"Nurse Bedside Shift Report" Survey

Nurses General Nursing

Published

{ NURSE SURVEY }

*Implementation of "
nurse bedside shift report
" is being attempted by so many hospitals now in an effort to improve quality of care.

*I created a fun survey! to assess nurses' stance and view towards "
nurse bedside shift report
" as part of my last BSN project.

*There are 13 questions, and I appreciate your time to respond to my survey:cat:

1. Do you feel that nurses' "
bedside shift report"
improves quality of care?

*2. Which of the following improve(s) by implementing "
nurse bedside shift report"
? (Select all that apply)

Patient-centered care

Teamwork and collaboration

Quality of care

Safety

None

Other

*3. Is
bedside shift report”
explained to patients during the admission process?

Yes

No

I forget to explain it at times.

*4. Are patients asked if they are comfortable with
bedside shift report”
every time? (Assume your patient is awake.)

Yes

No

I forget to ask at times.

*5. Were you trained in bedside shift report” prior to its implementation?

Yes

No

*6. If you were trained, what method was used? (Select all that apply)

Trained by education department (class, online module, etc.).

Mentioned in staff meeting by management team.

Assumed that all nurses will do bedside shift report” the same way.

No training offered.

Other method (please specify)

*7. Are sensitive topics always discussed as part of
bedside shift report”
?

Yes

No

I follow patient's preference.

*8. Do you like
bedside shift reporting”
as a nurse?

Yes

No

*9. Do all nurses participate in
bedside shift report”
during shift change?

Yes

No

*10. What are the barriers in implementing
bedside shift report”
? (Select all that apply)

It takes longer time than non-bedside shift report does.

Too many patients are assigned to each nurse to have enough time.

I don't like to talk to patients and/or family.

I am too busy in general.

No barriers.

Other barrier (please specify)

*11. Are patients encouraged to participate in
bedside shift report”
?

Yes

No

*12. How are patients encouraged to participate in
bedside shift report”
? (Select all that apply)

Before report starts, patient is reminded to participate.

This is talked about during admission.

Assume that patient will participate if nurses are in room.

Nurses stop at various times during report and ask patient for their comments or questions.

I don't encourage them.

Other (please specify)

*13. Do you have any other comments, questions, or concerns about
nurse bedside shift report”
as a nurse?

No

Yes (please specify)

Specializes in Skilled Rehab Nurse.

Is this homework? If so, how do you know for certain the people responding are nurses in

an anonymous internet format?

Specializes in Critical Care, Education.

OK - full disclosure - my organization mandated BSR 2 years ago. There was formal training, including simulation and role play. Training is part of our nursing orientation. But common sense does prevail. Based on clear evidence, it is NOT used in psych units. Discretion prevails in any setting in which the patient is not in a private room. We have accumulated a lot of data which shows the very positive impact upon patient care.

The vast majority of patients enjoy being briefed on what is happening - they like being "in the know" regarding their care. They often make contributions to their own care plan goals. We have a system that prioritizes any issues that pts identify during BSR (TV tuner isn't working, mattress pad is lumpy, etc).

Surprisingly, we also discovered another bonus... decreased reports of "bullying" during report. Those mean old meanies have no opportunity to be mean in front of the patient. Unexpected result, to say the least.

Physicians aren't enthusiastic. Apparently because: BSR is protected time - nurses aren't available to drop everything to fetch and carry; patients get too much information and ask too many questions afterward (srsly); patient complaints about their physician have increased... some indications that this is due to a better understanding of various clinical role dynamics so it's more difficult for MDs to blame the nursing staff for things like inadequate pain med or that yukky bland diet.

But of course, your mileage may vary.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

My facility supposedly went the way of bedside report years ago. Over the years it has evolved AWAY from the bedside. Instead, we give a computer-side report and finish up at the bedside to introduce the oncoming nurse to the patient, verify lines, tubes and dressings and elicit any immediate concerns. It works so much better this way! It improves quality of care as we review vital sign trends, medications and labs during the course of report. We can also glance at any relevant new orders, doctor's notes or test results. The oncoming nurse has a good idea of what is going on before she/he even enters the room to meet the patient. Moving away from bedside report has been an enormous step in improving patient care.

(However, we're forced to "pretend" when management is on the unit at report time. Our nurse manager is a genius at keeping upper management away from the ICU during report time, but sometimes one or two slip through.)

Your long and poorly constructed survey is in no way "fun". Perhaps constructing it as a survey, or a poll or a series of polls?

