Is this reasonable or just over the top?

[Lakeshore18]

Recently our Nurse Manager informed the nursing staff that we were now to conduct our shift report using certain "scripted" parameters. Basically, we are to wake patients up, conduct shift report at the bedside, include he patient in the process by giving him/her the opportunity to ask questions and add to the information we pass on to the oncoming shift, check all patient orders on the computer and then conduct a brief"physical exam" of the patient with the oncoming nurse. There are certain scripted things we are to say as well. For example the nurse going off shift is supposed to say:

"Good morning, Mr. Jones. I will be leaving shortly to go home to my family. This is Sally and she will be your nurse for the next shift. I have known Sally for 4 years and she is a fabulous nurse with excellent clinical skills. I feel confident I will be leaving you in good hands wth Sally as your nurse!"

After this, we are to continue on with the above outlined report, conduct the mini physical exam, check the orders in the computer and give the patient the opportunity to give feedback during our report. Generally we each have 5-6 patients on our very busy cardiac monitoring unit and our shift report is 30 minutes long!! My colleagues and I are at a loss to figure out how we will accomplish all of this in 30 minutes! I am all for including the patient and allowing them to give feedback, but I fear shift report will now take so long we won't be able to get all our work done! And what about visiting hours? Shift report takes place right in the middle of them at 7pm. Now there will be visitors for both patients adding their comments as well.

In addition, I am uncomfortable giving my opinion about the skills and expertise of the oncoming nursing staff. We are expected to stick to the script and give positive reinforcement about the capabilities of the next nurse coming on shift. What if he/she isn't a very good nurse or has poor clinical skills? Am I supposed to lie to the patient? And if I do, won't I be undermining my own credibility? Does anyone else think this is a little over the top?

[Ruby Vee, BSN]

It's over the top. But I love what some of the other posters have suggested doing with it.

[Rocknurse, MSN, APRN, NP]

Always make sure to add "do you want fries with that?" at the end. And don't forget the supersize option.

[JerseyTomatoMDCrab, BSN]

This offensive to both nurses and patients. Does management REALLY think patients won't pick up on this artificial exchange after the first 2 reports they are woken up to witness?

[scuba nurse, BSN, MSN, RN]

If this is what bedside nursing has come to, I am SO HAPPY to be out of the hospital environment!

I think this is degrading and insulting, and I would not support this at all. I am sure some IDIOT (a non medical business person) who thinks they know everything there is about caring for patients came up with this horrible idea, might look and sound great on paper, but in real life, it doesn't work.

And FWIW, when I would do my last rounds on patients before shift change, I would always tell them I was leaving, (and if I knew who was taking over tell them), and see that they were "all set" for a bit during shift change.

[JerseyTomatoMDCrab, BSN]

And FWIW, when I would do my last rounds on patients before shift change, I would always tell them I was leaving, (and if I knew who was taking over tell them), and see that they were "all set" for a bit during shift change.

Same here! I would say "I'm going to go prepare for change of shift report with the oncoming nurse, is there anything you need right now?" and if they said no, I would tell them I would come introduce them to the next nurse when we were finished. That was more than adequate for 99% of patients.

[brownbook]

I am guessing this comes from patients or their family saying they didn't know the name of their nurse, or their nurse didn't introduce themselves.

Patients are forgetful, they are sick, they are full of drugs. A nurse can spew the whole script, walk out of the room, and the patient within seconds will forget their nurse's name, the name of the oncoming nurse, etc. Yet I am sure some patients will write a complaint/suggestion that they never knew their nurse's name, who was taking care of them, etc.

I worked in a long term care facility. I spent an extra 15 minutes with a patient one morning, helping her dressed, a lot of TLC, we were getting along great, I felt so full of myself for giving my patient such good nursing care. I walked out of the room and she started moaning loudly...."help me, no one will help me, where is everyone, someone help me." I can just imagine her family walking in and raising heck about their poor mother not being helped! (No she wasn't in distress, she was sitting comfortably in her chair.)

Do hospitals still have, "allow", whiteboards in patients rooms? They can write down the nurses and CNA's name, the Dr's name, the date, etc.

[Fiona59]

We have those boards. They may or not be used depending on how mucjyof a gong show the shift is

[Daisy4RN]

This is customer service run a muck!! This is ridiculous and insulting to everyone concerned. People are in the hospital because they need medical care!! Its not a spa, not a restaurant, not a hotel, not a convenience/grocery store. I am so done with this BS stuff. Nurses cannot even do their jobs anymore because of all the customer service requirements. This would take way too long and will create a lot of OT and headaches. As others have stated there is no way to do this done in 30 minutes even if no pt asks for meds, BR etc (which of course they will!). White boards can be useful but not when it is a requirement (that gets the nurse a write up if not used) and/or if scripted info required. Our facility requires patient goals be on the board QD (as stated by the pt), you can only imagine some of the responses!!

[popopopo]

Can anybody pull up recent studies on bedside reporting? Aren't hospitals implementing this based on some studies conducted? I would love to scan over them.

I can write an essay on why bedside reporting doesn't work, even though I empathize with its goals.

[KatieMI, BSN, MSN, RN]

Can anybody pull up recent studies on bedside reporting? Aren't hospitals implementing this based on some studies conducted? I would love to scan over them.

I can write an essay on why bedside reporting doesn't work, even though I empathize with its goals.

This is one of the "studies" with one of the higher citation index for the subject:

http://journals.lww.com/nursing/Fulltext/2015/08000/Bedside_shift_report__Implications_for_patient.20.aspx

and another one:

http://www.mc.vanderbilt.edu/root/pdfs/nursing/who_says_you_cant_talk_in_front_of_the_patient.pdf

The problem is, all of that "evidence" has nothing to go with real life, both from nursing and patient's side. Just like all EBM, it deals with Average Jim and Average Nurse Sally, not with particular KatieMI who would never, ever in her life, for whatever it takes, play a mindless robo-nurse and who as a patient was exposed to this type of bedside report and found it absolutely abhorrent, down-to-bones humiliating experience.

[vanessaem, BSN, RN]

Wake the patient up to do bedside shift report? How well does that go? Waking up patients for anything other than giving them their meds or food rarely goes well, at least where I work. And your shift report is 30 minutes long doing all that crap yet they want you to clock out on time and will give you all kinds of grief when you don't.

30 minutes on 5-6 patients? No one's got time for that. So what about patients that are there for several days at a time? It will look silly if everyone's doing the same scripted banter every time they see them.

[honeybee_23]

The hospital I interned at had this format, except for the part about saying how great the next nurse is. In the MS units, shift change reports would take about 30 mins - 1 hour. Yes they always get out late. My boyfriend works there now and he goes into work about an hour early and leaves about an hour after the shift has ended. In the months he has working there, he has never gotten out on time.