Jump to content

Getting report during change of shift

Nurses   (10,465 Views 54 Comments)
by CTnewgrad826 CTnewgrad826 (Member) Member

2,354 Profile Views; 115 Posts

Just curious as to others experience with getting report during change of shift. Where I work, it seems the ED or other units are always calling to giving report on a patient being sent to our unit right at change of shift (7am, 3pm, 7pm, 11pm). Or in other cases we get report at an appropriate time but the patient gets sent up during change of shift. Of course this is going to happen every so often, it's unavoidable and I understand that and staff needs to team together to get the patient comfortable and ensure their stability before finishing their other change of shift duties.

What bothers me is when the nurse reporting off gives a huge attitude about being asked to call back in 10 minutes or so. I understand it's annoying to hold onto a patient for an extra hour because the accepting floor isn't prepared for whatever reason but I think change of shift is an acceptable time to delay the admission/transfer if possible. Change of shift has been shown to be one of the highest risk times for patients since full attention is typically drawn away to get and give report. I think more policies need to be in place regarding this related to what I've experienced so far.

What are your thoughts on getting report/accepting new admits during change of shift?

Share this post


Link to post
Share on other sites

Meriwhen is a ASN, BSN, RN and specializes in Psych ICU, addictions.

2 Followers; 4 Articles; 7,906 Posts; 59,622 Profile Views

Change of shifts...usually when the transfer/admission/discharge/code/AMA decides to happen :) Don't like to deal with it at change-of-shift, but it's going to keep happening no matter what we do, so we just do our best when they happen.

The unwritten policy that our units have is that we don't accept transfers/admits during the last hour of the shift unless it's critical (as in the patient is very psychiatrically unstable where they are). We keep that in mind when we're calling other units about transfers, so we're generally very good to each other. We have to remind intake--frequently--that we're approaching change-of-shift and it isn't the best time to get a patient. With transfers from other facilities...well, neither side always has control over when patients arrive because it's usually whenever BLS transport is able to get the patient from them to us.

If they call right at report time, we tell whoever is calling that we are doing change-of-shift report, that we will not interrupt report, and that we will call them back after report is completed.

If the patient should arrive during the last hour/at shift change anyway, the offgoing shift will do the basics (VS, safety search) and leave the admission for the oncoming shift.

Share this post


Link to post
Share on other sites

287 Posts; 5,240 Profile Views

I have a feeling this will never change. Continuous problem at our hospital. Now charge nurses are forced to take report if district nurse can't. So interrupt my report so I can give report to the nurse when they're done report? Imagine the possibilities with lost in translation there... We're fighting it, but ER fights harder.

Share this post


Link to post
Share on other sites

Gooselady has 23 years experience as a BSN, RN.

601 Posts; 7,266 Profile Views

We also had an 'unspoken' policy, developed in a committee of RNs from the floors and ER, that we would not accept report in the half hour during shift change. This only held true for the 12 hour (7a to 7p) change overs so we who worked 3 - 11 didn't really 'count'. But over time, we were able to beg, plead and send chocolate to the ER and other 12 hour floors to have mercy on us 3-11

ers. Most of the time this was respected, but then there are always irritable bureaucrats who weren't softened by pleading and chocolates :D

It truly is a problem to have to get report on a new pt while trying to get all your bedside reports inside a 30 minute time frame.

And yes, it drove the ER nuts to have to call back.

So out of respect for ER nurses, we developed another 'unspoken' policy to cover all the other times the primary nurse could not take report from the ER or whatever floor was sending us a patient. Whatever nurse was available, usually the charge, would take the report if the primary couldn't. We developed a 'transfer/admission report sheet' so a good complete report could be taken and then given in writing to the primary nurse. This worked quite well.

Share this post


Link to post
Share on other sites

35 Posts; 1,766 Profile Views

We can give report at any time, but patient's are not transported 30 minutes before or after shift change.

Share this post


Link to post
Share on other sites

NurseOnAMotorcycle has 10 years experience as a ASN, RN and specializes in Med-Surg, Emergency, CEN.

