giving report

Liddle Noodnik · Jan 12, 2011

I am not a new nurse but have sometimes run across the person who just finds fault with everything, period. Focus on the person who says you give a good report!

I'm sure it just makes him feel good to think he is SO on top of things. If he continues to be rude (ESPECIALLY in front of people!) I'd speak to him privately and fill him in on what HE doesn't know... (see? you can teach HIM something... lol)

At my last job there was one guy on the opposite shift who made fun of me and criticized me in front of people all the time re my clinical expertise ... He even picked on my APPEARANCE - age, hair, etc... He enjoyed doing that to pretty much everyone.

I was THRILLED to learn later, after I left that job, that he got fired - for COLORING HIS HAIR while on duty!!! can you believe it? There is justice in the world (snicker...)

Nrsstudent09 · Jan 12, 2011

I've actually been having this issue as well. There is a particular group of "clique like" nurses who are rather rude to us newer nurses on the unit when giving report. For example Monday I got an ICU transfer onto my unit. She was admitted to ICU 3 days before with lower GI bleed and low hemaglobin. I got her and there was no sign of bleeding, hgb was 11.4 and had an EGD done which showed an old healing ulcer and no sign of bleeding. This nurse wanted to know where exactly the patient had been bleeding from and I wasn't sure which I stated and I got the eye rolling and she said "i shoulda know better than to ask you" and walked away.

I have been doing nursing for about 7 months and I only have a problem with giving report to these 3-4 nurses. It frustrates me because they make us feel like we know nothing. All 5 of us that started at the same time were new nurses and we all feel the same way.

carolmaccas66, BSN, RN · Jan 12, 2011

How effing rude can you be! He's just being an ayehole cos ur new. I often find nightshift people like this, to be honest. They probably haven't slept, are tired, grumpy, peed off with the world and just take it out on you.

OK this is what I would do, as I've had people like this before (I hate the ones that interrupt you all the time as well):

1) Make sure BEFORE handover you get a quiet minute, (I can hear everyone laughing hilariously in the background), and write EVERYTHING down you need to handover. You can even do it while writing your medical notes, just little notations to remind you to hand stuff over.

2) And I'm sorry, handing over means you DON'T have to handover every tiny detail. What does it matter on n/shift if the patient had an echo done or not? The results won't be back till the next day, then their Dr will scrutinise it and give instructions (or write in the medical notes), re what should be done. I probably would hand this over, but it isn't going to make any difference to the patient. It is probably best for the patient to get a good night's sleep, as he/she will have had all these tests, and is probably exhausted (especially post op and old people).

3) I don't hand over FBCs etc or stuff that has been documented. They can look it up. Sure nightshifts can be busy say on med/surg, but so is your shift. And also the oncoming nurse should be checking pumps, drips, charts, med charts, etc as part of their nursing care. It's not your job to hand over every tiny figure about everything. You would be there forever.

4) I've listened to taped handovers for patients on the whole ward, and it takes a good 45 minutes. I find most handovers too long. I mean for example, you can tell me the patient's BSL when you did it at 5pm, but I'm gonna look that up anyway when I do the 6am ones, so it's not like the world will come crashing down. I would only be concerned if they didn't tell me when it was REALLY high or low, what they did, who they reported it to, etc. You get to learn what is and isn't urgent, yoy know?

5) Before I started another handover with him, confront him alone. He will be surprised, caught off guard and shocked. Say you are very critical of my handover, I AM new & am still learning - don't apologise for being new either! - and say 'How would you LIKE me to do handover to your satisfaction.' And after I finish handover I always say 'Any questions?' then if they forget and have a go at you, you DID ask.

Of course you will forget things. YOU ARE NEW! No-one was/is perfect, despite what they may say. You might just have to stand up for yourself a bit more, and say when he criticises you, well I'vd handed over what I THOUGHT was relevant, if you're not happy why don't you read the patient's notes yourself? And NO I am not a mind reader!

Only my say but this works for me with these snotty type of people!

ADDIT: Do you use a cheat sheet, ie one with the patients' names down the side and times up the bottom? You can write stuff 4 handover on that so you won't forget or carry a little notepad like I do. Get into good habits and a good rhythm and you won't forget anything later on.

NaKcl, BSN, RN · Jan 12, 2011

Let them roll their eyes all they want, do not pay attention to what they do. They are trying to get some sort of stupid satisfaction that they irritated someone with their stupid action. you cannot change their behaviors. do not waste your time and energy on them. They probably don't know the stuff they are aking to you either. Start report from your patients' head, LOC, NG tube, O2, trach, any significan hemodynamic changes during your shift, any surgery sites, drains, ostomy, urinal catheter, SCDs, BRP, ect. while you are describing your patient's head to toe condition, you can remember about what things have been done and things need to be done. during the day, if doctors wrote some orders, make a note to yourself, may be in different color pen, that will help you remember things too. Good report is important, but do not stress over it. Nursing itself is stressful enough. As long as yourr patient is still alive and well, you did your job well for your shift. It will get better as time goes. :smokin:

NocturneNrse · Jan 12, 2011

I understand what you're going through. He was being a jerk. That comment was unnecessary and frankly unprofessional in my eyes. I think the OP's advice about keeping notes going from system to system is a good idea. Using different colors always helped me too. I wonder what his reports are like.. hm... I've always found, the most persnickety nurses that would give ME a hard time, gave the most sporifice and horrible reports. Hang in there.. :hug:

BluegrassRN · Jan 12, 2011

Him: "Hmm, this interesting, (as he scanned what he wrote down) you seemed to have given me all the information except for what I actually need to know."

