Are you brief and to the point? Do you have your labs looked up and include any abnormalities worth mentioning? How about labs ordered for the next shift? Do you remind/point out any new orders? Do you say "uhhhh.... and that's all I've got on John Doe, thanks! Do you add on interesting-but-not-necessary info? Do you see report as a necessary evil?
There is an art to giving report, I'm convinced. Some nurses give it chiseled in marble, and other nurses, like me, give it in crayon.
1. The Inquisitor: Wants to know every detail, where pt lives, how many steps, when was last BM, what's their diet (although it's written on their Kardex), etc. etc. Gives you a frowny face when you don't know.
1a. The Doctor-caller: Probably was trained by an Inquisitor: Wants to know if you called the doctor for various unusual occurrences such as a temperature of 99.2 (honey, I probably have a temperature of 99.2!), Na is 134 not 135, patient refused to take vitamins.
2. The Tree-lover: (as in can't see the forest for the trees). He or she becomes obsessed with something such as a K of 3.6 when meanwhile the patient has been desatting all afternoon and you are trying to explain the detailed doctor's orders on that, etc. Will not be distracted from the tree they are obsessing over, even if patient is dying/dead, running out the door, or bleeding out.
3. The Martyr: KNOWS you had a crappy shift, but insists that you finish every last thing that there were orders for. If you try to turf it to his/her shift, nurse sighs, looks heavenward for strength.
4. The Supreme Being: Whatever you did is wrong, he/she is perfect, will point out what you should have done, in a less than educational tone of voice.
Many of the above reportees also like to use Eye-Rolling as auxiliary means of communicating their displeasure.
I LOVE the nurse who gets the whole picture, has no problem finishing some unfinished orders, doesn't insist on every detail because it is either 1. On the Kardex or 2. In the computer right in front of him/her.
I'm a total newbie, but I've gotten some feedback on my report.
As in, the first time I gave report (taped), I didn't give all the assessment data which were WNL (didn't do the "A+O, LS clear, ABD soft, non-tender...." business), but reported about everything that was abnormal and a focused report on the pt's main issue. I got completely torn apart by the nurse coming on, who always wants a full head-to-toe report.
So, now I do a combination of the two, but I give it fast and super-organized. There are people on both sides of the fence, so that way if there's data I'm giving which somebody doesn't want to hear they don't have to sit there for 3 minutes waiting for me to get through it. This is how I like to get report - fast and detailed. If I have to pause the machine to write down three or four things, that's fine. I'd rather do that than listen to someone ramble about things that are on the MAR or Cardex. The one thing from the Cardex I always give in report is code status. But diet and all that? The on-coming shift can figure that out.
I'm a total newbie, but I've gotten some feedback on my report.
As in, the first time I gave report (taped), I didn't give all the assessment data which were WNL (didn't do the "A+O, LS clear, ABD soft, non-tender...." business), but reported about everything that was abnormal and a focused report on the pt's main issue. I got completely torn apart by the nurse coming on, who always wants a full head-to-toe report.
I think it is kind of stupid to give all the normal stuff. I think your original report was better--I would prefer to get that report.
And the oncoming nurse who tore you apart should be forced to get catheterized by a group of nursing students. In 2 years, you will be able to give the report you want, and will probably not get torn apart. Some nurses just like to terrorize new nurses through report.
I think it is kind of stupid to give all the normal stuff. I think your original report was better--I would prefer to get that report.
And the oncoming nurse who tore you apart should be forced to get catheterized by a group of nursing students. In 2 years, you will be able to give the report you want, and will probably not get torn apart. Some nurses just like to terrorize new nurses through report.
Oldiebutgoodie
I agree, some nurses like to use report as an opportunity to make others feel stupid. And some nurses who are wonderful speakers are deficient caregivers. They are all talk and no action. I've followed some great report givers who use report as a stage to show off how knowledgable they are, but then I'll find out that some big things were left undone, or the patient is up in arms about their bedside manner.
I think nurses should be gracious about report. If they have a question, then nicely ask it, don't belittle!!! People are tired at the end of the shift and not everyone is a verbal whiz.
I agree, some nurses like to use report as an opportunity to make others feel stupid. And some nurses who are wonderful speakers are deficient caregivers. They are all talk and no action. I've followed some great report givers who use report as a stage to show off how knowledgable they are, but then I'll find out that some big things were left undone, or the patient is up in arms about their bedside manner.
