Interdisciplinary rounds format

[obxsteph]

Our med/surg unit holds daily ID rounds, often the nurses are unprepared to present their patient in a professional manner. Does anyone have a format in place that they use which helps a nurse come prepared to rounds? Often they end up being "drilled" by the hospitalist and I want to prevent that from happening.

[tigerfan]

In my hem/onc and BMT unit, we have interdisciplinary rounds every week day; BMT first, followed by hem/onc. Nurses come in as time allows...either come in and wait for their turn, or pop in when they can, getting someone else to cover their patients while they are in rounds.

BMT rounds: The team discusses the patients of whichever nurse happened to be in rounds at the time. The nurse starts the discussion with name, vitals, and I/Os. The Drs take over from there, with other disciplines chiming in as the discussion moves to their areas of expertise.

Hem/onc rounds: The nurse just says their patient's name, and the Drs take over from there. If they have any questions for nursing, (not usually - they get all the current info in the morning before rounds) they ask. We typically have computers in the conference room, so we can look up any information we don't know off the top of our head. Other disciplines in the room usually have laptops, and they are often quicker at finding this information than nursing is! Nursing also asks the team any questions they may have.

Bottom line: make sure everyone leaves on the same page. If there is set information that nursing is expected to present, it might be helpful to make a "fill-in-the-blank" type sheet for people to use until they get in the routine of always finding out that information before rounds.

[SharonH, RN]

Our med/surg unit holds daily ID rounds, often the nurses are unprepared to present their patient in a professional manner. Does anyone have a format in place that they use which helps a nurse come prepared to rounds? Often they end up being "drilled" by the hospitalist and I want to prevent that from happening.

Umm, that's too bad. It depends on what types of things they are being "drilled" on? Where are they falling down exactly? There's no point in coming up with a format with a whole bunch of info the rest of the team cannot use or have no interest in.

[SharonH, RN]

BMT rounds: The team discusses the patients of whichever nurse happened to be in rounds at the time. The nurse starts the discussion with name, vitals, and I/Os. The Drs take over from there, with other disciplines chiming in as the discussion moves to their areas of expertise.

That's all nursing has to contribute? Name, vitals and I&Os? The rest of the team then goes on to talk about their "expertise" while nursing stands by and does what????

[tigerfan]

I'm sorry if I was unclear: I meant that the other members of the ID team talk about their areas of expertise in relation to the patient.

No, nursing does not sit and twiddle their thumbs after initally presenting the patient in rounds. They are as much a part of the discussion as anyone else. I was merely saying that it is nursing's responsibilty to present vitals and I/Os to start the discussion. The OP said that nurses in her unit are often unprepared to professionally present their patients in rounds. All the nurses that work in BMT know that they are responsible for presenting this information, and therefore make it a part of preparing for their day to have it available for rounds.

After nursing intially presents the patient, the Drs do guide the discussion, but they are most definitely not the only people doing the discussing!

[SharonH, RN]

I'm sorry if I was unclear: I meant that the other members of the ID team talk about their areas of expertise in relation to the patient.

No, nursing does not sit and twiddle their thumbs after initally presenting the patient in rounds. They are as much a part of the discussion as anyone else. I was merely saying that it is nursing's responsibilty to present vitals and I/Os to start the discussion. The OP said that nurses in her unit are often unprepared to professionally present their patients in rounds. All the nurses that work in BMT know that they are responsible for presenting this information, and therefore make it a part of preparing for their day to have it available for rounds.

After nursing intially presents the patient, the Drs do guide the discussion, but they are most definitely not the only people doing the discussing!

Thanks. That's a relief to hear! oh wait I meant read!