How many patients are you expected to take report on?

iriska_meller · Feb 13, 2009

I work night shift on a medicine/geri/neuro floor. we have 2 stepdowns (4 pts each) and 27 floor beds. Each stepdown gets one RN, and the floor gets 3 for the night and 4-5 for day. We also have 3-4 PCTs on the floor. When we are lucky we have a charge nurse at night.

At the beginning of shift I take report on my 9 patients (which is still an awful lot!). Unfortunately, they are divided not by acuity but by bed numbers. So you might have 8/9 heavy people, or 9 walki-talkies (never happened yet).

When I go on break I give a short report, such as who is dnr/dni, who can get what pain meds, and if anything needs to be done. If something starts happening with a patient that is not yours you would probably look up his kardex, call the MD, etc.

I can't imagine taking report on all patients on unit. My report takes me at least 40 minutes as is.

AnnaMary · Feb 15, 2009

Thanks for you reply. Yeah taking report on 36 patients takes so long. So we split the ward and each took report on half and were responsible for our "side" of patients. This has lead to visitors, doctors, and patients having an absolute fit at the nurses for not having all the update info on all of the patients in an instant. There are only 2 or (3 on a good day) of us for the whole ward for god's sake!!

Any more?

sofaraway04 · Feb 26, 2009

On my ward the whole staff, nurses, health care assistants, students take report on all of the patients (24) and we also have a printed handover sheet which has the details on all patients. We then split into 2 teams and take 12 patients each team. I think it's good to have information on all the patients as DR's, relatives etc will ask questions, also in the event of an emergency you will know the basic details of the patient even if you weren't looking after them that day. In the evenings when there may only be 2 staff nurses, when the other goes on break I would be lost if I didn't know anything about their pateints.

handover's take 30 minutes generally as that is our overlap time.

AnnaMary · Feb 26, 2009

Sofaraway,

Just curious, what kind of ward are you working on and what are your normal staffing levels like? We can be anywhere from 25-35 beds with 2 RN's and 2HCA's and we got shot down on the idea of having printing handovers.

I think it is way too much. Obviously it is good if you can know everything about every patient but how realistic is it for us to be able to do that safely?

Mandylou · Mar 3, 2009

I work night shift on a med surg floor that has 38 beds. We usually have three RN's and 4-5 LPN's. The RN's sit and take report on all patients, the LPN's usually only sit in for their pt's. Report usually takes about an hour. It stinks, but it comes in handy when you are helping others out with their pt's.

Straydandelion · Mar 3, 2009

During day/evening I have taken report on just my patients unless charge then on all. Nights with one RN and 2 LPN's, I take report on all patients. In other words...take report on what you may be responsible for during the shift and NOT for the convenience of others. If I am covering for someone on break having just a brief report, and am asked something about the patient I let them know I am helping the other nurse and will try to find the answer.

sofaraway04 · Mar 4, 2009

Sofaraway,
Just curious, what kind of ward are you working on and what are your normal staffing levels like? We can be anywhere from 25-35 beds with 2 RN's and 2HCA's and we got shot down on the idea of having printing handovers.
I think it is way too much. Obviously it is good if you can know everything about every patient but how realistic is it for us to be able to do that safely?

we have 23 beds (just shut 2 recently) always full and it's an acute medical ward.

earlies should be 7 staff (4 RN 3 HCA)

lates should be 5 staff (3 RN 2 HCA)

nights should be 3 staff (2 RN 1 HCA)

note the 'should'! this week I have worked short on all 3 shifts I've worked so far.

Is your staffing 4 on all shifts?

I would be lost without my handover sheet and I hate having to hand write one when the printer breaks, actually even when that happens the previous shift will usually write one out and photocopy for next shift. What is their reasoning for not having printed handover sheets?

AnnaMary · Mar 4, 2009

We are lucky if we have 2 nurses and 3 hca's. That is for an early. Lates are 2 and 2 if we are lucky. Nights are 2 and 1. My managers has not been allowed to hire more staff for a long time. Usually they will float one of our HCA's away to staff another unit. We take acute medical, general medical, and care of the elderly.

AnnaMary · Mar 4, 2009

The nurses themselves started creating and printing handover sheets and management put a stop to it. We hand write everything that we hear in handover.

doubleplay · Mar 6, 2009

I am a new grad, starting on a med/surg floor Saturday. We have 4 patients if on days and five if we work nights. How can anyone have 12? I must be missing something.

AnnaMary · Mar 8, 2009

No you are not missing anything. Sometimes we have more than 12. This is in the UK and it is normal for medical wards.