I don't mind when people tell me they didn't get to whatever task or treatment. I would rather just go ahead and do it and let them go home. Lord knows I'd like the same consideration when I have a crazy night. (the exception would be notifying a doc of a recent change, the other nurse can better answer questions about the situation)
What puzzles me are the ones who go on and on about what a horrible day they've had, how they didn't stop for a moment all day long, no breaks, no potty, nothing. And yet NOTHING was done. It's rare, but I've worked with a couple who were consistently like that; meds not given, treatments not done, abnormal results not called, no charting whatsoever, you name it. Absolutely nothing.
I'd often wonder how their day could be so horrendous when it appeared they performed no job function at all.
Yeah, I agree that it's silly to report all the data that are WNL. I mean, the first thing they're going to do (I hope!) is an assessment anyway, so unless something is a pressing issue it's kinda pointless to go through all that. The nurse that tore me apart is notorious for her negativity, so I know it's not me. I'll just do what I can to give what the greatest number of people feel is a "good" report, which is my hybrid version. I think some people may also assume that if I didn't report normal data from a head-to-toe, I didn't do a head-to-toe (because I'm a new nurse). I'd rather just do what I can to avoid this assumption (which is also stupid). While I'm new and an easy target I think it's better that way.
I will give data that is WNL if it is diagnosis or medical history related. For instance, pneumonia and clear lungs, CHF and no edema, GI bleed and no bloody stools, etc...
I thank our hospital every day for going to the phone system "voice care" for report.
The shift before runs our work sheets with all the interventions on it, (much like the old Kardex's) and then each nurse dials into the phone system and gets the recorded report on her (his) assignment. The off going nurse can go ahead and tie up last minute tasks. The is no reason to repeat diet ,ect over and over. It is right there on the work sheet. Labs ordered are there, so just tell me abnormal things that is going to affect my care of pt. No more chit- chat, eye rolling.! Just ok ,you are off the phone ,any questions? Good, I'm out of here! So, you want to go get coffee, breakfast ,ect well report is on voice care when you are ready, I'm out of here,any questions ,call me or listen to report !!(No ,I don't leave until on coming
nurse has report and I am sure "hand off" is understood. Charge nurse hears report on all pt's and has another type of work sheet with dx,code,diet, IV's ,pain
level,education status for core measures, and room to note what they need.
I try to give a good report but I'm afraid that I don't. To me most of the people can be described in just a few seconds. "ABD pain, IV 20 in the LAC, NS W/O, Urine in lab, CT prep started." Others take a while because of the nurses need to know about changes in condition, family situation, or dangerous situations.
One of my pet peeves in the ED is being asked by the receiving nurse if I gave the PM meds that the doctor wrote on the admitting orders. Ummmm no. Those are called "Admitting Orders" for a reason. Unless the order has STAT or NOW in big, bold, preferably RED letters, I won't even see it. By the time I get those orders I have 3 more pt's One of whom I can guarantee is either demanding, abusive, or circling the drain.
If you have ever begun your day with getting a detailed, useful and concise report, started your shift with patient rooms the off going nurse left so neat and organized as her report is a fine way to start a shift. The chances of having a good day go way up.
If you have ever begun your day with getting a detailed, useful and concise report, started your shift with patient rooms the off going nurse left so neat and organized as her report is a fine way to start a shift. The chances of having a good day go way up.
Amen. It also helps if IVFs are either changed if low, or a bag is put in the room/server when it's going to run out at the beginning of my shift. Hey... they run on pumps... you know exactly when that IV will need to be hung
I thank our hospital every day for going to the phone system "voice care" for report.
The shift before runs our work sheets with all the interventions on it, (much like the old Kardex's) and then each nurse dials into the phone system and gets the recorded report on her (his) assignment. The off going nurse can go ahead and tie up last minute tasks. The is no reason to repeat diet ,ect over and over. It is right there on the work sheet. Labs ordered are there, so just tell me abnormal things that is going to affect my care of pt. No more chit- chat, eye rolling.! Just ok ,you are off the phone ,any questions? Good, I'm out of here! So, you want to go get coffee, breakfast ,ect well report is on voice care when you are ready, I'm out of here,any questions ,call me or listen to report !!(No ,I don't leave until on coming
nurse has report and I am sure "hand off" is understood.
Sounds like a cool system. I would love it if our hospital would go to that, cuz it sounds like a timesaver. They probably won't though, they like to insist that JCAHO requires a face-to-face report, which I don't buy.
FireStarterRN, BSN, RN
3,824 Posts
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