Nurses not prepared for report

[KatePasa]

Any suggestions?

[tokmom, BSN, RN]

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.

[serenitylove14]

Hmmm. I am a Float Med-Surg Nurse. When I get report I have a basic blank sheet with a little information on it about each of my patients. I do not go and look up information about each of them prior to report. During report, I get a basic run down and anything important that may have happened during the shift. Any other information I must look in the computer system, DURING, my shift and find out for myself, such us current orders, medications, etc. But that's how it is done at my hospital.

[Caffeine_IV]

I do prefer that the oncoming nurse has some information down about the patient but some nurses will take a LOT of extra time writing down info and delaying me from giving them report. So I would probably take the blank sheet of paper over that.

[Pam68]

Ya I agree with you. I always have to give patient names to oncoming nurses. I don't think it's a big deal at all. After they get report then it's time to look up stuff. Our floor doesn't pay for coming in early so why should they.

[Pam68]

I honestly think this is one battle to let go. Most hospitals anymore won't pay for us nurses to come in early. So why should we. I grab stickers from charts then get report. Then I look up the pts info. In my floor we all do this except for the new grads. I've had nurses so bent on getting the kardex info first as a result I end up going home late.

[ParkerBC,MSN,RN, PhD, RN]

We don't use a Kardex. We print off shift reports from Cerner. Has everything the on-coming nurse needs to know other than what happened during my shift and what still needs to be done. So, during report, I discuss only my abnormal assessment findings. The report has everything including NG's, IV's, ect. The only time I discuss anything other than abnormal findings- ie where the IV is placed is only if it infiltrated and I had to place a new one after the reports were printed. I have nurses who want the history, family information, ect. I kindly tell them I don't have time for that and the check their shift summaries for those answers. I have even cut nurses off giving me report for telling me information that I already have- In other words, I am only concerned with the patient at the present. What are the abnormals? Are there any interventions I need to complete?

[ParkerBC,MSN,RN, PhD, RN]

I'm not paid to come in early either- but I think it is important to be prepared for a shift. There is nothing that makes me more angry than a nurse asking for my help and can't tell me anything about her patient because she walks in at 6:58AM. I've stopped helping those nurses.

[Twinmom06, ASN, APN]

its better than my co-workers who walk in at 6:58 (or 7:04) and don't grab the blank sheet of paper until 7:10 and then start gabbing with the UDC...

[DatMurse]

What are the abnormals? Are there any interventions I need to complete?

I feel like this too. I dont care what is "normal". If their vitals are stable. and they say that. Its ok with me.

Are they tachycardic? If so, is that their baseline? When was the last time they dropped a deuce? Are they AAO? Whats their activity capability? I am a new nurse but I only pay attention to things that are out of the ordinary.

I dont care to hear normal things. Maybe I am being a butthead, but thats just me.

I do like hearing history, background info. About their personality, things they enjoy, ordering a banana with their morning meds, etc. Things to make them be more comfortable is always a plus.

[MunoRN, RN]

From the title of your post I assumed you were going to complain about nurses who look patients up first instead of immediately getting report, since that seems to be the most common complaint these days. Being new grads there is a good chance they were specifically taught to go directly into report when coming on shift instead of looking up patients first, so they're just doing as they were taught.

[RedInScrubs, ASN, RN]

I always give a run down of basic patient history before leaping into the current condition, unless the oncoming nurse had that patient before and already knows. Mostly because we aren't allowed to clock in too early, and I don't have time to fight for a computer to get more information when I know they just want to leave, so I do sometimes start with a blank piece of paper if the Kardex isn't available or updated, since sometimes people forget to update the Kardex and I don't get anything even if I have it.

Besides, half the battle sometimes with patients isn't the nursing care, it's dealing with the individual personality quirks that aren't included on the Kardex, and I prefer to get that in report over things I can look up later.

[nynursey_]

Ugh, nothing aggravates me more.

IF I get to work 20-30 minutes early, then I'll spend time checking in on CC, PMH, diagnostic testing, labs, etc. However, if I'm running behind, clock in right at 0700, and only have a few seconds to grab sheets of paper for report, then that's *my* fault. I don't make the off-going nurse pay for that error in time management. If I don't have a spare second to look up prior information of 5 med/surg patients, then I'll just have to get the information I need after the off-going RN has given me his/her assessment and what he/she knows. I shut my mouth, listen to their report, ask questions if it's necessary, and fill in the gaps on my own time.

And in doing this, I expect the same in return. So what's frustrating is when nurses that see me do this when I'm running late don't extend the same courtesy to me. I've gotten off report sometimes up to a half an hour late as a result of these types of nurses clocking in RIGHT at shift change and using 15 minutes of the 30 minute report window pre-collecting data.