1 Article; 1,065 Posts; 23,972 Profile Views

Here's what you aren't being told:

I work 7p-7a. The med-surg floor charge nurse will often tell us: We have a bed but we don't have enough nurses. Send them at 2300.

Sometimes they say: We just got an admission. Send the next one at 2300.

Or: We got a situation up here. Send them at 2300. It'll be over by then one way or the other.

I ALWAYS write "per floor charge nurse" on my reports that I call and send with the patient. I'm tired of being yelled at by the floor for their own internal conflicts. Need 10 minutes? I'm ok with that. 30 minutes? I'll stall, but my own charge nurse will be breathing down my neck for that bed to open up.

Edited by NurseOnAMotorcycle
clarity

Share this post


Link to post
Share on other sites

NurseOnAMotorcycle has 10 years experience as a ASN, RN and specializes in Med-Surg, Emergency, CEN.

1 Article; 1,065 Posts; 23,972 Profile Views

(Also, it is our change of shift. Would you like your entire report to be "I don't know, I just got report 10 min ago and don't know anything about them" or would you rather get report from the nurse who's had them for the last 6 hours and knows the family members by name?)

Share this post


Link to post
Share on other sites

firstinfamily has 33 years experience as a RN.

790 Posts; 5,562 Profile Views

It seems our unit is always getting calls from the ER with urgency in getting a pt up "before our shift ends", meaning the very beginning of my shift. To myself I wonder, why is it always at the end of their shift?? I have just gotten my assignment and usually have just finished getting report when I am told I will be getting a patient from the ER. I feel it is important for me to do my basic assessment on the patients I already have before I get one up from the ER who may take up a lot of my time. They are stable in the ER, so why the rush?? We have not resolved the issues and are usually being told that if we take report that will be acceptable and then ask them to ship the pt up in 15 or so minutes. When I asked the evening supervisor about this, her reply was that the ER has to empty by shift change, I don't get this either!!! A thorn in my side!!

Share this post


Link to post
Share on other sites

101 Posts; 3,656 Profile Views

I'm sure inpatient unit and ED nurses will have different perspectives on this. But it seems to me that if an ED nurse calls me at 7pm to give report but the patient was assigned to the bed 3 hours prior, the ED nurse held onto the patient for whatever reason and he/she needs to wait. And please don't tell me that giving me report at 7pm is now an emergency when you've had 3 hours to do so. Sorry, no empathy from me. Also, I am not blind to the fact that unit nurses purposely postpone admissions because they don't want to do the work. As a charge nurse I've had to deal with it plenty of times.

Share this post


Link to post
Share on other sites

181 Posts; 5,131 Profile Views

There is no way someone had a bed assigned and sat on the patient for three hours. Generally, once a bed is assigned you have 15-30 minutes to give report and get the person to their room. Unless you work it, you can't understand how you have to keep patients moving, as they never stop coming in. You need to get the patient to the floor to take the next patient. And yes, there is ALWAYS a next patient. We once tried not calling reports in the last half hour of a shift. Know what happened? Instead of no report from 6:30pm-7:00, we found that the nurse wasn't available at 6:20, 6:15 etc. The I'll call you back, when you call at 6:10, resulted in no call backs, unable to take report, and then before you know it, it is 6:30, and they can't take report. You end up sitting on a patient for an hour. It's all about throughput. The giving report to the Charge is supposed to stop this, that is why it is done. Charge can identify repeat offenders. Also, the ER doesn't want to pay incremental overtime to the Er nurse so she can wait 30 minutes to give report. Next time right before your shift, take a walk through the ED waiting room, as well as the unit. You stop receiving patients when your beds Re full, but we never stop.

Share this post


Link to post
Share on other sites

115 Posts; 2,354 Profile Views

I'm definitely not saying in any sense that the ED isn't twice or three times as busy, just posting to see others opinions on the topic and if/how other facilities handle this.

Share this post


Link to post
Share on other sites

115 Posts; 2,354 Profile Views

That includes ED nurses, I'd love to hear their opinions on this! I'm sure they feel they get the same attitude back from floor nurses at times.

Share this post


Link to post
Share on other sites
×