Bedside shift report greatly increases the time it takes to give report, and nurse to nurse shorthand is questioned and must be explained. Sensitive topics cannot be discussed in front of the patient/or family. There was a woman who was trying to keep her HIV status secret from her children, and the nurse just blurted it out during bedside report. It was well-documented that she wanted to keep it secret, but it just rolled right off someone's tongue who should have known better. The more people at the bedside, the more discussion there is. Maybe OK when you have only one patient in the ICU, but two patients in the ICU or six on the floor, and it's problematic.

In general, I think it's a bad idea that someone came up with to "increase patient satisfaction scores", which is as poor a metric as any I've seen to measure quality of care.

1. Do you feel that nurses' "bedside shift report" improves quality of care?

-No, not really

*2. Which of the following improve(s) by implementing "nurse bedside shift report"? (Select all that apply)

Safety

*3. Is bedside shift report” explained to patients during the admission process?

Yes, but not during admission, usually we explain it at report time, before we are about to do it, and ask their preference.

*4. Are patients asked if they are comfortable with bedside shift report” every time? (Assume your patient is awake.)

Yes

*5. Were you trained in bedside shift report” prior to its implementation?

No

*6. If you were trained, what method was used? (Select all that apply)

No training offered.

We had to wing it.

*7. Are sensitive topics always discussed as part of bedside shift report”?

No

Good heavens no. Especially if family is present. I deal in an environment that discusses things like sexual history and STD history, and those are very very sensitive topics that do NOT need airing at the bedside, and on L&D, family are often present.

*8. Do you like bedside shift reporting” as a nurse?

I neither like nor dislike it. I can take it or leave it.

*9. Do all nurses participate in bedside shift report” during shift change?

No

*10. What are the barriers in implementing bedside shift report”? (Select all that apply)

Other barrier (please specify)

In my area (L&D), very sensitive information is passed from nurse to nurse, and sometimes we don't share things with the patient for the sake of morale (e.g., she's not progressing so great, we think the baby is positioned in an odd way and may need help, her family is not being helpful and is actually impeding her progress...it happens) and practicality.

*11. Are patients encouraged to participate in bedside shift report”?

Yes

*12. How are patients encouraged to participate in bedside shift report”? (Select all that apply)

Before report starts, patient is reminded to participate.

Nurses stop at various times during report and ask patient for their comments or questions.

*13. Do you have any other comments, questions, or concerns about nurse bedside shift report” as a nurse (please specify)?

BSR, as with many things in healthcare, is not a one size fits all situation, and should not be mandated. Nurses who do not, for patient care reasons (or census reasons, which is just a simple reality), participate in BSR, should not be penalized. I feel like this is just yet one more measure that has been implemented by administrators who are so far removed from the bedside that they have no clue what it really takes to do the actual job.

Specializes in Med Surg.

The bedside report, or lack thereof, is tailored to the patients' situation. It is very easy for nurses to torpedo the effort by trying to screw it up, if they desire.

Specializes in Family Nurse Practitioner.
Wow. This post really resonated with me. I have always been very careful with what I said and how I said it at bedside report, because I just felt in my gut it was the right and proper way to do things. My patients are people, not specimens.

I wonder how many other patients have felt like you, and what, if anything, administration would do if they heard more perspectives like yours? I cannot imagine feeling so helpless, and I'm so sorry you went through all that, fwiw.

Agree and bet there are things omitted by an empathetic RN due to attempting to preserve some of the patient's dignity which really should be passed along.

Specializes in Family Nurse Practitioner.
Based on clear evidence, it is NOT used in psych units.

If you have access to this data the RNs I work with would love me forever if I shot it in the direction of the nurse manager who thinks this is the latest and greatest thing for an inpatient psych unit. :dead:

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
I absolutely agree. Sorry.

When I was in ICU after L&D, my husband had to go to the very top of the chain of commands to stop that done in my room. Even half sedated, I couldn't stand it. The most intimate details of the utter misery (which an ICU stay naturally is), like attempts to pass gas, staying of every of the three or four pelvic drains, stitches, discharges, my wane attempts to communicate, etc., etc., were all opened, physically touched and visually inspected and discussed in most colorful medical language. It was incredibly, monstrously humiliating - or at least I felt so, and still feel. Literally, feeling like a piece of meat being discussed in technical details by chefs. I was crying every single time it happened. Later on I worked a lot with surgeons who allowed even dirtier things to be said, but even they were waiting till the patient was fully asleep, and I was only minimally sedated if anything at all. The final drop was the description of my "2 PM attacks" of unexplained tachy/SVT with following discussion of me having some sort of time-related psych or something. The fact was, a NICU RN came daily around 2 PM to update new moms about their babies and I, of course, was crazy apprehensive. I just wanted, for whatever it took, to hear something about my little, sick girl once in 24 hours!!!

