Worst information given in shift report!!!

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TypicalFish

278 Posts

All of that information can be found on the chart. It just drives me nuts when report drones on and on because we are giving I&O, IV credits, BMs, etc. If there is something abnormal about that information, fine, tell us in report...otherwise, if we need to know, we can look it up.

My biggest beef is not being given correct information-I have been burned too many times-we do rounds in our ACCU, so you need to have the correct info, since you are presenting to, and being drilled by about 10 people. Recently, I was told by the night nurse that a pt's admittting dx was resp. failure and pneumonia-which made little since for him to be in the ACCU, oh, and he was such a apin to her all night that she "took her time" answering the call light because he was just being "whiney". I walk in at 0645, and he's diaphoretic, clutching his chest, and his bp is 178/98. DUH! so I spend the next 2 hours r/o MI-he had a hyperkinetic right atrium causing severe angina, and don't have time to read his H/P-I also had two other pts- (which I always do, since getting burned the first time) and look like an idiot when presenting. Later, the pt's primary comes by, and reading the pt's chart, stops me and asks "What does PEA mean?" (excuse me?) After being surprised by the question, I find that the night nurse forgot to mention, or didn't know, that this pt is in the ACCU because he CODED on the floor and had PEA. I usually get there early and read the H/P and progress note prior to 0645 report, but I got there and they were having a "morning minutes" meeting, then I went right to report, and the night nurse bailed at 0650, not 0715, the time that she should of left. That's right up there next to a nurse not telling me that a pt had urosepsis.

redwinggirlie

559 Posts

the worst report i ever got was a taped report. i had floated from med/surg to neuro to do charge on the night shift. our shifts started at 11:15, and that's what time i showed up to work. their shift started at 11:00. so when i got there, i found the taped report, two nursing assistants (one from an agency and one that actually worked there) and no nurses anywhere.

the tape started out: "the narcotic count is off and has been all day. in bed 1 is mrs. doe. she's seizing. she's been seizing all day. in the next bed is mr. jones. he just came back from surgery. we don't know what he had done. in room 3 is a dnr and another surgical patient. in room 4 . . . "

i listened to the tape and came out of the report room to find both aides frantically flipping through the kardex. knowing beyond a shadow of a doubt that something was amiss, i asked "what's up?"

"oh, ruby," one said. "which patient in room 3 is a dnr?"

"why," i answered somewhat sarcasticlly. "is one of them not breathing.?" i should have known better. the one that wasn't breathing wasn't the dnr.

you shouldn't have accepted that as a report. even if it is taped, the nurses are still there and you can query them.

Specializes in OB, M/S, HH, Medical Imaging RN.

The lung sounds and all that junk aren't important. They're still breathing. We don't do shift assessments in California nor do we double check insulin. You're so old school here in the South.

Post-script: This nurse got fired several weeks later for stealing Lortabs x 22 !

My pet peeve about report in LTC is the nurse who just says "everybody's fine" and expects that to work.

But, sometimes that is all there is to say. I work three nights (weekends) in row and report off to the same dayshift nurse two days in a row. If there is no change and they had a good day, I am fully satisfied with "everybody's fine." I always give a good report the first day on everyone's condition, but the next day we just hit the highlights.

We also ask each other if they know the patinet, if they do, we don't have to give the whole H&P, giving us more time for the patients we don't know.

It also helps when you are able to work with the same people and you know what they want in report.

And I really don't care that they had a cat when they were five...I would like to know, and know how to look up myself, what they do/did for a living. That information is gold!

chickdude1

23 Posts

Specializes in Telemetry.

I think my worst report for me happened during my Med-Surg I rotation this summer. The reporting nurse wanted to launch into a tirade about an argument she had with a patient's family member. My preceptor handled it beautifully--after about only 1 minute of this, she interrupted, saying "Yes, but the patient???" The reporting nurse then started supplying pertinent details....

Here's been another observation--don't let your opinion of a patient be colored by the info given by the reporting nurse. I had one who told me that my patient liked to keep the side rail down on one side of his bed so that he could pee from lying down into his bedside commode. She told me this with a look of utter disgust on her face. So, when I went into his room and saw garbage scattered all over the floor, I immediately assumed that he was a slob. However, when I stopped and thought about it, I realized two things: 1) the only garbage can this patient had was located across the room, so he couldn't throw anything in it, and 2) he was used to being very independent, was too weak to make it to the bedside commode by himself, and was too proud to ask for help.

When I moved the garbage can within reach, the garbage somehow wound up in the correct place (note to myself: Duh!), and when I had an honest conversation with him why it was important that I assist him to the restroom (I gladly offered to help him across the room to the restroom instead of insisting he use the bedside commode) and that I was happy to do so, he always let me know when he needed help!

