Getting patient information before shift

Nurses General Nursing

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My hospital just started strongly enforcing nurses to not login to a patient's chart unless you have clocked in (7 min before start of shift). It hasn't been a big problem for me since I usually come into work around 6:50 or so. However, a lot of other nurses are having a difficult time with this and are trying to go around it (e.g. gathering the patient's info from the previous shift's logged in computer). We also just started bedside shift report and the oncoming shift doesn't know much about the patient before report and it can get pretty lengthy if you have to explain pmh, h&p, assessment, etc. The nurses have gotten pretty frustrated with it lately and bedside report isn't consistent anymore. I was wondering what other hospitals have implemented for nurses to gather information before the start of the shift without clocking in or have it considered "working off the clock." I have read that some hospitals record the report on a tape or have a kardex. Any other suggestions?? Thanks!

I'm amazed at people that WANT to work for free. Hospital doesn't pay me to prepare for my shift? Then I won't be prepared.

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We have pt care summaries which automatically print about an hour before shift change. They show name, DOB, admission date, dx, attending/consulting MDs, most recent VS, activity, diet, upcoming labs or testing, list of orders since admission date, & current meds with the most recent administration time. I rarely feel it necessary to log into the chart until after I've received report; it usually only happens if report gets delayed because RNs trying to finish up with pts. Also, most of us don't show up until about clock-in time anyway. Much earlier than that & pt assignments probably won't

be up yet.

Have been asking for such a report but no one has seen it as important enough to address yet. If I had that wouldn't have to get there early.

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Specializes in Med Surg.
I'm amazed at people that WANT to work for free. Hospital doesn't pay me to prepare for my shift? Then I won't be prepared.

Ditto. Maybe I'm old and cynical, but I got burned by my old (non nursing) job. I'm fully prepared to give my 100% in return for my wage, but no way in the world am I giving more for free. If my job wants me to do something they'll pay me for it or it's not happening.

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Specializes in NICU, PICU, PACU.

Like someone else said, they can get you on a HIPAA violation if you log in off the clock. You should never do anything off the clock.

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I'm amazed at people that WANT to work for free. Hospital doesn't pay me to prepare for my shift? Then I won't be prepared.

Agreed. No wonder so many facilities unofficially expect this from nurses.

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With my first job, I always came in a few minutes to start gathering info for my "brains" sheet. With 6 patients the morning workload could be crushing sometimes and anything extra would help.

I also quickly realized that starting early, leaving late and skipping lunch most days to stay caught up was not a sustainable long-term strategy.

I don't work there anymore. I hear my old workplace is hiring right now. They are always hiring. Wonder why?

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Specializes in Rehab, LTC, Peds, Hospice.

Nothing for free! You don't do your workplace any favors either since there is an electronic trail showing you working off the clock. Someone complains about labor violations all employees histories are up for review - voluntarily or not you are owed $ for working and have set them up for expensive violations of the law. Supervisors should NEVER knowingly allow their employees to work off the clock (or eat an unpaid lunch while working) - they are liable too.

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Starting work before you officially start is always a recipe for legal disaster.I work in australia at a private hospital and all our pt charts are hard copy only thing that is electronic is our pt handover list with basic info updated each shift and our staffing system.based on acuity. interesting to see the difference between us and america. we are behind the times. if anyone wanted to come early to look at pt charts they could and nobody would even know unless someone saw them. and we have manually written timesheets. none of this computer clocking in and out business

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Where I used to work report didn't start until 5 after the hour. So if you are able to punch in 7 mins early and use that 5 mins, that is almost 15 mins you have to look basic info up on your patients. Plus, we had to be done with report and punch out on time, they really watched our incidental overtime. Once people quit complaining about the changes and quit being negative saying this would never work and it would take forever and accepted it as the way it is, it actually worked out quite well and people really started to like it. It really helped to start the day on a better foot, because in that half hour you would usually be sitting in a room talking about patients you were actually already meeting them and half assessing them, and the report was better (less subjective and more objective, less gossiping i guess you could say).

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Specializes in BNAT instructor, ICU, Hospice,triage.
I'm amazed at people that WANT to work for free. Hospital doesn't pay me to prepare for my shift? Then I won't be prepared.

I just don't have this mindset at all! I work for my patients and it has nothing to do with the pay. If it were about the money then I'd go into some job that paid me something, not nursing. I want to know what is going on so that I can be the best nurse and have my A game for my shift, and NOT put my license on the line for greedy lawyers to take away from me.

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I work for my patients and it has nothing to do with the pay.

And this Mary Martyr attitude is why hospitals can get away with not paying people to prepare for their shift.

15 extra minutes of preparation isn't going to make the difference between keeping and losing your license. It is a full week of pay that you're giving to the hospital for free each year. And I guarantee that the CEO and shareholders that are profiting from your giving spirit wouldn't give to YOU a free week of pay.

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Specializes in Public Health Nurse.
"Supervisors should NEVER knowingly allow their employees to work off the clock (or eat an unpaid lunch while working) - they are liable too."

I am a new graduate and I have yet to work as an RN so I have yet to experience this (though I did in my old job...they thought buying lunch that we can gobble in ten minutes should make us happy to work through lunch), but often I read these complaints on posts at allnurses...why do they allow a nurse to get docked for a lunch they could not take? I am sure these supervisors often come here themselves to read the boards and post their thoughts, so why not fix it?

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