Handing Over Like a Boss
Updated: Jul 31, 2020
Shift Change. The time we all look forward to especially if you work 12-hour shifts.
Handing over to the next shift can be intimidating particularly for a novice nurse. It's worse if you are in a foreign land where every sentence you make is likely to be followed by "pardon" or "sorry".
Like every skill in life, handing over reporting is a skill that improves with practice and time. Effective handing over is not just about your feelings as a nurse. Studies have shown that it contributes to continuity of care, ensures patient-centered care, reduces time wastage and promotes a culture of teamwork.
If you are a student or novice nurse, below are some of the information that you must always include in order to hand over like a boss. Remember, confidence is the secret ingredient.
It is obvious that you must start your report with the patients bed number, name and age. It is important to use two names including the surname. However, having worked in Kiambu County, Kenya, where names like Mary Wanjiku or Hannah Njeri are a staple, sometimes stating three names is a must (In my current practice two names suffice).
Stating the age is vital because its starts to create a mental picture of the type of care and/or attention that is needed. In the UK where "Do Not Resuscitate" directive is critical piece of information, consider stating this as well.
2. Patient's Condition through your Shift
Many people ignore this aspect. Personally, I feel this is helpful information. Was this patient calm? Were they restless? Were they confused? Did they sleep well? Did they communicate any needs? Were they cooperative or uncooperative with what you were offering? All these prepare the incoming nurses to know how to approach the patients allowing for more compassionate care.
Surface, Skin, Kinetics, Incontinence and Nutrition. This is more of a UK format but I believe it's component can apply to any environment.
Surface is the type of mattress the patient is on. In Africa,. foam mattress is standard. In the first world, there are different types of surfaces, ranging from foam, hybrid and air mattresses, each surface being suitable for the patients' skin.
Skin, clearly, is the condition of the patient's skin. Knowing if a patient has pressure/bed sore and its grade is important because it enables the appropriate care to be rendered. This include wound care, diet, infection prevention and pain management.
Kinetics refers to patients' mobility. Some patients require aids such as zimmer frames or walking sticks. Other may simply require supervision. This is particularly important for falls prevention.
Continence is basically the patients elimination status. Are they continent? Do they have a catheter? What is the color and quantity of urine? Have they opened bowels? Do they require extra attention when it comes to elimination? Knowing this helps to promote patients comfort and dignity while in hospital and also their skin integrity.
Finally, are the patients on any special types of nutrition and diets. Including the levels of assistance they required to feed so that the nurse can pay attention to this during the shift.
As mentioned above. the acronym is more applicable to nursing in the UK. However, these are all critical information that can be tailored to the environment where you are currently working in.
4. The Medical Plan
This information is usually decided and prescribed by the doctors. Part of it is for them to execute with a bigger chunk being for the nurses. This may include simple tasks like monitoring the patients intake and output and blood sugars to more complex ones like taking bloods and preparing the patient for different medical procedures.
With handing over reporting, there is no right or wrong information. If there is information that you feel the incoming nurses need to know then please, by all means, go ahead and state it.
For instance, you may have run out of sugar during your shift. Both nurses and patients must maintain an appropriate glucose level for the shift to run smoothly.
In the beginning, you may feel shy and timid and you will give a couple of shoddy reports. Do not be hard on yourself. Slowly, you will find a voice that is unique to you.