Nurses not prepared for report

Any specifics? Kinda hard to offer suggestions when there's no question on the table...?

Incoming or off going nurses?

Sorry, I erased it because I felt kind of snarky, but this relates to dealing with coworkers coming to get report without even knowing things like the patient's name.

Have you tried talking to them about it?

Incoming or off going nurses?

Incoming nurses. We the custom on my unit is to get the basics off a Kardex, ie name, dob, diagnosis, allergies, monitoring, labs, specimens needed, diet, code status, activity, standing orders and so on. Some new nurses, who just graduated, fail to see the point and come to report with a completely blank paper.

I did once. One of the new nurses said it was my "job" to tell her all of that stuff. I see report as an opportunity to share SBAR and information about what happened on the shift, not tell the other nurse what the standing orders are or the basic readily available info that's on our Kardex.

If the protocol is that they're expected to get that information from the Kardex, then I would give report as if you were giving it to someone who was prepared. If they're missing something, it is their responsibility to get the information on their own. Just my opinion.

I've encountered times when the information on the Kardex was more accurate than the report given to me, and sometimes it's exhaustive to remember to give each item on there or detail each specimen that needs to be collected. Beyond that, after twelve hours on the busy floor we rely on the Kardex to relay information that we may forget to mention. It's a long day and we're human after all. I guess what alarms me most is that the nurses who have developed this habit are new grads. When I was newly minted, those Kardexes were my holy grail that helped guide me.

I would just tell them....did you get what you needed from the kardex? If they're new....show them the ropes each and every time you deal with them be the same way....until they get it. Tell them straight up.....I'm sure they'll respect you for dealing with them forthright and honest.

Teach them what they need to know. If they choose to not do it....refuse to answer the questions. Tell them to get the routine down.

Incoming nurses. We the custom on my unit is to get the basics off a Kardex, ie name, dob, diagnosis, allergies, monitoring, labs, specimens needed, diet, code status, activity, standing orders and so on. Some new nurses, who just graduated, fail to see the point and come to report with a completely blank paper.

What time are they coming to report with a blank sheet of paper? What time does their shift start? You may be OK with donating 15 minutes or so of your time to get a bunch of information off the Kardex and write it down so you don't come to report with a blank sheet of paper, but after 38 years, I'm not OK with it. I don't get paid for coming in early. So I don't come in early. So I fail to see the point as well.

I work in the ER so no Kardexes but when I worked on the floors they used them. I never expected a nurse in report to tell me stuff that was on the Kardex. I can read and can get the information myself. In fact, I generally multitasked and was listening to report while flipping through the Kardex. It is not your job to tell them what is on the Kardex

I see many issues here.

1) Who trains the new grads? I don't think it's their fault if they don't know how to give or receive a proper report. It sounds like everyone does something different.

2) Is there not a protocol of how report is completed? We actually implemented a template that each nurse is expected to use during their report. It starts off with the name, age, diagnosis, code status, and ends with discharge plan, so it encourages the nurse to start thinking early on about pulling the foley, weaning oxygen, etc..

This template serves two purposes. The receiving nurse doesn't interrupt and ask questions, because they know the information and the order it will be given. Secondly, it's quick and to the point. If something is normal the nurse says "cardiac within normal"

Nurses have also redesigned their brain sheets to match the template.

We have actually timed the report from start to finish, and a nurse takes approximately less than 15 minutes to receive report on 5 patients.