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Tips for a Smooth Nursing Shift Change
Heather Stringer / Monster.com
At the end of a long day of caring for patients, it’s time to give the end-of-shift report to the oncoming nurses. Although it may be tempting to rush through this routine duty, patient safety hinges on a complete and correct exchange of information.
“We underestimate its importance,” says Elizabeth Henneman, RN, PhD, CCNS, an assistant professor in the School of Nursing at the University of Massachusetts Amherst. “It is one of the most critical times we have to communicate accurate information about the patient’s status and the plan for future care.”
Seasoned nurses like Henneman say the shift report can be a positive experience for outgoing and oncoming nurses alike if they avoid common pitfalls and observe some best practices.
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almost 3 years ago
2 comments
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Account Removed
over 4 years ago
Document, document, document!
joyrider
over 4 years ago
52 comments
I've worked in long term care for most of my 33 years as a nurse and "walking" rounds are the best way to remember details. I also use a patient roster, as long term care patients don't change often, and I write pertinent info in a space provided by the patient's name. I make the rosters myself on my computer and they have been a Godsend when working 11-7 and being responsible for 40 plus patients.
corinnda
over 5 years ago
4 comments
I really like the idea of giving report while going from room to room. this makes sense.
cj123
over 5 years ago
8 comments
i am a lpn. i have stress on the job with my coworkers.what do i need to do?
jenny122449
over 5 years ago
4 comments
When I worked in San Antonio, Tx I worked with this one nurse who would do walking rounds as well. However, these rounds and change of shift report was her last assessment of the pt and my first. We listened to the pt, and turned the pt to look at potential skin breakdown. I found this to be time consuming, however, It benefited the pt in ways that are irreversible. I think that if 2 nurses have the ability to listen and look at these pts together, then changes in status will be found as well as 2 opinions on the pt welfare.
normienurse
over 5 years ago
16 comments
I'm a new RN working my first job. We do "walking rounds" in the patients' rooms which does seem to provide more objective, factual change of shift reports. I am finding it tough, however, to get myself organized to give a good, complete COS report. I do make notes throughout my shift, but I'm wondering if anyone has any good advice for organizing their "brains". I work in a Progressive Care Unit, which is an ICU stepdown. I have 3-4 patients now, but when I'm done with my preceptorship, will have 5-6. I feel like I am drowning in all the info, what's important to pass on and what they can get from the Kardex, or chart. HELP!
rlk6798
over 5 years ago
2 comments
In this day and age, there is surely a way that a report sheet could be printed from the computer with all the information needed for each patient, NAME, DIAGNOSIS, DOCTOR, ACTIVITY, DIET, IMPORTANT INFO FOR TODAY (SUCH AS SURGERY, BLOOD WORK, ETC.), ABNORMAL VS'S, IV'S AND OTHER TUBES, ETC. , as well as a space for adding the day's information! Some do have printed report sheets, but most are limited information. Although this information can be found on the computer, if the facility has computer charting, it is not always easily or timely found.
As an instructor who takes students clinically, I have found that many places do not provide a report that is adequate. There are places where a written report is kept in the front of each patient chart [the one with the MAR/TAR, the care plan, etc.] separate from the main chart. The nurse may not be present to answer questions.
It has been that indvidual report is given to the individual who is following, but not to the rest of the floor. There has seemed to develop an attitude that "I do not need to know so I will not pay attention, write it down, or remember it. IF ,as a visiting instructor, I would ask a question of any kind, "that's not my patient," but I had to hunt to find the assignment sheet to find the name of the covering nurse. Some units tape report, but people talk through the whole report making it difficult for me or the students to hear. There is no time for our questions. Many times, the covering nurse had left by the end of the report if there was one. I always encourage my students to know the patient's code status for the whole unit so they do not go and call a code on a patient that is a "no code." They should know the activity or where to find it so that if they happen to answer a light, they do not get someone up who is on bedrest. They should know the diet so they do not give someone water who is NPO, etc.
How does walking rounds provide for HIPPA? Linda
nurse_dee_2006
over 5 years ago
50 comments
Gee 'walking rounds', what a concept! LOL! Wonder why that ever went by the wayside, and now is a 'new idea'?