wanted: thoughts on bedside reporting

Jenni811, RN · Mar 10, 2011

our hospital does sbar at the bedside. i think it is excellent for patient's and their families, they really like it alot. it really helps the patient to meet their new nurse for the day/night. patient's tend to establish a relationship with their nurse and begin to trust them, and when sbar is passed off at the bedisde the patient can hear what is being said to the new nurse coming on, their plan for the day. also another benefit is the patient can add input to their own report. for example, if previous rn is talking about patient's pain stating it was a "7/10" the patient can add something the previous nurse may not have known like "the tyelnol really didnt help, but the lortab helped alot" (that type of thing) it really gives patients/familiesa chance to participate in their own care.

downside- its really difficult when you have a patient with some type of mental illness, or has something that you don't want to talk about in front of them or the family. i once had a patient who was out there, i mean just crazy. she was stating that the president's wife was coming to pick her up to take her to a beauty pagent and it has to be before 12:00 because wisconsin is going to be cut off from the united states and become it's own nation...so obviously this is not true, but she thinks it is...so it wasnt like we were going to go in their and talk about it infront of her and her family. so we discussed what we needed to discuss in private, then we went in the room after that and did sbar. sometimes situations like this happen..once had a patient that had her biopsy come back positive for lung cancer, i knew this, the doctor knew this but the patient didnt know yet. doctor wanted to come and talk to her when her family was there and he had time to sit down and give the family their time to ask questions. anyway...i wanted to pass this on to the next nurse so she was aware, but of course i couldnt state that infront of the patient and their family yet. so you may run into things like that.

all in all, it has worked very well at our facility, the families love it. becarefull of doing sbar with family present. we always walk into the room, i introduce the next nurse and state "we are going to do report with you. are you ok with the people in this room being present for this, or would you like them to step out?", you'll be surprised at how many times they want them to step out, or just certain people to step out. so always ask the patient themself. if patient cannot speak for themself, we always ask the spouse or person that is there with them and taking part in their care.

ReWritten · Mar 10, 2011

When I started out 6 months ago, my floor did bedside reporting, but all the nurses HATED it. My manager was the only one that enforced it, and if she wasn't there, we didn't do it. But if we found out she was on the floor during report, we'd do it or find empty rooms to run and hide in.

We hated it, because we felt really uncomfortable giving report in the hallway where everyone could hear. Much easier/more practical to give it in the break room or at the nurse's station (which for the most part, is not out in the open).

But if there's something major going on, we'll walk each other into the room and show the oncoming nurse and interact with the patient. Personally I do see it's benefits as the previous poster made, but I just don't care for it.

JennRN65 · Mar 10, 2011

We recently started bedside reports. Complete report takes place as normal at the desk, but when the report is complete, both nurses go to the bedside to confirm all of the information (checking surgical sites, IV's etc etc). We have always done bedside on the the critical patients, now it's done on all patients. So far, so good.

Orange Tree · Mar 10, 2011

It's time consuming and impractical...especially paired with team nursing where you have 14 patients to get report on.

Jenni811, RN · Mar 10, 2011

Yes, i could see it being not practical for 14 patients. But our nurse to patient ratio is 4:1...so pretty practical.

Don't know a nurse that doesnt like it...

and we don't do it in the hallway, we do it in their room hence the name "bedside reporting" not "hallway reporting". Our facility doesnt have any double rooms, to confidentiality isnt an issue with that. Also we make sure the door is closed while doing it.

GM2RN · Mar 10, 2011

I can see it working well for those who have maybe 4-6 patients, but many more than that would make it prohibitive.

As an ED nurse, I don't have time to run to the floor with every patient I admit and wait for a nurse to be available to give report at the bedside.

Jess1990 · Mar 11, 2011

As a patient i hated it when my nurses gave a bedside handover. I felt so violated in that everyone else in that 4 bed bay could hear everything about me, and i really didnt want it shared. I was 20 years old and just had a MI, i was terrified and that was the last thing i wanted to hear 3 times a day...

However, as a nurse i LOVE bedside handover. And the majority of patients like it as well. It gives the patient an opportunity to feel involved in their care, and most if not all of them pipe up and contribute. And if the doctors are rounding at the same time they often like to chip in bits and pieces as well. It gives you that opportunity to introduce yourself to your patient and let them know that you will be looking after them for that shift, and also allows you to check your charts and make sure that all the meds that were due on the previous shift were signed for.

I think as a nurse you have to use your discretion. Give the general handover at the bedside but if you have a patient that really doesnt like others hearing all their business take it outside, same if you have any information that really isnt appropriate for the bedside.

:)

felineRN · Mar 11, 2011

As said before, when you're getting > 10 reports on pts its tedious. We also have a "challenging" pt population where families/pts will interrupt to ask for ice/blankets/pain meds etc etc... There are other times where one must be delicate with health history. I'll simply point to AIDS or Hepatitis on the screen rather than announcing it.

In stepdown where we get reports on 4 pts, it's priceless. We are more likely to have drips/restraints/pcas in stepdown and its great for continuity of care and to have your second check on multiple things. We also often do a quick skin assessment together if needed.

Basically: On a m/s floor with 7:1 ratios and two sets of report to hear, it's impractical.

In stepdown or critical care, it's very helpful!

NursePweezy · Mar 11, 2011

We call it ROC relationship oriented care I believe in theory it is a good idea but there are many pt that will just continuosly interupt report asking for anything we kinda have it down to a science now you know the pt who will benefit from this most of report is given (in a low voice)outside the pt room and the oncoming nurse is introduced to the pt where they ask if there is anything they would like the nurse to know about them.

Caffeine_IV · Mar 11, 2011

I was one that didn't like it in the beginning and took every chance to skip doing it or cheat at it.

However we have been doing it for months now and I really do like and I think the patients do as well.

It gives me the chance to meet the patient/family before I get busy beginning of shift things like (checking charts, pulling meds).

Cons: Patients/family that interrupt report to tell their long-winded version of how the day went or to ask questions.

Patients that suddenly need to be repositioned or go to the bathroom and that holds up the report.

recon2819 · Mar 11, 2011

I TOTALLY agree with Aussie. I have been on both sides of this, and as a patient. I HATED it. I too felt violated and very uncomfortable when the nursing staff did bedside reporting. It is worse however, when the hospital does "grand rounds" I have also been in a situation where a group of medical students stood outside my door in the hallway with their Prof and discussed my case. It was embarrassing and humiliating. I HATE BEDSIDE REPORT> If you are in admin.... PLEASE think about the patient as a person, not a case or room number.