Open up....Spoonfed report

Is going to be a bit difficult to backtrack because this nurse has been appeased and has grown accustomed to being spoon fed her patient information. Your coworkers must all be on the same page and I agree that management needs to be involved. Most shifts overlap by 30 min so if you divide the number of patients you have by 30 you will get the time allotment that can be used for report. So if you have 6 patients you get 5 minutes per patient. You can start the time limit on your own but everyone will have to do this as well because if you have a split report you will just be waiting to give your report while she is sucking all the info from the other nurses giving report.

I would also tell the nurse that each patient report will not go over 5 min. You give her a 2.5 minute report..she gets 2.5 minutes to ask any questions and then the rest she can look up on her own. Make sure that you can give a succinct and well rounded report in that time allotment. She will not change unless you lead her into the new way of doing things. She will not like it but the reality is that part or the job is getting tasks completed in the time allotted. She is being very insensitive to fact that most employes do want to leave on time after a long shift and incidental overtime often is reported in yearly evaluations as a negative and reflects as poor time management. Out of curiosity I wonder if she gets out on time or if her report goes on and on to the oncoming nurse. If it too is long winded it may reflect on her inability to select the pertinent information and then she will need to be give a cheat sheet or an outline to follow.

repeat after me "it's in the chart. You can read it there"

Yes, I'm also curious, when she gives YOU report, is report as lengthy and meticulous as she requires from other nurses?

Does your facility use SBAR? If so, demand that she stick to it. Your demands ought to hold as much weight as hers

Every patient should ideally have a running Kardex type sheet detailing their history as a quick reference, so you can skim these parts in report without her having to dig through the chart to find information she wants. And three ICU patients? Wow.

I wonder if this is an issue of lack of experience rather than micromanaging. How long has the nurse been on your unit or working in a similar environment? Is it possible that she asks for all this information because she doesn't yet have the experience to know what information will be relevant for her shift? My thought would be to have her immediately at the end of each shift determine how much of report was relevant to her clinically that shift and how much was not, but this might be a better task for someone in management to take on.

Use an SBAR if it's an option. Heck, use a digital voice recorder and hand it to her as you're walking out if necessary. We've all run across Miss Thing in our travels, to be sure. Sometimes you can get a manager on board with some kind of a notice that all reports must be finished in half an hour's time; if anyone requires more time than that they can punch in early on their OWN time and start earlier. LOL, I know that's not a viable option, just a dream :)

I do think some kind of written report sheet/SBAR is your best option. For anything else---"it's in the chart, go ahead and read up on it!"

A Med Surg Report is very diffferent from an ICU report. An ICU report takes 5 to ten minutes depending on the complexity of the patient.

The following is a minimum of a good ICU report:

Name age allergies code status attending MD and Consultants wt in kg.

Admitting dx and date of admission.

Hx of present illness.

Plan of care.

A head to toe systems report is standard, including skin and IV lines/gtts

Lab trends and interventions. You should always know your pt.'s bun and creatinine and some idea of the fluid balance.

Lastly what tests are ordered for today.

New orders that they need to know about.

Next of kin and any family/psychsocial issues.

An extensive hospital course should be written down separately with the dates of each procedure and placed on the clipboard.

If I ask you about the morning ABG or for the last H&H on a GIB do not tell me it's in the chart!

I will tell YOU to go get it.

It is your job and common courtesy to provide the pertinent information for transfer of care.

I've given 5 minute reports on ICU patients who were intubated, 2 stacks of pumps, balloon pump, yada yada yada .... and I've given 40 minute reports on walkie talkies who have been there 2 months. If you know how they want report, just do it so you can get on with your life.

Please ask your charge nurse and nurse manager to help you problem-solve this. Make it their responsibility for you to get out on time. This controlling coworker needs to be their problem, not yours. If you are not already putting in for overtime, you must insist on doing so. Hitting them in the pocketbook helps. Maybe your whole unit can come up with a standard format for report. If you follow the format, then any additional info this person wants, she'll just have to peruse the chart. She really needs to be stripped of the power to shanghai her coworkers.

If management is less than helpful, and you have a union, then a grievance may eventually be in order. Find something in your contract that applies to this issue (hostile work environment, if nothing else). When they have to respond to a grievance, they will have to deal with Ms Petty Control Freak. Good luck!

Thanks for the advice. I do put in for overtime any time I must stay over, and management does frown upon unapproved overtime. We have a standard report sheet with the basics for each patient that is updated each shift. I had never thought about the union, as we do have one.

Is going to be a bit difficult to backtrack because this nurse has been appeased and has grown accustomed to being spoon fed her patient information. Your coworkers must all be on the same page and I agree that management needs to be involved. Most shifts overlap by 30 min so if you divide the number of patients you have by 30 you will get the time allotment that can be used for report. So if you have 6 patients you get 5 minutes per patient. You can start the time limit on your own but everyone will have to do this as well because if you have a split report you will just be waiting to give your report while she is sucking all the info from the other nurses giving report.

I would also tell the nurse that each patient report will not go over 5 min. You give her a 2.5 minute report..she gets 2.5 minutes to ask any questions and then the rest she can look up on her own. Make sure that you can give a succinct and well rounded report in that time allotment. She will not change unless you lead her into the new way of doing things. She will not like it but the reality is that part or the job is getting tasks completed in the time allotted. She is being very insensitive to fact that most employes do want to leave on time after a long shift and incidental overtime often is reported in yearly evaluations as a negative and reflects as poor time management. Out of curiosity I wonder if she gets out on time or if her report goes on and on to the oncoming nurse. If it too is long winded it may reflect on her inability to select the pertinent information and then she will need to be give a cheat sheet or an outline to follow.

The problem is definitely worse when the report is split between two nurses as one has to wait for the other to finish up. However, I have stayed over 20 min before, giving her report on TWO patients. So that is 25 min per patient!!! She tends to go off on tangents when you're speaking and jumps ahead to things you haven't gotten to yet, so it makes it difficult for the reporting nurse to stay on track. And she likes to write down every word that comes out of your mouth:

Me: pt had a recent abdominal aortogram with right femoral artery balloon angioplasty

Her: abd..om...in....al aor..to...gram (sounding the words out to herself while writing)

so it's difficult to keep the flow of report moving smoothly as you must wait for her to write everything down.