Transition to bedside shift reporting

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I'd like my unit to transition to bedside shift reporting. My staff is adamantly against it. I think it will help our pt satisfaction scores! Does anyone have any suggestions/experiences as to what did or did not work? We don't overlap shifts, so I anticipate some issues with OT? HR is working with me on this one. I'll take any ideas I can get! Thanks!

Specializes in med surg.

Good old bedside report..

We have been forced to do it for several years- I don’t mind it as much anymore. Like others have said it does take longer most times- my opinion what takes longer are the requests made by patient during/just after report before leaving the room. I think you really have to learn how to delegate requests-even simple ones at report time- that being said there needs to be a tech or someone available to do these things so these nurses can get report done. We had the problem of the techs getting tech report at the same time as nurses- patients would either have to wait or we would do the tasks while in room and report time took longer.

Suggestion: Our manager changed the tech start times to 15 mins sooner and left 15 mins earlier end of day. Works great! Nurses are to be avail to help patient needs while techs do report and they are done with report and available to task while we do report

also... my pet peeve when an offgoing nurse asks the patient at the end of report “ is there anything we can do for you right now?” OMG.... noooo you are just opening up bathroom and task central LOL!!

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Specializes in Neuro.

I understand the benefits of bedside shift report. With that said, I don't care for it. It can be helpful at times, but other times it can be frustrating.

-I notice management is rounding as day shift starts and are sticklers about us doing it, come time for night shift hand off, day shift suddenly feels no need to do it, management is not there to enforce. And honestly, I am okay with this. Day shift is tired after 12-13 hours and can get out sooner and I can actually begin my real patient care sooner.

-At least half the oncoming nurses suddenly want to do their full on assessments while you are standing there giving report, or they want to do there shift dressing change etc., etc., I've been here for 12-13 hours at this point, no, please do full assessment on your time, not mine. I totally am okay with putting eyes on patient, making sure they are okay, showing oncoming nurse wounds/areas of concern on patient, but doing your head to toe with me standing there is unacceptable when we have several other patients to do report on and heaven forbid I still have some charting to do. Que the overtime.

-Hand off time nearly doubles. Coming off of night shift we are going in as patient is waking up, everyone of course has to go to the bathroom, or wants a juice, or an extra pillow or to get up in chair. People have needs, but we are in the room, techs are getting report too so are unavailable, so my 5 minute report just turned into 20 minutes because patient had to toilet and then wants to be up in chair and wants breakfast set up.

-I often have stuff I need to say about patient away from patient. They are anxious, violent, drug seeking, etc. It's not a big deal to wait and say this outside the room, it's just a fact, I give report in room, then have to sometimes give more report outside.

These are my complaints about bedside report. We occasionally have caught things at bedside, or noticed patient change while doing report or I remember something important I forgot to chart/say/do. It just often adds much more time to report. I've had what should be about a 15-30 minute hand off turn into an hour or more.

I rarely get out on time. Maybe once or twice a month I actually finding myself clocking out of shift "on time". Once or twice a month--and this is not unique to me on my unit.

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Specializes in SICU, trauma, neuro.

If your staff is giving pushback, it is your responsibility to listen to what the objections are and have a concrete plan that you will support for mitigating those objections.

Mine would be: shift overlap is 30 MINUTES. It’s not 45 because pt has requests or because you have assignment changes or because donning/doffing PPE takes extra time.

If it is impossible to give/receive report on the assignment the charge nurse makes in 30 MINUTES.... it won’t happen. End of discussion. Your manager’s pet initiative is not my schedule’s problem.

I imagine in a med/surg setting it would be very challenging to get it done in 30 minutes; you would at the very least have to have the same ratios budgeted for days and nights so one nurse is communicating with one nurse. Tall order I know... but shift overlap is 30 MINUTES.

They must be supported in ways to budget time per patient. So 5 patients is roughly 5 minutes per patient—the nurses MUST be supported in keeping that to 5 minutes. That might affect pt satisfaction scores that their nurses spend no longer than 5 minutes in bedside report per pt and don’t get a full bathroom trip and PRN meds during report — doesn’t matter! Shift overlap is 30 MINUTES.

If you try it and it doesn’t work FOR YOUR STAFF, you might need to find your Ernest Shackleton leadership backbone and push against the “hard place.” Your staff is your highest priority after pt care.

