Unreliable Report

[megananne7]

I can't stand when I get report from certain nurses on my unit, but I have been following the same nurse the past 2-3 shifts I;ve worked and I always get conflicting information in report or if I ask her a question (e.g. what rhythm in the tele they are), I get an "I dont know" or something else. E.G. Today, one patient I was told was "alert, confused." She charted they were A&Ox4, as they had been since admission. Same patient I was also told they have a stage 2 and stage 3, but 2 stage 2s where charted.

Also, I wasnt even done with report this morning and a new admission with Dx of CVA, that had come on her shift was screaming out for help. . . had a Hx of anxiety but I went in b/c she was c/o of new symptoms they hadnt had before. This nurse was aware of what was going on, sat at the nurses station while I checked her out and gave her ativan. That kind of annoyed me as I wasnt even familiar with the patient and here they are with new complaints and she basically refused to help.

On top of all of this, the nurse has a very thick middle eastern or Indian accent and is very hard to understand (no offense to anyone, but she is very hard to understand what shes saying sometimes), and I have to have her repeat things she's said, and sometimes she will say one thing and when I ask her to repeat, she changes it!

Does anyone else have issues with this?

[Virgo_RN, BSN, RN]

There are a few nurses that I hate to follow because it always seems like I'm cleaning up a mess whenever I come on after them, or they leave out a lot of pertinent information. If you work with the same people all the time, you get a sense of who gives you information you can rely on, and who you need to take with a grain of salt. Either way, you are responsible for your own assessment regardless of what you were told. One piece of advice I got when I was first starting out was that I should be able to bank on my assessments.

[aeauooo]

The best piece of nursing advice I've ever received:

Do your job and go home.

You can't make other people do what they are supposed to do. You can't make them live up to your standards. All you can do is the best you can do, leave when your shift is over, and make sure you don't take it home with you.

I'm not sure I would have survived the last 10 years of my career if I hadn't learned that lesson.

Part of your job may be asking for clarification during report, or even reporting substandard care to your supervisor. Maybe part of your job is straightening things out from the previous shift, and maybe part of your job is being willing to leave tasks that you were unable to complete during your shift for the next person to take care of - that's not a sin, a sign of some character defect, or poor quality of care - that's why nursing care is provided 24 hours every day.

If you bang your head against a wall, all you get is a sore head.

[Crocuta, RN]

Some people really resist it, but I've loved our change to walking rounds for shift turnover. It eliminates so many of these "I don't know" responses and charting problems. Since you're standing right there in front of the patient, involving them in the conversation and reviewing the chart, you can ensure that what you are getting for report is accurate. You also get to encourage the off-going nurse to label tubing, chart missing I&O's, clarify a nursing note and so on.

I know that in the past I've said some inaccurate things at the end of a 12 hour shift when I'm trying to remember which of the 4 COPD'ers also had a hx of PE. :wink2:

Personally, I also feel that the patients are more involved in their care planning, and the hand off with the off-going nurse introducing the oncoming nurse makes a smoother transition.

Perhaps you could encourage the nurse giving you report to go to the bedside with you and do a quick turnover. I like "Would you mind introducing me to Mrs. Smith? With her dementia, it might help her accept me better." Hey, use what you can. :chuckle