A few hospitals I've worked at have started to implement bedside shift report. I dislike it. There is information that I don't feel comfortable sharing in front of the patient because 1) it may make them unnecessarily concerned 2) it may insult them 3) they'll ask questions which would interrupt the flow of report. It seems that to play along with management, RNs will stand near the bedside but report out of earshot from the patient.
Variations I do like include forms of rounding together on each patient after report to check that the patient is alive, that tubes/wires/drains are labeled and present as described, or to clarify any complex parts of report.
But giving the entire report AT the bedside I think is nonsense. I've wanted to ask management WHY they think this is important. It's not mandated by JCAHO and yet management feels very proud to implement this as a "quality improvement" project. So what are you improving exactly? Well... I looked it up and research appears to say that the benefit of bedside shift report is to make THE PATIENT feel more empowered/involved/part of the diagnostic process. They are given an opportunity to ask questions and voice concerns which is supposedly going to make their care better or seem better.
I feel that throughout my day and especially during assessments, I give my patients ample opportunity to be involved in their care. This new interaction is just a disruption to the excellent care I already DO provide. I feel like I'm starting to sound like the heartless RN who just wants to get through with her day but I'd like to think that's not me.
I think of shift report as sacred. It is an exchange that requires high-level communication and attention to transmit vital information. I take this bedside reporting idea as another encroachment on our practice in the name of "patient satisfaction". I hear about bedside charting. What's left? Should all our communication with doctors and various practitioners be projected through the patient's speakerphone?
We are now having this rammed down our throats in my hospital. We are to do a FULL report at the bedside or we get yelled at and written up... I've casually mentioned to just hand me a dozen violations and I'll sign them, then they can just date them each day I work. We have attempted to give partial reports at the nursing station and get chastized for these as well...ALL AT THE BEDSIDE. As the oncoming/off-going nurse we now ask our patients if they want to be disturbed with report, some do not want us in the room, many at the time don't care. Medicare is basically looking for any and all ways to not pay for medical care of patients, they are setting the system up for failure and as always it is the nurse who is to blame. These idiots making these decreas should understand that not everything is black and white and as nursings and facilites we should be able to establish the shades of grey that work for everyone.
we have a printed handover and We do bedside report and a have a tick chart to make sure we handover safety aspects. and to check bedside charts are hourly rounding which includes a skin bundle and in/out sheet and vital sign sheet is on paper and this is an oppurity to make sure that information does not get missed.
However what we dont handover at the bedside is when pt have not yet been told a highly suspected diagnosis cause the doctors want to wait for more tests to come back, or if a pt is acting bizarre and is about to complain etc
We had just started this at my facility before I left. It did not go over well..especially for the night shift. We did not have to go in if someone was sleeping or was demented. I think giving report at the desk and than rounding is the best way, but I didn't get to really experience bedside handoff. As a wife of a patient I found it awkward and so did my ex husband (we were married at the time). But all in all rounding on your patients to check lines, etc. is a good idea. As a charge nurse when staff complained about condition a patient was in or an IV line was infiltrated, the first thing I ask is "did you round with the off going shift". If they didn't I tell them this is why you should. I said also, if the off going shift knows you are going to be one that insists on rounding, they will make sure the patient is in good condition.
We have always done bedside report on my floor. That being said we still give a complete report nurse to nurse prior to bedside. Bedside report consist of meeting the patient updating the dry erase board and looking at Iv's and drains or incisions ( only if you have a concern such as incision is red or draining). This is just to make sure your patient is alive and breathing when you assume care. My director started this because of an experience she had as a new nurse where she got report and being a new nurse was nervous so made the previous nurse round with her when she entered a room the previous nurse stated pt slept all night ( patient wast sleeping or breathing)
Had not been for a while. So you really don't have to give full patient report at bedside just doing the "in bed not dead " check and getting a base line for your assessment. It only takes about 3-5 min per patient. It is now actually implemented in the whole hospital.
I could not agree more. If you have been doing your job, you have been teaching and updating status your entire shift. In my ICU, nurses are doing a "public" report (the one in the room with the patient/family) and a "private" report (of the things that cannot be said in front of the patient/family). We are also mandated to do a joint safety check. I find that the safety check is rushed through, and I end up doing a more careful and thorough check again myself anyway. The bedside report is just PR BS; it is a performance of accountability and transparency. I hate having things that affect my practice implemented without any consultation. I hate having my professional judgment and discretion taken away from me. Hospitals are going to have to start thinking about how this sort of thing alienates their staff, because not many are going to want to enter or stay in nursing when they keep stripping away the little autonomy we have.
Our small community hospital has just started bedside report in the ICU. I find it very intrusive because most of the patients are still asleep at 730. This is just one more thing in a laundry list of reasons why I am going to retire early. I know if I am ever admitted as a patient I will refuse to have report given in my room.
I really don't like it either. I think things are missed and often report is dumbed down in front of patients. And sometimes the patient or family member will interrupt my flow of giving report and I could possibly leave out things. It's a distraction, being in the patient's room is a distraction. Also, we have computers mounted on the wall so I have to now try to find room to write and look at the computer while standing. I like to really focus and concentrate when receiving report, especially in the ICU. I do like going into the room to greet the patient and say this will be your nurse tonight and checking lines and drips together. I find that if you go into the room together and hand eachother off it's good for patient satisfaction and you can see things that you may have missed in report.
To me it's similiar to when doctors will make their grand rounds on patients in the morning (usually teaching hospitals). They are technical and like to discuss everything before entering the room. I think that's vital. Would physicians ever let management tell them they now have to round inside the patient's rooms? No. They would oppose it and management would listen. Management, in general, doesn't give a **** about nurse satisfaction IMO.
Let me just say, I hate bedside report. The physicians where I work are going to be trying out bedside rounding at their shift change in the ED. Should be interesting.
So now we have to divide our report between in and out of the room, thus creating more situations where information can get missed.
Not to mention you have twice the time and effort invested in shift change. And, like the old game, you are adding one more hand-off of information between shifts. Each seperate handoff creates now errors in the data. Less patient care time, more errors in report- yep sounds like a great plan.
.thumb.jpg.6293ac280c448c6df70cd1b102dc0fbe.jpg){kind=small}
tazzyjo
23 Posts
We are now having this rammed down our throats in my hospital. We are to do a FULL report at the bedside or we get yelled at and written up... I've casually mentioned to just hand me a dozen violations and I'll sign them, then they can just date them each day I work. We have attempted to give partial reports at the nursing station and get chastized for these as well...ALL AT THE BEDSIDE. As the oncoming/off-going nurse we now ask our patients if they want to be disturbed with report, some do not want us in the room, many at the time don't care. Medicare is basically looking for any and all ways to not pay for medical care of patients, they are setting the system up for failure and as always it is the nurse who is to blame. These idiots making these decreas should understand that not everything is black and white and as nursings and facilites we should be able to establish the shades of grey that work for everyone.