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Specializes in Critical Care; Cardiac; Professional Development.
On 8/1/2020 at 2:26 AM, MiladyMalarkey said:

I understand the benefits of bedside shift report. With that said, I don't care for it. It can be helpful at times, but other times it can be frustrating.

-I notice management is rounding as day shift starts and are sticklers about us doing it, come time for night shift hand off, day shift suddenly feels no need to do it, management is not there to enforce. And honestly, I am okay with this. Day shift is tired after 12-13 hours and can get out sooner and I can actually begin my real patient care sooner.

-At least half the oncoming nurses suddenly want to do their full on assessments while you are standing there giving report, or they want to do there shift dressing change etc., etc., I've been here for 12-13 hours at this point, no, please do full assessment on your time, not mine. I totally am okay with putting eyes on patient, making sure they are okay, showing oncoming nurse wounds/areas of concern on patient, but doing your head to toe with me standing there is unacceptable when we have several other patients to do report on and heaven forbid I still have some charting to do. Que the overtime.

-Hand off time nearly doubles. Coming off of night shift we are going in as patient is waking up, everyone of course has to go to the bathroom, or wants a juice, or an extra pillow or to get up in chair. People have needs, but we are in the room, techs are getting report too so are unavailable, so my 5 minute report just turned into 20 minutes because patient had to toilet and then wants to be up in chair and wants breakfast set up.

-I often have stuff I need to say about patient away from patient. They are anxious, violent, drug seeking, etc. It's not a big deal to wait and say this outside the room, it's just a fact, I give report in room, then have to sometimes give more report outside.

These are my complaints about bedside report. We occasionally have caught things at bedside, or noticed patient change while doing report or I remember something important I forgot to chart/say/do. It just often adds much more time to report. I've had what should be about a 15-30 minute hand off turn into an hour or more.

I rarely get out on time. Maybe once or twice a month I actually finding myself clocking out of shift "on time". Once or twice a month--and this is not unique to me on my unit.

Do you do report using the EMR? I have found doing this allows everything to be communicated in a fairly straightforward manner even at the bedside, covers all aspects of report, including behavioral issues (you simply look at the MAR for drug seeking and review it together). Why do those things need to be stated away from the patient? Just curious. A patient won't be surprised you have noticed they are anxious. In fact, it may calm their anxiety to know we are noticing it! There's no secret that they are violent. If they are drug seeking, you can simply say they want their PRN pain medication frequently and the physician is aware. We all know what that means.

Its curious to me that we are afraid to say things about the patient's care in front of the patient. If it is done factually and respectfully, there's no reason they can't hear that.

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Specializes in Rehabilitation.

I did my residency project on bedside shift report. It's important cause physically seeing the patient helps you remember things, and reporting using SBAR won't leave the next nurse with any surprises. It also helps you make sure that the patient's alive! I definitely recommend BSR, change the board, look through the computer for orders, say hi to the patient all at once.

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5 minutes ago, jb_mmmm said:

reporting using SBAR won't leave the next nurse with any surprises

That is not a feature exclusive to bedside report

6 minutes ago, jb_mmmm said:

It also helps you make sure that the patient's alive!

Not exclusive to bedside report

6 minutes ago, jb_mmmm said:

look through the computer for orders

Not exclusive to bedside report

8 minutes ago, jb_mmmm said:

change the board

8 minutes ago, jb_mmmm said:

say hi to the patient

Changing the board and saying hi/bye to the patient are reasonable things to do at the bedside.

As far as it being important to physically see the patient in order to remember things, it would be interesting to see whether an SBAR delivered in the two different places would show the superiority of one over the other with regard to critical information delivered.

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Specializes in Neurology.

there are pros and cons .. write them out then list them .. which outweighs the other but be realistic.

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On 7/30/2020 at 3:46 PM, BRoBSN said:

Thanks! These are my concerns as well! It's very difficult to try to present something positive when I'm not really on board with it myself! But, as I said, I really don't have too much of a choice so I hope to present it with a focus on increasing patient/family involvement / satisfaction. When I initially talked about bedside shift report, a year ago, I was presently surprised with the number of positive responses I got from my staff. Hopefully this positive attitude remains and "rubs off" on the negative Nellies!! We shall see ?

I don’t know, I feel like pushing patient satisfaction scores may trigger a negative reaction in me. However, pushing the ability to look at your patient and using them as a visual reminder is beneficial.

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