No More ED Report?

[FarmerFNP]

So a couple of days ago out ER director told the directors on the floor that the ED nurses will no longer be giving report when they send us patients. True to their word, I received two admission from the ED with no report. They now send us an ED flow sheet which basically just has the patient's name, visit reason, and most recent vitals, as well as nurses notes if they have been entered (mostly the notes are "Reported off to so-and-so, RN).

We are all pretty upset about this. I work on a busy med tele floor and half the time we don't even know we're getting a new patient until were receiving report, at which point we can get ready to get the new patient. Now we really don't know anything until after we have received the patient. I understand the reason for it as it helps move patients from the ED faster, but it's causing a lot of concern for the floor nursing staff.

So basically, I just wanted to get other nurses' thoughts on this. Any input is appreciated!

[HouTxNurse832]

Wow that sucks.

Honestly at my facility the ED might as well not give report b/c they are horrible and give inaccurate information all the time. For example, I've gotten things in report from pt's BP was 125/64....15 mins later upon the pt entering my unit its 218/102 to being told if pt can ambulate to restroom and pt comes to room and is paraplegic and has a suprabupic cath. The other nurses and I just take it with a grain of salt, and trust nothing they say which sucks b/c it's your colleagues. Now, on our unit we do get a TON of direct admits straight from doctor's office in which you get NO report. Just a little sheet from the doctor stating diagnosis and orders. It's not too bad. It's a little more time consuming though.

Good luck with everything though!

[ProgressiveActivist, BSN, RN]

No handoff of care and no opportunity to ask questions is board reportable.

your managers are idiots.

[MunoRN, RN]

That's considered patient abandonment in my state and others where the handing off nurse is required to ensure "receipt and understanding" of the report as a requirement of their license.

[ChristineN, BSN, RN]

That's considered patient abandonment in my state and others where the handing off nurse is required to ensure "receipt and understanding" of the report as a requirement of their license.

I think the hospital would argue that the written report the floor nurse is receiving is a hand off of care. Ithey would be technically correct, but JACHO has recently come out and stated that for nurse to nurse report verbal is best.

[ChristineN, BSN, RN]

As an ER nurse, I prefer to give verbal report via phone or in person on my pt's to the floors. Yes, it does take time, but if you are just expecting a brief report focusing on why they came to the ER and what was done that sound not take longer than a few min on a med-surg pt.

I would question the ER nursing director being able to make a change like that on her own without the rest of the hospital input. I know my hospital has processes you need to go through if you want to change a policy, and one person, even a manager, can not just change something that would be affecting the entire hospital.

[MunoRN, RN]

I think the hospital would argue that the written report the floor nurse is receiving is a hand off of care. Ithey would be technically correct, but JACHO has recently come out and stated that for nurse to nurse report verbal is best.

Sending a written report does nothing to confirm "receipt and understanding" of the report. I have seen a hospital argue that a written report was sufficient with the BON and lost.

[bebbercorn]

As an ED nurse, I can say sometimes it can take hours to get a receiving RN for verbal report. In the case a nurse is unavailable, we send written report, but it has more than recent VS, it includes CC, PMH, Systems assessment, labs, meds received, radiology, etc. It's not as good as verbal report, which I believe to be superior, but I feel a lot safer sending that up. With a good EMR, though, one can access most of these records.

[Esme12, ASN, BSN, RN]

I have seen facilities that have instituted this change. Some successfully some unsuccessfully. In both instances it was an attempt to prevent the floors from postponing report and facilitate the patient out of the ED. The faxed "report" needs to have specific information, and an opportunity to ask questions to ensure compliance. Depending on how the policy has been written this can be considered a hand off report.

Managers/administration can change "non clinical"/procedural policies without a ton of input from other floors/medical directors. There is so much that goes on behind the scenes it is amazing. I will bet that your manager knew about this and has been present in meeting where this has been discussed. I they say they haven't...they are covering that they had little to no input and saving themselves from the wrath of the floor.

They present it to administration at meetings and it is approved for trial. It's that simple.

[annie.rn]

We rarely get a verbal report. They send an SBAR which is usually pretty complete. It freaked me out a lot when I started there a year ago but I've gotten used to it. I still don't really like it, though.

[BiotoBSNtoFNP]

I work in a large teaching hospital and my 60 bed med/surg floor does not get any form of report from the ED. We get a call from the nurs supervisor saying we are getting an admission and it is the admitting nurses job to look up the ED doc and ED rns notes and vitals to make sure they are appropriate for our floor. The ED sends the patient up whenever they can-no phone call or verbal report, no printed sbar...you just rely on the documentation in the emr from the ed

[thenightnurse456]

What's the managers rationale for this? Time saver?

It just sounds dangerous...