elkf

We are starting the bedside reporting at my hospital. Honestly, I am not excited about this at all. There are numerous variables that stand in the way of this. First, I believe the oncoming and off going nurse need to be in an area with minimal interruption so we can discuss the history, issues and areas of concern regarding the patient without interruption. It is not a time to look to try to "look good" in front of the patient to set a good image-that is not what it is about and I believe it is being treated more as a "customer service" issue rather than a serious report that needs to have limited interruption as to provide quality patient care. I don't know why the nursing desk as become an area "off limit" to reporting. I have been a nurse for 16 years-so I am old school. I like to write my report out, look at the chart to see the orders in the last 24 hours and have the computer at my disposal to discuss results of tests etc (I am in a unit so I know floor nursing may not get this involved). This is not possible with bedside reporting. Not to mention there are numerous portions of the report that the patient should NOT hear. For example, test results, interpersonal conflict with family members, etc-you get my drift. The SBAR reading at bedside doesn't get it, like I said I like to write my report which helps me organize my thoughts and is an easy reference for me to look at from a personal standpoint. SBAR is great to have, especially when patient is going to a different area but personally it is too all over the place with info-my personal opinion. Anyway, at my facility they say "just tell any portion of the report outside of the patient's room if you don't want them to hear". Really? And you think they can't hear it, especially in an ICU. Then its not really "bedside reporting" then is it? That is ridiculous. This is how pertinent info will forget to be passed along. The report process is a very crucial time to obtain pertinent info that will have an impact on the patient's care for that day. It is not a time to "look good in front of the patient" like they are staying in some 5 star hotel. Patients should not be involved in the REPORT process. The assessment is when you involve the patient. After report then the on going and off going nurse should go and look at the patient to see if the Heparin is infusing at the correct dose, or if the patient is lying in feces that they have been in for 6 hours etc. -get my drift. That is when you can introduce yourself, but only after the nurses have given report in an area were they can focus with limited interruption; which is not in the patient's room. They say this is "evidence based". Well from the evidence I have seen-no. Patient's should certainly be involved in their care, however, we have to be careful. We need to remember there is a line between caregiver and patient and when you start to enact areas with too much patient involvement the line becomes distorted. What next? Think about it.