No verbal reports at my hospital!!!!!!

[mina123]

:uhoh3:Hi our managment has this new policy in place where nurses on either shift cannot give any verbal reports at all during change of shift. We have report sheets which we give to incoming nurse and some of these sheets are 5-7 days old and no nurse has that amount of time to update them. So we take a great amount of time reading thru our entire care plan and figure it out what's going on with this pt. Sometimes the intial dx is even wrong with these care plans as it might say SOB whereas the pt came with ABD pain or something else. I have work in so many other different hospitals and i have never seen such a thing that there's absolutely no verbal report given and we work 12/hr shifts a lot can happen in these 12/hr which each nurse is clueless. When families ask us any question we have to go back to physicians H&P and figure it out. I have tried to talk to management about this that this is a very unsafe practise but noone wants to listen to us nurses. They say its saves the hospital the change of shift time and nurses can clock out on time. I think this is outreageous any suggestions ???????

[loricatus]

Sounds like the Joint Commission would like to hear about the policy in your place. Patient safety is being compromised to save a buck.

http://ajcc.aacnjournals.org/cgi/content/full/17/2/95

http://www.jointcommission.org/NR/rdonlyres/ACA4DBF6-90FD-4400-BE7E-4C6F881E5DCD/0/08_OBS_NPSG_Master.pdf {look at 2E}

http://www.psnet.ahrq.gov/primer.aspx?primerID=9

[rockenmomRN]

Lots of hospitals use this system. its really not as bad as it sounds (as long as everyone follows the rules). You will grow to love it b/c you don't have to wait around to get report from 4 different nurses.

You will also come to love starting on time and leaving on time. I'm not in management nor do I want to ever be but I do know that last year our unit paid out 2million dollars in O.T. (ouch) a great deal of that was spent on those 30 minutes between 7:30-8 while nurses were still giving report.

Also, in the interest of the patient if anything major happens there is nothing wrong with a little nurse to nurse report to give the highlights. Give it time anything new sucks at first. Our unit instituted bedside report at the end of last year, and lots of folks baulked at it (including me). Now I like it b/c we can do a quick assessment, turn our patients, see if there's anything they need.

just give it time.

[RNKPCE]

Hand offs are a big Joint Commission thing.It is one of the national safety goals. The oncoming nurse has to be able to ask the off going nurse questions.

http://www.jointcommission.org/AccreditationPrograms/LaboratoryServices/Standards/09_FAQs/NPSG/Communication/NPSG.02.05.01/hand_off_communications.htm

[rockenmomRN]

nothing says you can't do written report. In fact it seems it would be safer than a verbal/taped report. It does say that there must be allowance for oncoming nurse to ask questions.

[mscsrjhm]

My experience last week with written/faxed reports:

Direct admit-(frequent flier- didn't need report) to room 1, 30 minutes after her arrival-lab called- her K+ was 2.8.

While calling Doc re critical lab, US tells me my blood is ready for room 2!!

Knew I was getting an admit- but had no info, and didn't even know pt had arrived- no report.

Lab for pt in room 2- K+ was 2.9 (no kidding)

10 minutes later- room 3 returned from GI- no report. Family immediately at desk demanding food- or Doc be called.

So, two critical K+, no report, 2 units PRBC ready- (7.4)- one IV site.

How stinking dangerous is this? Really.

If a critical lab has to be called from lab to nurse, then nurse to Doc, why shouldn't that requirement continue onto report.?

Day before- transfer from tele- nothing on report about her thoracentisis that am. Had it been a phoned report- I would have asked about the pleural effusion noted 3 days prior, but...

I'm not sure they are gonna be able to work the kinks out of this system.

[Tweety, BSN, RN]

"Handing off" is indeed a very important thing.

A while back our manager tried the same thing...written report only. Each shift would wait for the next to arrive and then just leave. It caused a lot of problems, so now we have an approach that works very quickly....a combination of written and verbal.

What is not effective is sitting in another room and giving a verbal report and you write down what they say. That is frustrating and sometimes takes 30 minutes to an hour, especially if you're getting report from several people.

What we do is write everything down on a flow-sheet type of report that is computer generated and we go over it the next nurse. Throughout the day the nurse adds any changes on this report. The night shift starts a new sheet for the next 24 hours. Report is lickety split.