New handoff report- scared!

[Fiona59]

Lila, it's pretty much the standard in AHS and every other facility I've worked in.

It's actually an efficient way to do it.

You don't need to give all the vitals, only the abnormals. IV solution and rate, bolus if any given. Blood sugars, usually the last three are given. Dressings, type and frequency. PRNs/Pain meds, what and how many times over the shift. Abnormal labs, any scheduled xrays, blood draws, etc. (Lilaclover, Bed 2. DAT. Bed Rest/bathroom. Vitals stable, normal saline KVO. Chem strips 9.0, 5.6, 10..0. Saline Soak BID done once on our shift. Maxeran IVx2, Morphine s/cx 3. CT and Chest xray in AM. Residents at bedside, Mother insisting on doing am care.)

Oh, and we warn about the batpoop crazy relatives. A good report can get 30 patients done in 20 minutes. But we all know that AHS only cover 15.

[psu_213, BSN, RN]

I worked on a unit that tried something similar. The offgoing nurses (or maybe it was just the charge nurse....I don't remember now) would give report on their patients to the entire group of oncoming nurses. The theory was that if nurse Sally was off the unit (or otherwise indisposed) then all the other nurses would know what is going on with her patients in case XYZ occured. One of the issues was some nurses want very detailed report on the patients they are getting so they would ask a ton of questions on the patients they were going to receive--for example "when were their last 3 BMs? Were they soft, hard? Yesterday she only ate 77% of her lunch...what percentage of her dinner did she eat? Maybe a bit of an exaggeration, but you get the idea. All this was a waste of time for nurses who did not have the pt and/or wanted more of the "bare bones" type of report. This "system" lasted about 3 days.

[XYZ***123]

i agree. this has to be the dumbest and the unsafest form of hand off I have ever heard of. I doubt it will last long. Just practice and as time goes on it will get easier. i stutter and can relate to what you are fearing. i still dig deep down inside and find away to truck through it.

Jamie

[CodeteamB]

I wouldn't count on it going away, as Fiona pointed out, this is (in my experience) the standard with our mutual employer. I really prefer person to person report, it's quicker and there are opportunities to ask questions without inconveniencing an entire room full of people, however, I know why it is done this way.

First, on a unit where staffing ratios change from day to evening to night the assignments don't stay the same. So, If I have rooms 2,3,4 & 5 and the evening assignment is 2,3,8,9 & 10 and 4,5,6,7 & 12 then I would have to give report to 2 nurses, and they would each be getting report from at least 2 nurses, turns into a mess pretty quick.

Second, it does help the NAs (and to some extent the nursing staff) to have a basic overview of all the patients on the unit.

As to the nerves, there is some great advice here, hold questions to the end, and if you get there most of those questions will be held forever when people realize they can look them up themselves :)

[carolinapooh, BSN, RN]

I don't know what idiot came up with that system, but there is no way that a charge nurse can give a report to the oncoming charge nurse to the level of detail that is needed for appropriate care. Charge is different from regular staffing. The "need to know" is different.

I see problems in that unit's future.

They tried this on my unit. It lasted a week.

[carolinapooh, BSN, RN]

I worked on a unit that tried something similar. The offgoing nurses (or maybe it was just the charge nurse....I don't remember now) would give report on their patients to the entire group of oncoming nurses. The theory was that if nurse Sally was off the unit (or otherwise indisposed) then all the other nurses would know what is going on with her patients in case XYZ occured. One of the issues was some nurses want very detailed report on the patients they are getting so they would ask a ton of questions on the patients they were going to receive--for example "when were their last 3 BMs? Were they soft, hard? Yesterday she only ate 77% of her lunch...what percentage of her dinner did she eat? Maybe a bit of an exaggeration, but you get the idea. All this was a waste of time for nurses who did not have the pt and/or wanted more of the "bare bones" type of report. This "system" lasted about 3 days.

Now since we are a relatively small unit we do actually give 'mass report' with all the nursing staff together, which in our situation I prefer - but we are a ten bed BMT unit, so it's a bit different.

[SoldierNurse22, BSN, RN]

We did this on my hem/onc ward. I can understand how it may not be feasible all the time, but it worked great for us.

Everyone knew what round of chemo everyone's patient was on. It facilitated teamwork and reduced errors.

[carolinapooh, BSN, RN]

We did this on my hem/onc ward. I can understand how it may not be feasible all the time, but it worked great for us.

Everyone knew what round of chemo everyone's patient was on. It facilitated teamwork and reduced errors.

That's why we do it. But on a huge unit it might not be feasible. I can't imagine this on my civilian 32 bed unit. Report would take, well, days.

[wyogypsy, RN]

I did not read all of the above comments so this might already have been said, but the oncoming nurses should not be asking questions of you; but of the offgoing nurses. So they can get report from you and save their questions for the floor nurses.

[SoldierNurse22, BSN, RN]

That's why we do it. But on a huge unit it might not be feasible. I can't imagine this on my civilian 32 bed unit. Report would take, well, days.

We ran into this issue on my ward, too. It was 22 beds and some people were REALLY detailed. We'd sit in report for an hour sometimes because miss smarty pants couldn't figure out when to stop talking.

What this system was meant for was just to give a quick rundown of the conditions of the patients and their chemo cycles. Specific questions and a detailed report was obtained afterward from the patient's primary nurse.

[Lennonninja, MSN, APRN, NP]

This would be insane in my 30 bed ICU. We do charge nurse to charge nurse report and then primary nurse to primary nurse report. I would hate to sit through report on 28 patients that aren't mine.

[linzjane88]

We do a brief mini report on the entire floor (name, when they delivered, pertinent medical or social issues) which takes