Learning how to give an awesome and succinct end-of-shift report is a vital skill that is crucial to patient safety. Once you start practicing giving/receiving report in clinicals, you will be astounded at how often this is a disjointed, unorganized mess that leaves you discombobulated and with more questions than answers. To give an awesome report, follow these tips:
- Use a report sheet (also called a “brain sheet”) that works for you. I have the sheets I use posted here, your unit may have a standard one to use, or you can make your own. Whatever the case may be, and no matter how many of the “cool kids” give and receive report without writing anything down, use a report sheet. It ensures information does not get lost and helps you give report in a timely manner.
- Develop a system for conveying information. For me, this is SBAR utilizing a head-to-toe format in the “assessment” portion. Some people jump around from head to gut to feet back up to cardiac with a detour to respiratory and psychosocial. Don’t be that person. It’s head-to-toe, top-to-bottom, beginning-to-end all the time, every time. It’s the only way you’ll be confident you’ve remembered everything (and even then you may still call the unit on your way home!).
- Include a bedside check with the oncoming nurse. Some hospitals require the whole report be done at the bedside, but if yours doesn’t then please go into the room together. Check the patient, check their gtts, surgical incisions, chest tubes, vent settings, wound VAC, and neuro status together. This doesn’t have to be a long, drawn out process…just a quick bedside check to confirm that the stuff in the chest tube now looks like the stuff you’ve been seeing all night, or that the draining on the surgical dressing hasn’t changed, etc…
- Review any new orders together. On the floor, there may not be time for this, but definitely review orders if you are in a step-down or ICU. This ensures critical items were not missed or forgotten. And yes, some things will get passed shift-to-shift. This is fine as long as you got something done and the patient is better off for it.
- Ensure you leave time for questions. Don’t take up the whole report timeframe chatting about the patient’s cute grandson or how fantastic your new compression socks are working out. Leave time for questions, and leave time for your fellow nurses to also give report in the allotted timeframe and get out of there on time!
- Speak with confidence. If this means you need to practice a little bit beforehand, then practice. Sneak back to the supply room or at least go over it in your head. As a student, you can make an excellent impression if you convey information well…this is the perfect time to shine!
I hope this helps you master the art of giving excellent end-of-shift report…a skill that is often overlooked but absolutely vital and always much appreciated! To help you get the hang of it, I’ve recorded a Podcast episode using a fictitious patient…you can check it out here (or simply subscribe via iTunes and receive episodes automatically!).