Where I am now, bedside reports were mentioned a few times and we are sort of off-handidly "encouraged" to do it, but I won't do it unless I know for sure that patient is for real ok with it. Punishment or not, this us the case where I let the chips fall as they might.

With all due respect, the way you describe your bedside report taking place is NOT how it should be done. First, if patients state "I DO NOT WANT BEDSIDE REPORT" then the staff should honor that. Secondly, bedside report, if done correctly, is not the staff talking about you, around you and over you. It's talking WITH you, collaborating WITH you, and you PARTICIPATING IN your care plan, your needs, and your discharge planning.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
We do this where I work, and I mostly feel like it is a waste of time. Not

all patients are comfortable with being basically talked about in front of

their faces.

Again, bedside handoff should not be two nurses talking about the patient in front of them. It should be the offgoing nurse AND THE PATIENT filling in the oncoming nurse on what has taken place over the past 12 hours, and the patient and nurses discussing what else needs to be accomplished on the next shift for him/her to meet his/her discharge goals.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Bedside shift report is perfectly decent round peg that has been haphazardly jammed into all kinds of square, oblong, and star-shaped holes mostly by people who have no particular love for, experience in, or skill at the bedside.

EXACTLY. Thank you. Done correctly, it works fabulously.

Specializes in PCCN.
Again, bedside handoff should not be two nurses talking about the patient in front of them. It should be the offgoing nurse AND THE PATIENT filling in the oncoming nurse on what has taken place over the past 12 hours, and the patient and nurses discussing what else needs to be accomplished on the next shift for him/her to meet his/her discharge goals.

How does this work with dementia patients?

Specializes in ICU, LTACH, Internal Medicine.
With all due respect, the way you describe your bedside report taking place is NOT how it should be done. First, if patients state "I DO NOT WANT BEDSIDE REPORT" then the staff should honor that. Secondly, bedside report, if done correctly, is not the staff talking about you, around you and over you. It's talking WITH you, collaborating WITH you, and you PARTICIPATING IN your care plan, your needs, and your discharge planning.

Number one, I was intubated and unable to communicate, much less participate in anything. I could write, but paper/pen must be offered and physically held by someone for quite a while. Only my husband had enough time and patience for that (cannot blame those nurses too much, though - I was very sick, and a lot of work as every critically sick patient; yet, they just shot me with Versed for "comfort" which for some reason never came). Number two, when the cause of my distress became known, the two responces were: 1) we have a policy of this and schmolicy of that and wejustdoingourjobs, and 2) this is America and 21 century, not whatever you came from, get your big girl pants and stop whining about nuthin'.

Literally, I was spoken with like that. Only a call from the very top of the chain stopped it at once, and BTW so-called "common rounds" as well (that was another thing, when a woman, recent postpartum, usually after very traumatic delivery, with cuts, wounds, massive drains, tubed and usually tied to the bed, was exposed to three or four rounding teams at once - so, lying down like that with everything and more down there wide open for 20 to 25 people, male and female, to see and enjoy, unable to make a noise, to ask, to plea, to beg, to just crawl out there somehow. Only able to cry silently, and you better not do that because they will immediately shoot you with sumethin' good for you' pain if they see tears, and you sleep like a log and miss the moment you live every day for now: the visit of that nurse at 2 PM, and then you won't be sure your baby is even alive till tomorrow).

I do not know how I did not die from the shame alone there. Somehow, despite of policies still in place, sky did not fall down when my husband made a huge noise and it all stopped and I was treated with as much modesty and privacy as the situation allowed all the time thereafter. Later on, I spoke with other moms in NICU, most of whom passed through the same ICU at one point or another - turned out, we all universally hated it all but only we spoke out because the situation was totally out of our cultural background and I just physically couldn't stand it.

What was interesing, bedside rounds and all that was totally gone 2 years later when I had to return to the same surgeon for plastics. That time, they went so long as to purposefully interview families about cultural backgrounds and followed things to the point. I wonder if someone else made a complain.

Well, now everybody knows why I love LTACH so much :yes:

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