Bedside Reporting

1 One of my facilities recently implemented a mandatory "bedside reporting" protocol which has created a lot of chaos and bad tempers.

My issue has and always will be the breach of confidentiality. We are not allowed to discuss patients in elevators and cafeterias but can do so in a ward room with 3 other patients (and sometimes their families) eavesdropping?

Then there's the time management factor. Administration says "2 minutes max per patient." My ***. When patients start asking questions, it's more like 20 mins.

Not to mention that there is often information needed to be passed on that is simply not suitable for patient's ears. This is a reality, but maybe less talked about, fact of nursing.

So far it's a pilot project to be evaluated after a trial period. Can't wait for it to be tossed out the window! Last edit by dianah on Oct 7, '10 : Reason: Terms of Service -- all *s.
Not to mention that there is often information needed to be passed on that is simply not suitable for patient's ears. This is a reality, but maybe less talked about, fact of nursing.

I don't know whose brainchild this idea was, but it is one of the worst I have heard about.

Yeah I hate that too. First, it's hard to write while you're standing, and you're right there is often information that is not for the patient's ears, and the ward room clearly violates patient confidentiality. Discussing a patient's non compliance in front of them could easily represent emotional jeopardy. Write up the major concerns and present to management. "I hate it" is not going to hold much water with them, but there are numerous legitimate nursing concerns here. Good luck.

We do the same, but not in the present of others. If i we go to the pts room and others are present, the outgoing nurse just introduce the incoming and tell the patient he/she is leaving. Then we come out to a secluded place and finish the report. I like it and i don't see anything wrong with it. It allows me to eyeball the patient quickly.

I prefer what you're calling "bedside reporting" as is also known as "Walking Rounds" in my neck of the woods. No; you don't stand in front of God and Zeus spewing out the most intricate details. Once a person has it down it's actually quiet easy.In my experience most of the reporting/exchange of info happens while walking the halls and then going in to see if all is well. You could also do a short summary exchange prior to the actual eyeballing. Here's an area where you need to use your common sense skills. Carry a clip board to take notes. This type of report lets you see the patient first hand and ask questions right there as opposed to doing rounds after the other shift leaves and you find (as it inevitably happens in many cases) not all is as reported.I believe you'll be pleasantly surprised.

We implemented this in my facility as well. We don't do a full report bedside, as others have discussed..we do report outside the room in a private place, then go in together and briefly assess the patient. A patient had come back from cath lab, and the two nurses assessed the groin puncture site together..it was firmer than it had been, but not so firm as to raise red flags. Without bedside report, it might have been missed, and it turned out that the patient had developed a pseudoaneurysm. That patient was back in the OR that night. I think bedside report is a good thing.

Again , we are supposed to be professionals. We realize this is an unacceptable form of shift report.Unfortunately, most nurses will go along with protocols dictated by an administration out of touch with the unit/paient and of course, nurses needs.Nurses need to stand up to ridiculous protocols and correct the problem. After all, thats what we do! Solve problems.

my administration started this, but all we're required to say is, "good morning mr./mrs. whoever. this is whoever who will be your nurse today. we're going to look over your chart and give report. nurse whoever will be in shortly to care for you." or any kind of variation of that. we are also to look at tubes, o2 adjuncts, etc. it's meant to be a 30 sec hand off visit. not actual report at the bedside.at least for us it is. idk about other facilities.

My facility switched to bedside reporting which has worked out very well. You get to eyeball your patient, the IV lines and rates, 02 rate, and ensure the outgoing shift isn't leaving you with 10cc of fluids. While the nitty gritty details are not given in the room usually on the walk their, the introduction of the oncoming nurse has drastically reduced the amount of call lights going off at 0730am. Patients say they feel more comfortable knowing who is caring for them for them, and that they have seen their new nurse at 0630 rather than 10 or 11. It is hard to get used to, but works well once you get in the groove.

We are supposed to do "Bedside report" at the hospital where I work. It works quite well when we do the majority of the report at the desk while looking over the chart together then head in give the patient a brief update regarding the plan of care, off-going nurse introduces oncoming nurse, patient is asked if they have any questions, move on to the next. I am a supporter of "bedside report" for several reasons1. It allows off-going nurse to assess whether any changes have occurred in patient prior to handing them over. (For example we had a pt s/p stroke who just happened to be sleeping during bedside report, offgoing nurse reported no residual effects from previous stroke, go in to assess an hour later, after finishing report and rounding on one of my other patients who needed pain medication and pt was confused, aphasic, etc. Yet I did not know whether this was lingering residual that the nurse forgot to mention or new onset, never again will a neuro pt be allowed to sleep through bedside report.)2. It holds the offgoing shift accountable for things they didn't do. How many times have you walked into a pt's room to find trash everywhere, and the pt complaining about pain meds and a salad they had been promised hours ago. Well guess what now its 8pm and the kitchen is closed and I look like the bad guy.3. It allows the patient to have their questions answered so that we all know the answer and it allows the patient to give us information we may not have. You don't know how many times the nurse has told me they have no idea when surgery is, go in tell the patient, well you have such and such a procedure scheduled for tomorrow but we're not sure what time yet only to have the patient tell me it's 3 o'clock. 4. You can make a clear division of responsibilities. If a patient during report asks for pain medication and help going to the bathroom you can delegate duties to make sure nothing is missed. I know change is always hard and there are days I just do NOT want to go in that patients room another time, but try to be open minded and give it a chance.

I too was resistant about bedside reporting, but as others mentioned, it certainly has its benefits, and I now welcome it.Our hospital has a computerized SBAR form, that is updated every shift that includes pertinent info: name/DOB/MD/allergies/vitals q ___/ diet order/ and then the info that can be typed in like IV site&date of placement/ IVF/ Dx/chief complaint/ pain meds/last dose given/ tests to be done/lab work. Then it has the last 2 sets of vitals signs and lab work results automatically generated on this form. Anything significant, I will type on the form, and then point it out to the RN/discuss as needed.I believe this SBAR form is what keeps our bedside report short and sweet! We just go in, introduce ourselves, update the white board (RN name/ tech name/ MD/ diet/ plan) and quickly review what the plan is for the next 12 hour shift while I am there, and then inquire if there is anything we can do for the patient at this time?Granted some patients will not recall what the plan is, look at the white board for info, but generally, the patients and family, are happy to be informed of their care and that we will address their concerns. I know that is what I would want if I were a patient.

I wish they did this in long term care but as stated above with an eyeballing no major HIPPA violations would be good... no surprises like I get left with and I used to do a first round thing myself with my only 8 to 10 patients I used to have when worked acute care and I would take a look see and introduce myself it helped alot but I dont know how it would work in LTC with 20 to 28 patients a shift... just my