Cheers!

ChickDude1

What has been some of the worst information you've ever been given during shift report on your patients? Don't you just hate hearing "i don't know" or "i'm not really sure" when it comes to essential information like last BM, last BS on a diabetic patient or I & O's (especially on surgical patients)?

slinkeecat

208 Posts

When I give report I am concise and to the point. I expect to receive it in the same manner.... I do not care about your love life or lack thereof. I do not want to hear about your family...brother, sister, mother, father, hubby, child's drinking problem, drug problem, etc. I don't like having to wait on report while you change clothes so you can go drinking, bar hopping, etc. I don't want to clean up your dinner trash, old coffee cups, scrap paper , that you leave all over the nurses station either!!!

I really get upset when I get this...

Her: Well, Mr. So & So Removed his foley, has been a no void since 12 noon, and his vitals have been really funny, he is pale and he doesn't seem right....he's got a temp...

Me: did you cath him? ....

Her: well, no I was hoping he'd pee

Me: He hasn't voided in 11 hrs? Did you call the doc? Give him tylenol?

Her: hmmm, well I was kinda busy...and Dr. X is just so rude and unpleasant...

and we were out of tylenol and I did not have time to ask pharmacy to bring it up...

OH, I just want to scream.... Lazy? Stoopid? Thoughtless half-wit? spineless?

Then I go and assess the patient and he is in bad shape and we can add Urosepsis to his Dx.

That, my friends.... Makes me so angry.... Especially when other nurses tell me she is on line ordering crap rather then attending to the needs of the patient... or leaving a bunch of crap that i have to do, because the off going nurse is too freaking lazy....

I just thought I'd mention it.... lol.... It happened to me last nite....

Tweety, BSN, RN

34,248 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I received report that a patient was "brain dead". Mind you I work med-surg, not Neuro Intensive Care where they do donor cases on brain dead people. I kept my mouth shut, knowing she probably meant "permanent vegetative state" from a head injury.

I assess the patient, and yes, he's severely brain damaged, but opened eyes, nodded yes and no to simple questions, moved his right side and obeyed commands. Didn't look brain dead to me.

mich_01085

31 Posts

Specializes in Rehab.

The worst??? "This patient is doing fine." I walk into the room 15 minutes later and find him Cheyne-Stoking!

djg

3 Posts

I agree with you cotjockey and prickleypear. Some people drag report on forever.

MichaelLooney

68 Posts

My pet peeve about report in LTC is the nurse who just says "everybody's fine" and expects that to work.

EXACTLY! Then we come to find out Mrs. Worth is in the hospital, Mr. Fowth threw up after every meal as soon as he got back to his room, and Miss Everstein died last night.

babynurselsa, RN

1,129 Posts

Specializes in ER, NICU, NSY and some other stuff.
I once got report from a nurse who forgot to tell me that the baby had an extra digit on her hand that had been "tied off" a few days before. I had no clue, and nothing was written on the patient care summary either. So there I am, unwrapping the baby, and caught a glimpse of something black in her hand. I jumped so fast that I banged my arms on the isolette portholes and scared the heck out of anyone within ten feet of me! The shape of the digit, the black-purple color of it, and the black sutures that were tied and then snipped to look like two little antennae...I thought the kid was holding a cockroach!

:rotfl: :rotfl: :rotfl:

Gompers I know exactly what you mean. I once had a baby that was about 2 weeks old by the time I had her. Up until that point NO ONE had noticed kiddo had webbed toes on one foot.

at your cervix

203 Posts

Specializes in OB, Post Partum, Home Health.

The worst report I ever got was from a nurse that reported that her patient was new mom who had just delievered her second baby, had had a full term infant that died of sids and had one miscarriage. As the charge nurse, I assigned this patient to one of the other nurses who went in to do discharge teaching and came out furious! Apparently in the course of doing discharge teaching she tried to be very sensitive of the fact that the patient had had a baby die of sids when it was three days old, when she got to the baby care stuff she was very careful to go over the back to sleep and no second hand smoke stuff, then acknowledged that the patient may be very nervous in taking this baby home since her last baby had died. The patient got a very confused look on her face and said, "This is my first baby, I had a miscarriage but I have never had a baby that died." As it turns out, no one on the unit that day had ever had a baby that died of sids, we have no idea where she got this info. She was notorious for giving incorrect reports, like saying that her patients had been medicated at a certain time when they had actually been medicated several hours prior, or that babies were breastfeeding well when in fact they were bottlefeeding, or were in the NICU and had never attempted breastfeeding, but this was probably the worst bit of misinformation that she ever gave. As you may have guessed, she no longer works with us!

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