You: "I didn't know I needed to hold your hand and spell out every little detail for you. Do you not know how to use our computer system to obtain routine information? Would you like me to show you how to look up all these little details for yourself, so you won't be so dependent upon others for your information?"

Altra, BSN, RN · Jan 12, 2011

Telling the nurse to look up results, that they have all night would be inappropriate. I'm guessing they haven't worked a 7p-7a shift.

I'll respond, since that was my comment. And for the purposes of this discussion, I'm basing my comments on my experience in the ICU, since report in the ER setting is a whole different animal.

I'm talking about results that are not pertinent right now when we're handing off the patient. The OP mentioned an echo, and that's the kind of thing I'm referring to here. I have encountered nurses who I just wonder ... really? can you not start your day without me verbally telling you the results of an echo?

IMHO, that is simply a power gesture -- an attempt to feel superior by asking a question for which the other person does not have an immediate answer.

And it has nothing to do with days/nights, as I rotate both.

Biffbradford · Jan 12, 2011

Let's say that you're just sitting down for report and the patient begins to crump right then and there (don't you just hate that?), so you jump up, do some stuff, and page the attending as the other nurses grab the code cart. Well, seeing as though it's now 2330 on a Friday, a different doc is on call for the weekend and nicely says, "Oh, okay. I don't know this patient ... tell me about him"

Well, it sure would be nice to know the results of that echo now! :eek:

I think you learn what details each nurse wants during report. Some nurses (not just new ones) are paranoid that they will get burned somehow and want every single detail, yet others (usually the ones who have over 20 years experience) won't even sit down as you talk to them. Don't take it personally, not everybody gets along like best friends. Tell them what they want to know, if need be - walk them through how to use the new equipment in the room, or show them that dressing you've reinforced twice but the doc refuses to do anything about it. Then, go home and drink yourself to sleep.

imanedrn · Jan 12, 2011

This is why I love being in the ER now! :loveya:

I haven't read the replies, but my guess is that the OP is a new grad? I remember being a new grad on a med/surg floor, and I felt the same way giving report sometimes. There was the one gal who hadn't been a nurse for more than a year and always grilled me. :argue: I remember she would call me out if the pt's Mg or K+ was low, and I hadn't given it. Always made me feel so incompetent!

Now that I work in the ER, giving report is so much easier. Obviously, there's a lot less to reports on our pts. But when we hold inpts (like at this time of year), out report is still shorter than most floor nurses. We highlight the main points, and all is well. (i.e., I don't need to know if a 35yo healthy woman doesn't have any open wounds, however it is worth noting this when a 75yo demented nursing home pt w/ diabetes doesn't have them.)

When we're not holding inpts, and I actually get to transfer them to other units, I review the major points: Do their lungs sound like junk? Was the CT ab/normal after their syncopal episode? Is their 1st set of CEs positive after their acute CP? Is a stress test ordered? After I review those IMPORTANT points, I ask what else do THEY want to know? Some nurses like to diligently fill out their SBAR forms, so they ask if they're on O2, what kind of diet is ordered, what's their activity level? I want to tell them they can look at the orders themselves! But I answer nicely and move on. Then I suggest I can review anything else I forgot or they might have questions about at bedside. Once I deliver the pt, I suggest they can call me if there's anything else. Most don't because, in reality, we can get most of the answers we need if we just read the chart... :banghead:

In the case of the OP, I imagine this receiving RN is just a big ole douche. He probably likes picking on new nurses. I've been in her shoes (as I mentioned). It sucks. But it does get better! So here's my advice...

Honey, grow a pair. Don't be afraid to stand your ground. You couldn't give that thyroid med until later in the day. They didn't have the med when it should have been given. You gave it when you could. Did you talk to pharmacy about how this would affect the pt? Will it harm the patient more to give it later or not give it at all? (I assume the latter, but I don't hesitate to bother pharmacy when I have questions like these.) Don't be afraid to pose questions like this to your receiving RN though. It sounds like he just wants to nit-pick everything just because he can. If you forget something that he asks about, just "Oh yeah!" it and move on. (Never let 'em see you sweat!) If, ultimately, he doesn't like how you give report at all, just start it something like this:

"What would you like to know today?" (Don't forget the big ole turd-eating grin! )

(I would throw in some way more sarcastic slaw than that, but I'll keep it G-rated :saint: )

I know others have said more than enough, but good luck to you, sister. Damn nurses won't stop eating their young, so the youngin's gotta' learn to fight back! Give 'em heck!

:w00t:

Music in My Heart · Jan 12, 2011

Personally, I don't care about hearing a recitation of what's documented on the Kardex or the labs since I'm going to look at those, anyway. I also don't care too much about where is the IV... it'll be pretty obvious once I look at the patient.

Mostly I care about what's due in the next two hours, any marked changes in mentation over the shift, whether they had the patient out of bed and, if so, whether they're stable, how they're taking their PO meds (crushed, with applesauce, by the handfull, whatever), whether they're continent or not, and whether d/c or xfr is imminent. Labs, tests, meds, etc I can read for myself - and really prefer to, anyway.

Short and sweet is my philosophy.

Biffbradford · Jan 12, 2011

I like your style. :cool: Hit the high points as I read the history, then on to the next one. I'll write 'ya up if you screwed something up, no worries. :)

day12hrs · Jan 12, 2011

Don't be bullied!

Nobody gives perfect report, not even the most experienced nurse. What I do is I let the other nurse bully me a couple of times. And then around the third time when I get report from that person, I start to ask them the same detailed questions in the same manner they ask me in. I give them their own juice strong and don't give up until they cool down. This is not good advice, but this is what I do.