New grad nurse needs help giving report

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On my 2nd month working in the ED. I still continue to struggle with giving handoff report to the next shift. I'm aware that the general method is SBAR but I still am all over the place when giving information. I start off pretty well in the beginning stating why the patient is here (chief complaint), but after that I start to trail off and present information that is not pertinent to the matter. I found out from my friend that I have had co workers complain about that. Any tips/advice?

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34 minutes ago, zbar said:

On my 2nd month working in the ED. I still continue to struggle with giving handoff report to the next shift. I'm aware that the general method is SBAR but I still am all over the place when giving information. I start off pretty well in the beginning stating why the patient is here (chief complaint), but after that I start to trail off and present information that is not pertinent to the matter. I found out from my friend that I have had co workers complain about that. Any tips/advice?

Why can't people be grown ups and state their issues directly with one another instead of resorting to gossip? If someone were giving me report and went into detail I didn't know, I would recognize they are new and tell them in a helpful educational way. I am so glad I found that there really are places where everyone isn't immature.

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Agree. ^

Complaining about a new ED nurse's report instead of coaching is unacceptable.

**Get on the assertive, pronto.**

Go to the educator and let him/her know that you are looking to improve in this area and ask for some coaching. This should involve not just discussion with made-up examples, but some help from someone who can evaluate what you are leaving out, and what you are including that is truly extraneous. In other words, someone who knows the patient a little (or can also review the chart) and then listen to your report in real time.

Do not mention that you have heard through the grapevine that people have been complaining about you. Approach the educator (or your manager or whomever is overseeing your orientation - - [speaking of which, please tell me that you still have a preceptor working with you...] - - in an upbeat/positive and proactive manner about this.

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Yes I do have a preceptor that works alongside me. Technically I'm on my own now and have my own team. If I'm ever drowning in tasks the preceptor will assist if possible (sometimes they're drowning also). I have actually built a good rapport with my preceptor. The fact that my coworkers are talking about me is not the main problem. I really just want to be a good nurse so I can come home and feel accomplished.

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Specializes in ER.

I'm surprised that ED nurses are the ones complaining since, much more than other specialties, we seem to be most able to 'start from scratch'. I'm not the best at oral presentations, which is basically what report is, a mini speech about the patient. But my fellow ED nurses aren't picky. It's those obsessively detailed ICU nurses who relish picking apart a hand off.

I think they just probably enjoy criticizing the newbie. Be patient, they get over it. You'll also get better at everything.

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Specializes in ED, ICU, Prehospital.
14 hours ago, Emergent said:

I'm surprised that ED nurses are the ones complaining since, much more than other specialties, we seem to be most able to 'start from scratch'. I'm not the best at oral presentations, which is basically what report is, a mini speech about the patient. But my fellow ED nurses aren't picky. It's those obsessively detailed ICU nurses who relish picking apart a hand off.

I think they just probably enjoy criticizing the newbie. Be patient, they get over it. You'll also get better at everything.

Get a brain sheet. I don't know your caseload but mine was typically 4-5 in the ER. Pick one off the net that is specific to ER.

They usually go by systems not SBAR. SBAR is great when you're a little more confident. MOI. Neuro, cardiac, gi, gu, integ, pain. What you did..meds/procedure/diagnostics. Plan?

Doing report in the ICU was the hardest transition for me coming from EMS and ER. I was blowing steam out my ears by the end of my 1 pts' HALF HOUR REPORT. Good golly and I'm pretty patient and tolerant. I hear everything from ejection fraction to husband of patients personal preference for pudding choices.

Just keep the brain sheet with you. Write only what is hard data and add if you need to things like....family is crazy bring Cheetos and soda.

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Specializes in ER.

Handoff to the next shift should be pretty easy. There are 3 basic things I want to know: 1) Are they with it (A&Ox3?) ? 2) Can they walk? 3) Do they have an IV and does it work (draws blood)? Those are my top 3 things for standard ER pts anything else is just the cherry on top ?. If they are admitted and are bed holds then a little more info is nice but I can also print off the H&P and read that. An example would be like "Room 1 is standard CPer. He's alert, can walk, has an 18g that works great, vitals have been stable the 2nd trop is due at 1300." You don't need to tell me about his bowel sounds or if he and a T&A at age 5. There are your co-workwers! You should not feel uncomfortable giving report.

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Specializes in Psychiatry/Mental Health.

I'm a new nurse and I used to be horrible at report. I second what HomeBound suggested. Brain sheet! I actually get compliments now sometimes.

When I get report from ER I also like to know if meds were given and why, only because sometimes the MAR doesnt always show why. I had a pt that was transferred from another hospital with all kinds of opioids on board but only got nausea meds from our ER, and that was related to the pain meds!

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

Absolutely the brain sheet is key. I use the same sheet and give the same order for all reports. Primary diagnosis, PERTINENT history (I don't need to know about an appendectomy 47 years ago!), things like oxygen, IV access, and then system highlights. Once you have a flow down you will be a champ. Good luck!

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Specializes in Hospice.

Brain sheets are great! Even if there is a brain sheet already made up, figure out a system to document specific info on it that works for you and helps you organize info. I've ended up making up my own template before.

Listen carefully to the reports you receive - the good and the not-so-helpful. Base your brain sheet off of this and subsequently your report format. Figure out how to organize info for complicated patients. Ask for feedback when you give report. This is just one more thing that takes time, learning to give a "good" hand-off report.

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Specializes in mental health / psychiatic nursing.

Brain Sheet! Also think what is the critical information you would want to know if you were coming on shift and taking over this patient - those are the key items to put into report.

It can help to have a flow/order for information by priority that you go through (and your brain can help with this) so that the order of information is more or less the same on each patient. It makes it easier to hit all the pertinent bits while still keeping it succinct.

In my world (psych), I usually start with ID information (name/primary dx, 1-2 sentence pertinent hx) and then move into safety/legal status, medical concerns, med changes, mood changes/bx issues, etc. and end with any items that need follow up (e.g. please follow up with pharmacy re: x med.)

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Specializes in Medsurg.

What everyone on here said so far. I would also address that person. Not saying you should be all ghetto but draw that line. Once that line has been crossed, people will hopscotch all over it. She may even become one of your most favorite people to work with!

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