Verbal Hand-off Reports - Are they no longer necessary?

Nurses General Nursing

Published

I work as an acute care Med-Surg float nurse and my hospital has implemented a new process where patients are being transferred to units from other units, ie. the ED to the floor, ICU to the floor, and from affiliate hospitals to our hospital without having to call and give a verbal report. I find this practice outrageous and an accident waiting to happen.

The reason behind this new policy is to expedite patient transfers and open beds faster. All I ever learned is how important patient the hand-off is, and now we are actually no longer required to give report to the next nurse who will be taking care of the patient.

Apparently now that we have the EPIC system to do our patient charting, the decision-making people feel that verbal reports are no longer needed. However, I have had several instances where EPIC contained very little patient information and virtually no history, so I literally had to ask the female patient, who was busy vomiting, why she was even admitted to the hospital. The fact that she was a stage 4 CKD patient with only one remaining kidney was nowhere to be found on EPIC. She needed pain meds, but her current medication reconciliation had not been completed, delaying her receiving any medications.

And I must also stress the last Magnet hospital I worked at did the same thing by getting rid of verbal report for patient transfers. Has anyone else been experiencing this practice, and if so, how do you deal with the huge safety risk? What happened to placing patient safety first?

Where I work we always get verbal report from other departments. When admitting orders are written for a pt a report is faxed to the floor and I take that, go to the computer and read up on my pt. This is crucial. I'll then call for report and ask about the couple things missing like labs that weren't sent (usually they were drawn but are still sitting in the ED). They cannot send a pt without first giving report. I like this system because it has occasionally caught situations where orders were not complete or the pt really needed to be on a tele floor or something.

What I find strange is that we don't do verbal reports between shifts. Our shifts don't overlap and we get scolded for being out late (more than 7 mins) so we just write report in the four allocated lines in the "handoff screen" which the next shift prints out and goes off of. Sometimes when something happens last min that I didn't have time to update I will stick around to tell someone but I try not to do it often because I don't want to be clocking out late all the time. I hate coming in, printing my report and having a billion questions because the documentation is unclear. Does anyone else have this system in their facility?

Specializes in Med-Tele; ED; ICU.
What I find strange is that we don't do verbal reports between shifts.

I hate coming in, printing my report and having a billion questions because the documentation is unclear.

If this is anything but a rare occurrence then you and your colleagues need to define what constitutes a sufficient and appropriate handoff report.

Please, do not let anyone make you feel dumb for expecting a verbal handoff. It is ABSOLUTELY ESSENTIAL for high quality care and safety. I am required to give a short report to even my transporters about the patients baseline assessment (no diagnosis) as well as medical transport when a patient is being transferred. What if that patient arrives and codes on arrival? What are you supposed to say "hold up, no one do anything let me check the computer to see this patients code status!" Absolutely not. This jeopardizes your license as you are liable for taking wrong action and responsible for knowing the patients history at all times. I would never work for an hospital with such policies, it's a lawsuit waiting to happen.

In the ED where I work (SoCal), we are required to perform a bedside hand-off ED RN to ED RN. unless it is a neuro pt, most RNs sit on their butts and give a brief verbal at the computer with cerner. Also, the primary ED RN is required to go with their pt to the ICU or monitored bed for a bedside hand-off as well. It became problematic and unsafe when another RN would transport the pt who knows very little when asked a question says, "I am only the transport."

wow. i'm finding that person to person communication is so important. it bothers me that people are not giving that and relying on a computer to relay information. scary...just had a med situation that i got in trouble for. guess i'm not being paid to think anymore.

guess that explains the raises...lol

Please do not let anyone make you feel dumb for expecting a verbal handoff. It is ABSOLUTELY ESSENTIAL for high quality care and safety. I am required to give a short report to even my transporters about the patients baseline assessment (no diagnosis) as well as medical transport when a patient is being transferred. What if that patient arrives and codes on arrival? What are you supposed to say "hold up, no one do anything let me check the computer to see this patients code status!" Absolutely not. This jeopardizes your license as you are liable for taking wrong action and responsible for knowing the patients history at all times. I would never work for an hospital with such policies, it's a lawsuit waiting to happen.[/quote']

Do you have an example of how "a lawsuit waiting to happen" would come from not getting a verbal report?

In a matter of 5 minutes, I can look up in Epic chief complaints, medical hx, meds given, allergies, code status, vitals, lab results, imaging, and focused assessments on a patient coming to the floor from the ED. What else do I need to know?

So no, as many here have attested to, verbal reports are not absolutely essential. You may have your preference, but that doesn't me they are necessary.

Do you have an example of how "a lawsuit waiting to happen" would come from not getting a verbal report?

In a matter of 5 minutes, I can look up in Epic chief complaints, medical hx, meds given, allergies, code status, vitals, lab results, imaging, and focused assessments on a patient coming to the floor from the ED. What else do I need to know?

So no, as many here have attested to, verbal reports are not absolutely essential. You may have your preference, but that doesn't me they are necessary.

this entire post is predicated on the notion that the ED will have their charting in order before they send the patient up. This is not the case most of the time.

Just as verbal report isn't necessary because we say so, so is it true that they are not unnecessary because you say so. You know what they say about opinions.

this entire post is predicated on the notion that the ED will have their charting in order before they send the patient up. This is not the case most of the time.

Just as verbal report isn't necessary because we say so, so is it true that they are not unnecessary because you say so. You know what they say about opinions.

I'm in the ED now, and am able to get my charting done. Maybe it's because I don't have to waste my time playing phone tag with the floor nurse to give a verbal report.

True enough about opinions. I will say, however, that opinion is based on my experience of not having ED to floor reports at two different facilities. It seems like most here against that are basing their opinion on what they think will happen, not on experience.

Specializes in Med Surg, Specialty.
What else do I need to know?

Several people including myself have already responded to this.

I really like EPIC of all the different software I've used. You can customize for what you feel is important and what you want to see on the top page. You can read all the provider notes,orders,labs, history etc. Our tracker will change to Room Ready with RN and # to call. Our report is a call to the floor, ask if the have read the PT's chart and ask if they have any questions. Everything should be in EPIC and it is great for trend analysis. If EPIC doesn't show it then the RN has documentation issues, even subjective PT info should be in the nurses notes. As we all know, if its not documented it didn't happen.

this entire post is predicated on the notion that the ED will have their charting in order before they send the patient up. This is not the case most of the time.

Just as verbal report isn't necessary because we say so, so is it true that they are not unnecessary because you say so. You know what they say about opinions.

I've had patients dumped into my rooms without so much as a heads-up, kiss my ass, or thank you. The first, at least, would be appreciated for safe transition of care.

+ Add a Comment