Quote from NurseSpeedy
Absolutely HATE faxed report from the ER. Got a patient with a nitro drip not attached to the pump with the clamp wide open. No mention of the drip. Patient was just dropped off in the bed for me to find. Then I was actually overjoyed when I found the tubing to THAT iv tangled in his linen with the iv cath attached so it just free flowed into his bed and not him. The NS was clamped for transfer. That iv was still in the patient. Patient admitted with HTN. Nurse suffered a CVA on arrival to unit.
A couple of thoughts-
Fax??? Are they created on a typewriter? While state of the art in the 80's, there have been a few developments since then. Presumably faxes are used only in facilities that still paper chart. Or do I have this wrong? Are there places that computer chart that have ER nurses go through the computer to create a fax for the floor?
Regarding the above example: I don't think the chief problem there was the fax. No real reason to think that if report had been done differently, the details would have been any better. Stuff gets missed in verbal report as well. And, the real problem here is the med not infusing. Not knowing a NTG is running is annoying, but it generally won't affect care- unless the receiving RN doesn't notice it. BTW- which nurse had the CVA? I get annoyed at work sometimes, but have never actually stroked out.
Regarding verbal report: If you were to start from scratch and design a system (One that uses computers), there would not be two people, one of them verbalizing critical information, while the second hand writes it on a piece of paper. We do that because, well, that's how we were taught. In fact, it was the only way Clara Barton could inform the next nurse.
If it was a good idea, other industries would use it more. Picture in a nuclear power plant at shift change: "Got a pen? OK, so that valve over in bay 22 has been cranky all night. I am just so frustrated- no matter how I adjust it, the alarms keep bugging me. The refractory reciprocation levers are working great- not a problem all night....."
ER nurses regularly take patients from other nurses with little or no verbal report. That has nothing to do with being more capable, or needing less information, it has to do with how we get that information. EICU (Off site critical care) docs regularly make life or death decisions based on information they glean in 2 minutes off a chart. And they care for dozens of patients at a time.
Report is very much like the game of telephone that kids play. That game is based on the fact that information that gets passed on verbally invariably becomes inaccurate.