have to bug the nurses because I had everything marked on my paper. I couldn't imagine getting through a shift without communicating with the nurses. You should suggest it to your managers!

[Nursey103, ADN, RN]

On my floor, the nurses give report to the PCA's. We tell them diet, VS freq, void/foleys, drains, etc. If something changes throughout the shift, I'll update them either verbally or if I'm busy, I'll page them. I follow up throughout the shift. It seems to work well for all of us.