Is there ever a time bedside report is inappropriate?

[NRNPH]

Sore subject. Bedside report.

I don't mind it at all. The only time I don't like to do bedside report is for confused patients, dementia, impulsive patients that are fall risks that you finally calmed down and they are in a low stimulation environment and the like. For these patients I believe it to better to do report outside and then enter the room to see the patient. I feel that patients who are confused and aren't oriented would not benefit from a bed side report. I feel it could confuse them more or they make take some information you say and misinterpret things and could cause issues. I feel patients who finally have calmed down, suddenly get stimulated and worked up and start bed exiting again and I feel it does not do any good for them to hear it.

I was told by a charge that these were not reasons to not do a full bedside shift report in the patients room. Just wanted some thoughts on what practices were in other hospitals. What are those reasons where a full bedside report would not be reasonable?

[Emergent, RN]

It's okay for a meet and greet, and eyeballing the fluids running and general, good PR plan of care stuff. But, the nitty gritty of the patient's psychosocial baggage, embarrassing details, crazy relatives, manipulative drug seeking, and so forth, is best shared in hushed tones in the hallway...

[NightNerd, MSN, RN]

There are absolutely circumstances when bedside report isn't appropriate! Like you said, agitated or confused patients who are already overstimulated, patients in severe withdrawal or psychosis who get paranoid, or those with visitors who shouldn't know the nitty gritty of the patient's hx and care come to mind. Hell, as a patient I wouldn't want bedside report if I was taking a nap. In these circumstances, we give report outside the room, nearby but not within earshot, keeping our voices down; then we quietly go do safety checks and whatnot and introduce the next shift/say goodbye.

[NRNPH]

Obviously there are things we don't share in front of the patient what we don't need to be sharing but I found it odd that during shift change when I felt it was inappropriate to go into a patients room and do a full bed side report who had major short term and dementia (obviously afterwards we introduce ourselves after), I was told that's not a reason and they had us go into this confused pt's room who is barely oriented to self and do a full bedside report. Even if it was a pt who had been up all night and finally was getting some sleep in the morning and passes out right before shift change. I don't know how else to advocate that these are good reasons that a full bed side report is not done when they audit us every morning.

[KarenMS]

I hate being pushed into a bedside report at 7:15am when the patient finally finally finally fell asleep at 5:30am. Then they wake up. How is this healthy?

[FolksBtrippin, BSN, RN]

We didn't do bedside report in psych. I don't think it's ever appropriate for psych. We did involve them in their care planning at team meeting when it was appropriate.

[Reyval04, MSN, APRN]

We just started bedside report and I am not for it! I see their point of patents getting involved in their care...but I also see HIPAA violation. Most of the rooms at our hospital are not private. If I was a patient I don’t need My neighbor knowing my business! I agree to go in the room and do a ‘safety sweep’ and should be just that.

[Davey Do]

On 5/4/2019 at 11:41 AM, NRNPH said:

What are those reasons where a full bedside report would not be reasonable?

When the patient room is locked and the patient is up in the locked-from-the-outside dayroom, psychotically acting out.

Seriously, NRNPH, as FolksBtrippin said, on psych we next to never give beside report, even with those who are bedfast.

On the geriatric psych unit, a full door and windows were recently installed so patients could not hear report.

[kp2016]

Any policy that states you must always do “insert stupid idea of the day” will be inappropriate for some situations/ patients.

It’s sad that you have a manager who is so busy following the rules that they can’t see reality.