When Giving Report Please....

[lilarox]

Everyone has an opinion on the best way to give report, and opinions on what not to do. I like to believe that most of the time I do a good job. There are days where things just do not flow well, and I do not win report giving awards. That said, I always try to be respectful of the oncoming shift when giving report. I think it is important to mentally put yourself in their shoes (or think back 12 hours...) so you give the report in a manner in which you wish to receive it.

So I'd like this thread to be a sort of feedback for report giving. It can even be a dumping ground for things that irritate you while getting report. All positive and negative comments can teach us something, and I am constantly trying to improve.

So I'll start, with more of a dumping versus a positive uplifting.

We have a nurse that tells you NOTHING in report, to sum it up it goes something like this: You have a patient in room xx, Any questions? Obviously he/she says other things, what he/she does say however is usually superfluous. Granted report is really short, guess that gives me plenty of time to figure out all that I needed to know.

Okay I will leave it at that and let everyone else chime in. For now.

[CodeteamB]

Keep it short and sweet.

-Age, gender, name

-Chief complaint/diagnosis

-what we have done

-what needs to be done

-abnormal assessment/ lab findings (eg: lung crackles, L sided deficits, trop elevated, gap 21 etc)

-miscellaneous (eg: speaks only Cantonese, son had to be removed by security, police aware of injury and following up etc)

Also, stay focused on report so we can all get on with our days. This shouldn't take longer than 3 minutes/ patient unless the patient is sick enough to be the only one you are handing over.

[FineAgain]

Pt "A" is confused, irritable, has a 1:1 in place. He has xx for tubes and pulls at them. Wearing mitts. "But when was his last BM?" Uhh...can't remember but it's in my charting. "Well it would be easier if you wrote it on your paper, then you could tell me". Really?????

[SwansonRN]

From what I've read you all would hate the way I give report. I'm not even the exception in my unit, either. Sometimes report on one patient can last half an hour. Granted, we only have one or two patients, but our culture is to give very thorough and detailed reports.

I remember in my clinical for nursing school on a gen med floor we were practicing giving hand off report. I went first and went by systems, mirroring what I had observed in my internship (the ICU where I currently work). I was talking about peripheral pulses, bowel sounds, skin turgor, etc. My instructor let me finish and sort of laughed and said, "that was nice, but I stopped listening 10 min ago!"

[RNGriffin]

From what I've read you all would hate the way I give report. I'm not even the exception in my unit, either. Sometimes report on one patient can last half an hour. Granted, we only have one or two patients, but our culture is to give very thorough and detailed reports.

I remember in my clinical for nursing school on a gen med floor we were practicing giving hand off report. I went first and went by systems, mirroring what I had observed in my internship (the ICU where I currently work). I was talking about peripheral pulses, bowel sounds, skin turgor, etc. My instructor let me finish and sort of laughed and said, "that was nice, but I stopped listening 10 min ago!"

If you report for 30 mins on a single patient every shift, I would definitely speak with the nurse manager. That's inconsiderate to those coming and going. 1 hour of nursing skills is wasted in report?

[joanna73, BSN, RN]

It depends which unit you're working, and the condition of the patient. ICU is usually 1-3 patients. I work LTC, so there is no need to provide a long detailed report on 30-40 people. We report on the sickest most unstable residents in greater detail. Otherwise you're in report forever.

[HyperSaurus, RN, BSN]

Not if you only have 1-2 patients. Then, that would be expected.

[Cal-Neva]

I was taught SBAR format in school and have used that primarily. I have felt it was a great way to organize my thoughts and made sure that I included the pertinent info. Report in ICU and Telemetry were different animals though. ICU was much more detailed with lots of assessment info and Tele was almost more of a report by exception just so report didn't take an hour for 4-5 patients

[Nurse Kyles, BSN, RN]

From what I've read you all would hate the way I give report. I'm not even the exception in my unit, either. Sometimes report on one patient can last half an hour. Granted, we only have one or two patients, but our culture is to give very thorough and detailed reports.

I remember in my clinical for nursing school on a gen med floor we were practicing giving hand off report. I went first and went by systems, mirroring what I had observed in my internship (the ICU where I currently work). I was talking about peripheral pulses, bowel sounds, skin turgor, etc. My instructor let me finish and sort of laughed and said, "that was nice, but I stopped listening 10 min ago!"

The culture of my unit is also to give very detailed report. Every nurse uses the units specific report sheet, and we go through the entire thing. Patient Name, background of admission, med hx, code status, POA, Resp, cardiac, GI, GU, neuro, skin, activity, pertinent labs, new orders, if patient wears teds, SCDs, isolation precautions, planned procedures, PRN meds, PCA, IVs, Gtts, etc are all discussed. This takes from 15-30 minutes to go through report on three patients in Progressive Care. On a rare occasion, the report takes 45 minutes. Report that long usually means it was a train wreck day with three really sick patients. Most patients have a lot going on, so it is really necessary to give detailed report. If the patient has an especially long story or very detailed wound care etc, I usually will type it up on my downtime on NOC shift. I also write out all the patient histories on sticky notes to pass along to the oncoming nurse. This really speeds report along.

I was giving report on a patient who was a transfer to us with a small SDH, had been planned for d/c but failed PO challenge and many hours later was finally being transferred to a facility to whom s/he was capitated for overnight obs and AM d/c. The nurse on the other end seemed to be filling out their Kardex or admit papers judging by the voluminous and divergent questions. I finally reached my limit when I was asked, "And what's the status of his/her flu shot?" I replied, "I haven't a clue; you should ask him/her when s/he arrives in 30 minutes."

I spent more time on the phone reading information out of the chart than I did with the patient.

[wooh, BSN, RN]

Just tell me vitals stable. I don't want to know every dose of insulin in the las 24 hors and what they had for snacks, especially if they are going home this morning.

I do want to know who has crazy spouses.

This is me. I can find everything in the chart. Tell me what's NOT in the chart. Who has crazy family and who will talk for hours on end so I need to go in with a get-away plan.

And it would be nice if people would accept report the same way. It's one thing if you haven't looked in the chart. But if you've spent 45 minutes looking at your charts before you'll let me give your report and I just saw you looking at THAT MD PROGRESS NOTE, don't ask me what THAT MD PROGRESS NOTE said. You can read just as well as I can. And if you can't, why did you waste my time while you were trying to read? Either just let me read it to you, or buy yourself Hooked on Phonics.

[SwansonRN]

If you report for 30 mins on a single patient every shift I would definitely speak with the nurse manager. That's inconsiderate to those coming and going. 1 hour of nursing skills is wasted in report?[/quote']

I can't imagine a nurse manager asking an ICU nurse to abbreviate their report. More is more. The only thing getting abbreviated is our lunch breaks.

[LadyFree28, BSN, LPN, RN]

This is me. I can find everything in the chart. Tell me what's NOT in the chart. Who has crazy family and who will talk for hours on end so I need to go in with a get-away plan. And it would be nice if people would accept report the same way. It's one thing if you haven't looked in the chart. But if you've spent 45 minutes looking at your charts before you'll let me give your report and I just saw you looking at THAT MD PROGRESS NOTE don't ask me what THAT MD PROGRESS NOTE said. You can read just as well as I can. And if you can't, why did you waste my time while you were trying to read? Either just let me read it to you, or buy yourself Hooked on Phonics.[/quote']

Agreed, btw. :)