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How does your facility handle 'shift to shift' reports?
I just started working in a rural hospital medsurg unit and we 'tape' report. This seems entirely inefficient to me, and i thought 'tape recorders' were a thing of the past.I hate it!
Just curious to know how other units do it - I am going to try to advocate for a new system. Thanks
We're supposed to tape reports on each patient on a telephone recording system. That means if you're relieving me at 1900 and getting pts Smith and Jones, you type in their MR numbers and can listen to report as soon as you arrive. It leaves me to care for the pt until you're done, and then I update you on anything that's happened since I taped the report and you have time to ask questions. We avoid the annoyance of the whole shift listening to a tape together on all the patients, and the pt doesn't get ignored while we spend 30 minutes giving a verbal. However, this is only how it works in theory. In reality, almost no one uses the system. Mgmt doesn't push it on my unit, and the nurses are all against it. Also, half of us don't have codes - that means if I take the time to record report, I have only a 50/50 chance of avoiding having to give an entire verbal report on top of it regardless. People often can't find the time to make the recording, if they get busy in the last hour or so, and it's not perfect. I think it COULD be a great system, but only if everyone gets trained on it and gives it a chance to work.
The one hospital where I worked did taped reports but we had 5-6 tape recorders and each nurse did a tape for all her patients, Ideally she would be passing her whole assignment to one nurse. It worked fairly well. THe outgoing nurse would be on the floor finishing up and would wait to see if the next one had any questions, or we could fill them in on anything that came up sice we taped or anything we forgot. If we didn't have time to tape we did verbals. We also had a Kardex sheet that had a quick rundown of why the pt was there- total hip/knee, post op day__, etc and the a printout of all the orders and we would put in the margins what IV fluid and rate they had or if they had a heplock, if they had a bed alarm, restraints, traction, etc.
We do verbal and rounding. We have a kardex that prints up each shift and you get the patient you had the night before usually so its just an update which is nice. I don't think i would like taped/written report, how can you leave if the oncoming RN is late, who cares for that patient until she gets there>>> just curious.
I do not like the way we give report. We used to have taped report, and if they started the tape on time (a big if) everyone got report on all the patients in 20 to 25 minutes. Some of the nurses were unprofessional and read newspapers, ate meals, gossiped, etc., before, during and after the tape was playing, so it often took 45 minutes. Now each nurse is responsible for tracking down the nurses who had her patients, because it is rarely the same set, and going to the charts together to get report. The last time I worked I had four patients, who were assigned next shift to four different oncoming nurses. It is chaos, and not only do you not know much about your own patients, you know nothing at all about anybody else's, even if you're "charge" In addition, it routinely takes about 45 minutes to an hour to get all your skimpy reports and the halls are clogged up, patients' families come out and want blankets, etc. It is not working but the nurses brought it on themselves by abusing the taped reporting.
mama_d, BSN, RN
1,187 Posts
On my floor we do verbal (which we are supposed to combine with walking rounds, but that rarely happens). The med-surg floors do written report, which I can't stand. There's never enough info.
Verbal does has its drawbacks, can be time consuming, especially if you have to report off to multiple nurses (nights usually has to report to three different day nurses b/c of our staffing grid). But I like the fact that it can be tailored to the nurse, and there's some stuff you can say face to face (like "the daughter's a nutcase, look out") that you just can't put into writing.