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Discussion

Report by exception?

I am new at a facility and have never had report in the way that this facility does. I am wondering if anyone else works at a facility that does reporting by exception?

I am used to having report sheets with every resident's name on it and going through every resident one at a time. Granted, maybe for 80% of them you just say "John Doe has been ok this shift," but at least you know that much. Now where I am working, if a person has a problem, new med, etc, you state that to the oncoming nurse. Those residents with nothing going on are not even mentioned. That means that in a facility with 50 people, maybe 8-10 of them get reported on.

The reason this bothers me is that it is too easy to forget something. I mean, during report the way I am used to, when you mention John Doe's name, maybe you remember something that happened with him that you forgot to write on the report sheet. This new way, you don't even mention the guy and may forget something important. I get why it is being done, report takes less than 5 minutes and there is no overlap where the facility has to pay for 2 nurses in the building at one time.

I find that I need to make my own report sheet so that I list everyone's name and at least look at all the names during report in case I forgot something. I just wondered if any other LTC nurses do this report by exception thing and does it bother you?

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    Do they have an updated kardex?

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    My LTC does this. It doesn't really bother me. We also have a shift report tablet on the desk where we can write things.

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    No Kardex, no report tablet. If you want to know something other than what was given in report, you have to look in the chart.

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    I think that would bother me. Our long term care floors at least run down everyones name....even if much of it might just be 101a was fine, 101b was ok...etc. I work on the rehab unit in my facility (so report is some what more intense/detailed), so when I fill in on a LTC floor for a shift I like each resident to at least be acknowledged so I know they were ok.

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    I'm like you. I like to hear/see every patients name and that they are OK. I do agree that just saying and seeing the name may jog memory of something that happened during the shift. I like to cover all bases I guess also it's just what I'm used to. If I am new to a facility or unit I for sure want to hear about every single resident. I like to make my own papers which the other nurses started using as well where I typed up a spreadsheet of resident name room # spaces to write each vital of FS and any notes about them. Helps me organize when I go to chart and put in vitals and my aids can write down any vitals/BM/intake output. I make several copies and leave it at the nurses station so I have one everyday.

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    At a hospital where I worked clinical rotation on rehab floor, all the charting was by exception. The report was taped and they mentioned all of the patients.

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