Shift Change on Med-Surg

[nursemel374]

How do you do shift change at your hosptial? We recently had the Joint Commission out and they told us we need to do 1:1 nurse to nurse report instead of the charge nurse general report we give now. We are wondering how we can get this done in 30 minutes!!!

[everthesame, LPN, LVN]

We give 1:1 reports on my unit. As long as your relief is on time it can usually be done within 30 minutes. What generally slows down the process is when your assignment is split and you have to give report off to 2 or 3 different nurses. We have techs and they answer call lights from 0700 or 1900 until 0730 or 1930 while both shifts of techs are on the clock. This really helps.

[angelique777]

Hi

I am curious what part of the country your located in. I have only known about 1:1 nurse reporting so did not know that in other places they did it differently.

Although when I have been floated to CCU I give a brief report to the charge nurse about my patients and give the more thorough report to on coming nurse.

It helps to have your report sheets done and organized with all pertinent information about the patient before next shift arrives. On our unit we all use basically the same style report sheets. Therefore in the worst scenario that time was a factor I pass on my report sheet to the next shift and verbally review everything I wrote with oncoming nurse. However some nurses want to write there own report sheet which makes the report longer. Therefore it helps a lot if your report sheet is done well and kept organized by systems.

Just like the previous reporter states if just reporting to same person not so bad. However, when reporting to several people well little more time consuming and stressful. When they change assignments well your just want to pull your hair out. One night I gave report six different people cause they kept changing assignments. :trout:;)However, when its the same people three days in a row its great cause then your just giving updates and your done.

I think the 1:1 report is good because you get a feel for what your patient like before you see them. Hope its a good transition and change for you.

Take care

[Piki]

We tape our report. On very rare occasions we do verbals.

[CHATSDALE]

have had different ways orf giving report

1] there was a report room with a long table..oncoming nurses and sometimes the aids, took report from each team leader,nurses usually stayed for reports on all patients cnas would listen to report for their assignments

2] nurses would go from room to room together and give report as they walked, oncoming nurse would give assignment to aids

3]report was taped or given to oncoming 1:1, though oncoming charge would often be there as well

if you are having trouble with info being exchanged or if as seems the case joint commission 'suggested' one on one

don't consider the joint commission as the enemy...we are all on the same side

delivering care in the right way to the patient

[KJB_65]

When I was in the hospital we gave 1:1 report. Time constraints weren't a problem.....well as long as your relief was on time and ready to write. The charge nurse would then come around to each "pod" and get quick report from each individual nurse. It worked well.

[loriangel14, RN]

I have never experienced a 1:1 report.Where i work the charge tapes a general report and then you leave as soon as the next shift shows,no overlapping.All I have to do is give the charge the pertinent info she needs to include for my pts.They listen to the tape when they are all ready.

[leslymill]

I am surprized that JCAHO is requiring a primary care approach over a team approach which is what they are doing. I am surprised your still reporting like a team instead of primary, I thought most places had switched over. I prefer giving report on the patients I am responsible for so if their are questions I am first handedly right there to answer them.

[RanieRN, MSN, RN]

We used to have the charge nurse tape for everyone--individual nurses would write their report sheets for her. Then we tried just passing on the written reports. Currently, the individual nurse tapes on her/his patients. When it was just charge taping, we were out of report much faster (maybe 20 minutes); with individual taping we often don't make it out in time for some 1:1 if we need clarification.

[cooblu]

i prefer 1to1. time factor has many elements, how many patients, how many ways is it your assignment split, are the oncoming shift on time and ready, able to keep the report focused. some facilities have a printed and updated report sheet (a mini-cardex) of the relavent history, current status, pending labs & proceedures - helps a lot.

[Nrs_angie, BSN, RN]

Where I went to school, they did team nursing. The RNs had a team of 12 or 13 patients each. They tape recorded report on all 13. Then the oncoming Charge nurse, RNs, LPNs, and CNAs would listen to the tape report. There were major problems with this I felt:

1) Not everyone would arrive on time, because CNAs were getting vitals & toileting, ect. RNs were beginning med passes, ect. Charge nurses were making calls, taking off orders, ect. So you would sit in the room waiting for everyone on that team to show up. Finally one would show up, but another would have to leave to go do something. It was a big waiting game. UGGGHHH!

2) People kept interrupting. The unit secretary would come in to tell the Charge a message, so the tape would go on hold. The CNA would come in to grab another CNA to help lift someone. ECT.

3) People kept talking durring report, so that you could not hear a darn thing that was being said even at full volume! How irritating!

4) The RN giving report had to tape on 13 patients so she would talk so darn fast and give lots of needless info... in a hurry to get out on time when her shift was over.

When I started working.. it was a magnet hospital where we gave 1:1 report. It was soooo much better. Often times we gave verbals, but occasionally we taped.

Advantages:

1: you can get done in 30 minutes, as long as you give the "need to know" info, and don't waste time with the "nice to know" INFO.

2: less interruptions because you can find a nice quiet area to sit with the other RN, and get all your info at a regular pace. this time also allows you to ask questions of the other RN. with the taped reports of team nursing, the nurse was already gone home for the day, so you could not ask any questions.

3: you knew pretty much exactly what to expect before you walked in the room.

Disadvantages:

1: when your assignment is broken up, you may have to wait to get/give report from 2 or 3 RNs. but in the mean time, you can do other things.

2: some nurses may arrive on time, but they are not ready to take report. they may like to complain about their assignment, or vent about how their husband doesn't help out around the house, before they are ready to get report from you. if a certain nurse seems to do this often, make it a point to tape record the report so you don't have to listen to her ramblings.

[santafe]

reciently our shift report has changed to getting report from the charge nurse after she gets report and comes to the floor. we are expected to take care of pt and obtain meds for patients before getting this report. It might save time but is it safe or are we legally responsible until we get that report