I’m STRUGGLING with report

Nurses General Nursing

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I’m a little ashamed to say this, but I’ve been a nurse for 6 years and I am really struggling with giving a strong report. A little background; since graduating, I immediately became a community nurse. I have do paediatric home care. I take care of one child a night and only have a couple children I see. When I am finished my shift, I either give e very quick report to another nurse, but more often it’s the parents. I’ve been doing this for 6 years. Fast forward to 2021 and I just a job in an acute care hospital on a paediatric unit. Overall this is a HUGE learning curve. I’m kind of struggling as I 1000% feel like I just graduated. There’s a specific nurse that always asks me so many questions when I’m giving report, and it’s gives me anxiety because often I don’t know the answer for her. I don’t know how to make this easier for me. They give me so much info in report, and when I feel I have written enough background info down, it’s never enough. I wake up every morning stressing about giving my end of shift report. Does anyone have any advice on my best approach to a decent report. 

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

For me it all comes down to having an organized sheet for taking report that then makes things make sense so you can give a good report. I used to have one with check boxes so I could minimize the amount of writing. Things like central line, foley, PIV L/R, O2 device, make them something you can just circle and not spend time writing. Then you can focus on what's being said during the report.

As for other people asking a ton of questions, once I've determined the pertinent information that I need to convey for the nurse to take over care of a patient, I'm not going to stress if they want more. I've said to people, "I'm not sure about that but I'm sure you can find it in the MAR/notes/chart/etc". I'll let them know I'm not going to research everything for them, they can read a chart in their eight or twelve hours just like I did. If you feel like you're being asked questions that you should know but you don't, try to figure out where you're leaving things out.

I also don't give people a verbal head to toe assessment. I point out the main reasons a patient is there, the main things that happened in my shift and their access devices. Those to me are the basics. 

Good luck, you'll get there! 

Specializes in CMSRN, hospice.

+1 to everything @JBMmom said. There are people who will ask question after question (I just met that person on my new unit, so I feel your pain, OP), and part of the challenge is knowing what's important and what they can find out for themselves.

What I like to know, and what I make sure to give in report:

  • Code status
  • Why the patient came in
  • Pertinent medical/surgical history (e.g. dementia, diabetes testing fingersticks/SSI; no tonsillectomy at age 6, etc., unless it somehow was relevant to the present visit)
  • Any significantly abnormal assessment findings/labs/etc. (e.g., confusion, O2 requirement not at baseline, no BM in a week, wounds, etc.) - I try to avoid going through every body system to describe in detail a benign assessment
  • How patient takes meds
  • If continent
  • If ambulatory
  • Plan for the patient - are they on any drips currently, any upcoming tests/procedures, placement issues, that kind of thing

There are lots of additional helpful guides and videos to giving report if you search Google, but those are the things I definitely make sure to hit. Most other stuff can be looked up in the EMR.

Be patient with yourself! This will get easier with time; it just takes some practice. If you have a former preceptor, educator, or charge nurse with a spare minute, maybe you can review report on one of your patients one shift to get some more specific feedback as well.

4 hours ago, Nyah Nicole said:

Overall this is a HUGE learning curve.

Yes it is--no need to feel ashamed! This is a significantly different role for you.

4 hours ago, Nyah Nicole said:

There’s a specific nurse that always asks me so many questions when I’m giving report, and it’s gives me anxiety because often I don’t know the answer for her.

Oh boy...? 

Always asking so many questions? I'd say there's about a 95% chance this is more behavioral/attitude related than a need for crucial information that you are missing. There are people who do this. As far as I can tell, it allows them to make someone else feel less-than, which helps them feel superior and helps them feel better about themselves.  As mentioned above, it is quite fine to say, "I don't know," or "not sure about that." And when you answer that way, have some finality in your voice and don't linger on the topic. Another piece of advice I'm fond of, though it may sound silly: Stand up straight, muster up an energetic/in-control look, greet the person, make good eye contact, try not to fidget, etc.

Let the report anxiety go. Just don't go there. Take it easy on yourself. Everything is going to come together!

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