Walking Rounds

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This topic contains 3 replies, has 3 voices, and was last updated by Profile photo of haltatx haltatx 4 years, 7 months ago.

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  • #6795
    Profile photo of LisaRN
    LisaRN
    Member

    At our facility we are being required to perform walking rounds with the oncoming nurse. According to management, this consists of entering the patients room, waking the patient and family members up and having an “interactive” report with the oncoming nurse. Also we are utilizing white boards in the patient rooms by filling out our names, assessing the patient’s pain on the pain scale and updating the boards with any patient concerns and questions. All of this is supposed to improve our HCAHP scores. Management has been faced with great resistance to this and have been following us around and implementing penalties for those who do not comply. My question is..Do any of you have to perform these walking rounds and how do you feel about this?

    #6800

    I work in an ER, so it is a different beast altogether. Our reports usually take about 30 seconds on our way out the door to lunch. The only exceptions is if we need to pass on important information like still needing a urine sample, another med needs to be hung after the current med is in, just gave some narcotics so keep the pulse ox alarm on while I’m gone, etc … but usually we try to take our breaks when our patients don’t require anything for 30 minutes other than discharge notes.

    I can see the value of in front of the patient reports in that the patient can pass on what is really his main concern and you can see all of the tubes that are in place and get a baseline mental exam in while everyone is still there. That being said, I would hate having to do that. A lot of what goes into report isn’t anything I would want the patient or family to hear. Not that I slam all of my patients behind their back, but sometimes I want to tell me coworkers, “this guy gives me the creeps, don’t shut the door and don’t let him between you and the door.” I’ve felt that way about people that have not tried to kill anyone, so I’m glad I didn’t say it in front of them, but I have also said it about people that have gone ballistic, so I think things like that add to the value of change of shift reporting.

    #6803
    Profile photo of LisaRN
    LisaRN
    Member

    Jason-
    This is a problem we are encountering ourselves. I argue hippa violation when family and friends are present, I get told ask them to leave room. (by by hcahps) I argue that we can’t possibly cover everything we need to say in front of patient, they say “history, everything must be done in front of patient, period.” (by by hcahps) I agree that bedside reporting could be beneficial to both pt and nurse, like you said checking lines, neuro status, but I also feel there are things we say that cannot and should not be said in front of pt. i.e. this pt requires lots of drugs or he doesn’t know he has cancer, or she has HIV but doesn’t want anyone to know. Another issue is once we have the information and come back to these same patients each night or day why go over it again? Update me and let’s move on. Also these rounds take an enormous amount of time when you have 5-7 patients and 3-5 nurses to give or get report from. What? You are here past 7:15? Not acceptable! What? The patient decided to tell their whole life story to the oncoming nurse? You didn’t walk out mid-sentence? (by by hcahps) a arrggghhh! Lol

    #6873
    Profile photo of haltatx
    haltatx
    Member

    I understand the frustrations everyone is facing but this is being done everywhere now. I like the bedside report. It lets me check the fluids, foleys, dressings, IV sites, etc. with the previous nurse there. If there are any deficiencies, they can take care of it right away instead of tripping off duty and leaving you with a soiled patient, empty fluid bags, full foleys, patients in pain, and dirty rooms. If the patient is asleep, we give report outside the door and don’t wake them. If there are other people in the room, ask the patient’s permission to speak in front of them or ask them to step out of the room. I find that I get better report this way and that I give better report this way. Instead of reading from a cardex, like so many nurses do, we can discuss the actual person in front of us. If there are things better kept between the nurses, cover that before or after the bedside report. Maybe it takes a little longer, but it will make a better nurse out of the ones who leave things undone that they should have taken care of because they will get tired of you pointing these things out to them. Just the other day, the nurse I was getting report from during bedside told me the patient was on LR at 75 ml/hr. I turned the bag around and said “She has NS hanging. Which is it according to the orders?” Embarrassing for that nurse because she didn’t know what fluids her patient had. She was just reading off the cardex which was incorrect. Since we started this, I have had fewer and fewer things to point out. I like introducing the next shift nurse to my patients. They feel like an important part of their care and are more comfortable during shift change (which can sometimes be a no man’s land for the patients).

    None of the issues brought up here are unsolveable. Be creative and critically think of ways to get the job done better and safer for your patients.

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