00:01
Let's now get down
to the nitty gritty.
00:03
How do we do bedside
shift report?
And this is how we're
going to start our day.
00:08
So if you take a look at this
image on one side of the screen,
you're going to notice
throughout the presentation,
there's a little clock there
just to kind of let you know
where we're at in
our 12- hour shift.
00:18
So of course, before we start,
we want to make sure we knock on
the patient's door before we go in.
00:25
Make sure of course,
to introduce yourself and your colleague
and explain what you're doing.
00:30
So who this is usually
going to consist of
is the off-going shift nurse
and the oncoming shift nurse.
00:36
Next, this is a great time to go ahead
and open up the electronic health record
if you have one in
the patient's room.
00:43
And then we can check in here.
00:45
This is also helpful to have the
patient's data in front of us
and make sure we have the
right patient identifiers.
00:52
Now with the oncoming and
the off-going shift nurse,
we're going to conduct
a verbal handoff report.
00:59
Now, this is really important
because this is going to help
include the patient
and we're going to talk from the
night shift nurse about what occurred
to the day shift nurse, so we know exactly
what went on in the previous shift.
01:13
Now during this time,
this is a great time to perform
what we call a
focused assessment.
01:19
Now here's the difference guys,
we talked about a head to toe
assessment, right a thorough one,
from head to toe in nursing
school all the time.
01:28
But at this point, this is right
when we start our shift,
we have our upcoming shift with us
we're in the room with the patient,
and we're doing what we
call maybe a general survey.
01:38
So we're going to look at, hey,
what infusions are hanging?
Are they breathing okay?
What lines,
what catheters do the patients have?
I also kind of like to say that this
is eyeballing the patient if you will,
because we're not necessarily doing
a full head to toe assessment here.
01:55
Because again,
we're just making sure
and checking on the patient's
safety at this point.
02:00
Next, this is a great time to review
the plan of care and the orders as well.
02:05
Then this is again,
we've talked about this earlier,
but this time, if we want to include
the patient in the conversation,
you may think, "Okay,
well, that's a little odd
to talk about the patient,
they're standing there."
This is a key piece of
bedside shift report.
02:21
Now the reason why we
do this is this is meant
to include the patient
in the plan of care.
02:27
Also, they're going to check
us for accuracies actually,
they may say, "Wait a
minute, the night shift
if you remember,
we actually did this.
02:35
This medication didn't work for
me, we try this instead."
"Oh, yes."
So it's also really good to make sure
you include them in the conversation.
02:43
Now once we've done that,
just keep in mind all of these
steps, this was for one patient
or we're going to
give thank our patient
and then move on to our next
patient that were assigned to.
02:55
Once we perform bedside shift
report on all of our patients,
what are we going to know
after this information?
Well actually guys quite a bit,
we're going to know
the physical condition
of the patient from
our focus assessment.
03:07
And again, guys,
I can't stress this piece enough,
I will tell you,
there's many times that
right when you come on shift or
right when you're exiting shift,
sometimes there's
some single events
or some adverse effects that
happened to the patient.
03:21
So it's important at this
time frame that we go in,
do a quick general survey
or focus assessment
to make sure the patient's safe.
03:30
Now, after that bedside shift
report, if you remember,
we talked about key events
in the plan of care,
we know a little bit
about their medication,
or excuse me,
their medical history,
their information,
the baseline condition of the patient,
and any immediate needs
that the patient may have.
03:49
Now, once we've gathered
bedside shift report,
here's the thing
to keep in mind.
03:53
This could be a report on one
patient, it could be on seven,
it just depends on where
you're working at that point.
04:00
So typically, when you're talking about,
oh, maybe a team of five, for example,
it's going to take at least like
a half an hour or so give or take
on your time of the day.
04:12
But once we gathered that
information, what do we do next?
Remember, we have to prioritize.
04:17
This is one of the biggest
things for new students to learn.
04:21
Now, if you remember
when we prioritize,
what are the first
things we got to know?
Oh man, those ABCs, right?
Airway, breathing,
and circulation,
that's super important in the condition
and the status of our patient.
04:35
So make sure once you've
gotten that information,
you're considering these 3 things
on who you may need to see first.
04:43
So consider the whole picture
of your assigned patients.
04:47
Now what's going to matter what
you gotten bedside shift report
of who you're
going to see first.
04:52
So of course,
we talked about the ABCs.
04:55
It's going to depend actually,
what your patient feels like?
What their condition is?
Maybe are there any stat orders
meaning they have to be done right now?
Are there medications that
have to be done quickly?
Are there critical lab values
that have to be addressed?
Also keep in mind any outcomes
and your patient goals.
05:14
So here's a great
example of this.
05:16
Maybe you get a report
on a few patients,
maybe one patient is...
05:22
maybe they're struggling with
constipation after surgery
and their vitals are stable.
05:26
Their condition is stable.
05:28
They're just trying to
facilitate about mimin.
05:31
Maybe your other
patient, however,
is having active
chest pain overnight.
05:36
They're stable for the moment,
but we may need to go see them
first over the constipation patient.