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!
Each of our units has a pager that stays with the UDC (or at the desk if there is no UDC) - we get name, age, MRN, Doctor and diagnosis on the page (and room number they're assigned to). The charge nurse assigns a nurse to get the admission, and we look up notes, vitals etc...we then get a call from the ED that notifies us that the SBAR report is in the nurses notes, and then a 2nd page when they are ready to be transported up. It works ok - except when we get a page for say....new onset of AFib and they assign to us - we're non tele! We then have to page the doc and protest, and it usually gets changed right away.
Specializes in Med_Surg, Renal, intermediate care.
I agree. We might as well do away with shift report. My hospital has EPIC so we can look up information but we still suppose to receive verbal report. Yet, I'm one of those nurses that doesn't believe the ER nurse until I see the patient. There have been many times to were I had to rapid response a patient as soon as the came up from ER. Then I had to file out an incident report because the pt was transferred to the wrong level of care.
I agree. We might as well do away with shift report. My hospital has EPIC so we can look up information but we still suppose to receive verbal report. Yet, I'm one of those nurses that doesn't believe the ER nurse until I see the patient. There have been many times to were I had to rapid response a patient as soon as the came up from ER. Then I had to file out an incident report because the pt was transferred to the wrong level of care.
This is very unfortunate that you have such tension between floor vs ER. At my hospital we have had meetings with floor nurses and ER nurses to do what we can to try to make reports and transfers go smoothly. We should not be on sides, but all be looking out for the best interest of the pt
Specializes in Transplant, Med/Surg, Internal Medicine.
Wow, and I thought I had it bad! We have an issue with admissions at change of shift. We were working on something to change that, but apparently it fell apart. "Well this patient has been down here for 3 hours" holds more than you just walking in the door and trying to get your bearings, let alone your assignment.
I can't see how not getting report is safe. There have been times like others where the report I have gotten has been crap-oh yes, Mr Jones is pleasant, alert and orientated and continent...only to get the patient confused, angry, and soiled. Too much can be missed by simply sending off a piece of paper. Questions need to be asked! I hope for your sake, and your patients, this get changed!
I used to work at a hospital like this that would send patients up from the ED to a very busy medical/surgical floor without giving report (hell, they've sent people with skyrocket BPs who needed to be a more intensive care unit). I just find this practice to be shocking.
Not surprisingly, this hospital has very poor patient satisfaction scores (the ER received a 19% last fiscal year...yikes).
If I worked as RN and found out the hospital encouraged this, I would report it to the BON. That's just dangerous, irresponsible, and lazy.
ED reports are so pathetic, I wish I didn't get one some of the time just bring me the patient. Typical report. "Umm yeah vital signs stable and lungs are clear". Patient comes in tachypnic, febrile with a BP in the low 60s.....obviously septic. Did you draw a lactic acid or procalcitonin? No....Are blood cultures done? No, I didn't get to that. What in the......
I am on a travel assignment right now in Tucson, and they do not give verbal report. They use EPIC and put in an SBAR, and you can also look at the nurses notes to find out everything they would tell you over the phone. I found it's pretty easy to adjust to. Good luck.
At my facility the ED only calls report to the icu and cvcu. On med-surg, we have 30 mins from time of bed assignment to call if we have questions. Often, I don't know I'm getting a PT until 10 or 20 minutes into that. I am usually busy in another room. The patient shows up and I don't know anything. We do have an electronic sbar but it is not used often. My coworkers and I are presenting to managers next week about going back to getting report.
Twinmom06, ASN, APN
1,171 Posts
Each of our units has a pager that stays with the UDC (or at the desk if there is no UDC) - we get name, age, MRN, Doctor and diagnosis on the page (and room number they're assigned to). The charge nurse assigns a nurse to get the admission, and we look up notes, vitals etc...we then get a call from the ED that notifies us that the SBAR report is in the nurses notes, and then a 2nd page when they are ready to be transported up. It works ok - except when we get a page for say....new onset of AFib and they assign to us - we're non tele! We then have to page the doc and protest, and it usually gets changed right away.