Hand off

[b747girl5]

Please help me. I am a new nurse (2 months) and I suck at giving report. Its is the most stressful part of the job for me. All someone has to do is ask me one question I dont know the answer to and the rest of by he report goes down the tubes. I feel as though if I am not reading my SBAR I can't remember the info. It gets so bad with me stumbling cos some nurse had intimidated me, you would think I never spent 12 hours with these patients. I am in desperate need of how to prepare a solid sbar. I get physically sick to my stomach at the mere tight of giving report. Most of the times its okay but those times when its bad, its real bad.

[bellini]

To add to what others have said, a systematic body systems approach is helpful so that nothing is missed...I like the mnemonic Could an RN Want to GUess What's GoIng on for Circulatory, Respiratory, Neuro, GU, GI. Then finish up with a review of the labs and meds, and orders for your shift.

[Nurse Beth, MSN]

When asked a question you don't have the answer to: "That's a good question. Let me check on that when we're done here"

[Cactus Nurse]

girl don't freak out. IF you're float and they are staff and with them 3 days a week, they already know whats up and are just looking for any changes.

I literally start off by saying "well everyone is still alive nothing major lol"

It's a joke, but it's refreshing to hear when you have some weeks with one to many deaths

if your nurse coming on is same from yesterday, then report is easy- what is new from the last shift?

emesis? c/o constipation? f/c has trouble flushing so you changed it? IV ATB order d/t ___, you don't need to spend an hour talking, UNLESS oncoming nurse is new to them, in that case whatever you don't know say "i'm not sure, because I'm not always here, so if you have questions look in their chart," and move on.

We have 3 units at my facility, I work mostly in the subacute, but if I pick up a shift I go to LTC usually and if I don't 100%, I tell them look in the chart if they have further questions (that aren't relevant to what I'm actually saying).

We don't use SBAR btw, we have a cute lil report sheet that has things like maybe simple dx, IV, f/c crushed, whole and PEG or not, but that's it.

[RNbubu]

Why the patient is here; what has happened so far; what is the plan.

Then important orders or things that need to be clarified. And any significant assessment findings.

Then I answer any questions they might have and I do refer them to the pt's chart.

I myself arrive early so I can check my pt's chart and be prepared when I get report. I appreciate when the oncoming nurses do the same so we can focus on the important things.

I had 12 hours to learn all about this patient and so will the oncoming nurse. During hand off I want to focus on what is most important. We need to get/give report on multiple patients.

Finally: it is super normal to feel the way you feel. It will get better.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Just wait until you get that oncoming nurse who tries to tell you during report how your patients did during the night.

Unfortunately, we have 'special' nurses in this field, and the newer you are (float and agency nurses fall into category, too, compared to regular staff), the more they will be assigned as your relief. It's unfortunate and unfair; but I've seen this more times than I can count because the veteran/regular nurses don't want to be bothered with them.

The key to this is to not even start report with these folks until you're in front of your computer. When your done and are proceeding to the next patient, if you're asked another question about the previous patient, take that nurse back to that previous patient's room and log back onto the computer. That'll stop a LOT of that nonsense.

Some of these nurses want so thorough a report so they can put in their shift assessment without having to actually do the assessment. You are new but what you're encountering is not ALL you.