Not getting report/hand off on patients

[sleepdeprived1]

I am not one to complain, BUT I am getting very tired of never being able to start my shift by getting report like the other shifts ALWAYS do. I work 3rd shift and everytime I come on the unit the report book is NEVER completed. Either 2nd shift is working on finishing or needing the report book so I cannot take it (many chart in computer and print out and cut and tape their notes in book so have to wait-takes them forever and many times they have not started charting when I come on the floor).

The few times I take the report book and go in report to read (I am only RN on unit at NOC) but difficult to get the whole picture when no 2nd shift notes added or an admission is not in book yet. 1st and 2nd shift always start by going in report. They do not do ANY DIRECT PATIENT CARE for first 30+ minutes. Depending on census there are 2-4 nurses on unit (days and pms)and ALL of them go in report and get report on ALL patients (regardless of assignments). This takes well over half an hour as they do like to take their time and I do not mind I do what I can and pass any pain meds or prns and finish any unleft charting that needs to be done. When 1st shift gets out report will give verbal on any questions they have for me..(shifts overlap by 30minutes) I am never out of there on time either. So why is it okay for them to get report and take over 30minutes when I don't even get it many times at all.

Many times report book is not finished until 2 hours after the beginning of my shift. And there is NO WAY I can wait that long. Many times, I walk on the unit and have admissions waiting for me, patients up at desk asking for prn's, someone needs something and I jump right in and do what needs to be done. Next thing I know its 3-4am and realize I have not even read report because its been so busy so rush through it quickly and when day staff comes in and has a question like how many discharges are there? i look like a COMPLETE idiot since many times I don't know.

I was always taught in nursing school the importance of getting/giving report for patient safety and I want to refuse to start work until I get report but it is not realistic to wait 1-2+ hours for it either. Anyone else have these concerns?? Or suggestions?? One nurse (my preceptor) told me while I was on orientation "We don't do report like the other shifts" but I think that is just plain wrong.

Is it okay to refuse to start work until I get report? Only been a nurse for 6months so this is somewhat new for me.

[Boog'sCRRN246, RN]

What is this report book you speak of? Why can't you just give a verbal, nurse-to-nurse report? Seems kind of inefficient

[morte, LPN, LVN]

sounds like long term care. sometimes called a "log book". to the OP....2' shift needs to step it up, and truly, they may need more hands on deck, probably more than half adm. come on that shift. If you have acc. to the computor, I presume you do, can you check thru that for some idea? and until you get report the other nurses till have responsibility of the patient. Good luck.

What is this report book you speak of? Why can't you just give a verbal nurse-to-nurse report? Seems kind of inefficient [/quote']

[anotherone, BSN, RN]

report book? why not verbals? i think jacho is heading into "requiring" that. 1st 2nd shifts, if this is a hospital , are very busy . writing a report might be longer than a verbal report

[sleepdeprived1]

I work psych inpatient hospital. Report is PRIMARILY done from written, but I ALWAYS stay till shift after me is done reading the book so I can f/u with questions they may have and always tell them what meds ive given in meantime and other issues that may need their follow up....

When I start my shift, I start work right away after med. count/discrepancy check... because the report book is unavailable. I only get verbal if I ask specifically and many times verbal report is very short to the point that I have NO INFORMATION AT ALL FROM IT (especially after comparing written report) although it depends on staff. Many of these employees seem to care more about socializing with each other when I walk on the unit then giving me a full hand off shift report, although the newbies seem to be more genuinely caring and willing to give me verbal report.

[anotherone, BSN, RN]

this seems dangerous. poor communication/ reports/ sign out leads to errors. does management know ? would they care?

[Been there,done that, ASN, RN]

Report is a requirement of the legal hand off between shifts.

Sounds like you work in a small, for profit facility. Be careful and thoughtful as to how to approach this problem.

These kinds of facilities will can you in a heartbeat if they ,, or staff.. see you as a trouble maker.( Do NOT let them see your anger).

Bring the problem to your immediate supervisor.... along with a solution. Perhaps, instead of an entire book of report, there could be individual sheets on each patient, handed to the oncoming nurse.. then placed in the book.

Good luck, keep us posted.

[Altra, BSN, RN]

I'm sorry but this sounds grossly inefficient -- notes are typed in the appropriate place within the computerized documentation system and then printed, cut and pasted into a book?