Report Interruption--Was I Wrong?

[Pinky89]

On our busy med/surg unit we give report to the oncoming shift in the hallways, usually at the med carts or where ever we can find some room. This can be frustrating at times (especially on day shift) at shift change because family members, patients, and basically anyone who needs a nurse at that moment sees us in the hallway "talking" and they think it's an appropriate time to interrupt us. Last night one of my patients was a one day post-op right hip replacement who was a 2 assist with a walker to stand and pivot to the bedside commode. The aid and myself got her out of bed twice together, so we both knew her very well and how she ambulated. Later that night this patient needed to use the bedside commode again and the aid wasn't available so I asked another nurse to help me. This time, I felt the patient did very well and could have gotten to the bedside commode with only 1 assist. Fast forward to shift change and in the middle of report, the patient's call bell goes off and the aid goes in to help her. The aid pokes her head out and asks if I can come in to help her get the patient to the bedside. I explained to the aid that I felt she was capable of getting her up with only one person because the last time I was in there she did very well. I have worked with this aid many times and I know her capabilities (which is why I felt she was able to do it without me), so I didn't think it was necessary to break away from report at that exact moment to help her. The aid was very irritated with me and went back in the room to help the patient, only later to approach me and say that what I did was wrong. I explained to her that the last time I got the patient out of bed she did better than before and I felt only 1 assist was necessary.

Was this wrong of me to tell the aid that she was capable of getting the patient out of bed? Maybe I should have interrupted the report to help her, but I really felt she was capable of handling the situation while I finished report.

[chrisrn24]

I might have said something like "I'm busy right now but if patient T can wait five minutes i will come help."

There are many aides who will do some of our residents with assist of one but I don't feel comfortable doing it alone so I ask for help.

[Orca, ADN, ASN, RN]

It should have been enough for you to say that you were in report and you could help as soon as you were done. Transfers are generally not a medical emergency. The aide needs to learn to approach you at a more appropriate time unless there is an emergency situation.

[Nurse ABC]

No you weren't wrong. Did she manage by herself? If she did, she should've realized you were right. Our aides never interrupt us during report unless an emergency. They always ask another aide or an oncoming aide for help with things like that.

[DoeRN]

No, you weren't wrong. If she felt uncomfortable transferring the patient alone she could have said the nurse are giving report right now and as soon as they are done I can have one of them help you. Or she could have asked one of the other techs to help her.

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[Quit Floating Me, BSN, RN]

I have mixed feelings to this...

1.) If you truly felt the aid was capable of doing it alone then saying she could do it alone was enough and that you were in report and could not stop at this moment *was not a wrong thing to do*.

2.) Right hip replacement ... 1 day post op ... many things could go wrong in that five minutes regardless of the patient being able to transfer very well throughout the day with the two. I've been in this situation where I felt the patient was capable of being transferred with 1 assist (and has done it in the past) and suddenly patient feels too weak, dizzy etc and just plops/slides down to the floor which is an incident report, many calls, assessments etc. Patient safety is ALWAYS a priority over you "getting out on time or early."

3.) A patient should NEVER have to wait to use the bathroom just because you are giving report to the oncoming shift. Sure, nursing is 24 hours and you cannot be expected to do it all but that extra assist and 5 minutes away from giving report (the night nurse could go get report from another nurse or look over meds etc while waiting) may be the difference between a smooth, safe transfer or an incident report.

[anotherone, BSN, RN]

I rarely get people out by myself primarily so I dont injure myself and because so much can go wrong like another poster said. That being said I abhor interuptions during med pass or report. Communication issues (interuptions being one of them) are a big reason for screw ups. I firmly believe nurses should be able to give uninterupted reports in private but somewhere on the floor in case of emergency.

[ComeTogether, LPN]

Nope, you were totally right. Of course assists can change throughout the shift, we all know that, but all she had to do was begin to transfer the patient and if she found it wasn't going well sit her back down and let you know.

Especaillly if she did sucessfully transfer the patient alone and saw for herself it shouldn't be a big deal. She probably just feels dumb for asking for help and being denied saying you can do it alone. It almost never happened to me, but I always felt bad when it did like I should have known better. Although, that's totally not how I would handled it.

[cjdmomma]

I think you were wrong. You cannot totally judge someone else's comfort level. If the tech didn't feel comfortable doing it alone, and felt that FOR HER the patient safety was at risk, the very least you could have done was tell her it would be a minute. Maybe the patient told the tech that she was shaky or weak. You don't know. What you did do, however, is put your needs over the patient's.

[NurseNanci1]

I think you were wrong. You cannot totally judge someone else's comfort level. If the tech didn't feel comfortable doing it alone and felt that FOR HER the patient safety was at risk, the very least you could have done was tell her it would be a minute. Maybe the patient told the tech that she was shaky or weak. You don't know. What you did do, however, is put your needs over the patient's.[/quote']

Well said