The Art of the Nursing Report

Giving report to another nurse can be sometimes be a challenge, especially if that nurse has striking similarities to nurse Ratched. I think you all know what I’m talking about. There’s always that nurse who asks the question you somehow don’t know, or they roll their eyes because you didn’t do some menial task they deemed important. 

I know it sounds funny, but I use to dread giving report to the oncoming nurse, or to a nurse on another unit. If you’ve been a nurse for some time, then this problem likely doesn’t apply to you. The longer I’m in this profession, the more I’m able to just not give a crap what other nurses think. But if you are a new nurse or still in nursing school, then this topic might be of particular interest to you. Here are some tips and suggestions for nailing your report and getting fewer eye rolls in your direction.

Confidence is Key

Confidence is a major factor that plays a role in almost all areas of medicine. The less confidence you have, the more nervous you’ll be, and the more likely you’ll be to screw up. The same holds true for giving a simple nursing report. 

Listen, I understand that confidence is something that comes with time, but sometimes you can trick your mind into it. Do whatever you have to do to convince yourself that you are a bad-ass nurse who doesn’t take any shit from anyone. Don’t be a dick, of course, but try to build that confidence inside yourself.

A big part of my success in nursing has been my ability to hide my fear. There are times that I may be shaking inside, but I show nothing but a rock solid exterior. Picture the duck who is paddling like crazy under water, but all you see on the surface is smooth floating. When you speak, do so with authority. The moment you show weakness is the moment nurse Ratched will go on the attack.

Write it Down

The idea is not to write a novel here. Rather, you want to jot down all of the important things that are relevant to taking care of your patient. Think about what you would want to know if you were the nurse on the receiving end. 

Start with simple things like name, age, gender, allergies, and code status. Then go over the history and physical. Go from head to toe to help you remember better. Start with Neuro and work your way down to Cardiac, Pulmonary, GI, etc. 

Now you can move on to IV gauges and placement. What are the drips they have hanging and what will need to be hung? Don’t go down the entire med list, but point out the ones of importance. For instance, you might want to mention that the patient is on a beta-blocker, but you held their last dose due to bradycardia.

What other drains do they have? For instance, is there an abscess drain, JP drain, nephrostomy tube, wound vac, etc? Does the patient have a foley or a rectal tube? How has their urine output been (may have been mentioned previously in the H&P)?

If the patient is on a ventilator, go over the settings and any changes that have been made. Are they planning to wean them off or keep them on for another day?

Now you need to think about skin breakdown. Does the patient have any pressure ulcers? Are they mobile, or will they need to be turned every couple hours? Does the oncoming nurse need to do any dressing changes, and if so, how should they be done? 

Now you can talk about the labs if you haven’t already. They don’t need to know that the sodium is normal, but they will likely want to know that the potassium is 7.5. Just go over any labs that are out of whack, as it will be assumed that the others are normal. 

The last thing you’ll need to do is talk about the plan for the patient. What is the ultimate goal here? Are they preparing for discharge soon, or for downgrade to another unit? How hard should they be pushed to get out of bed and ambulated? You get the idea.

Build a report sheet so you have a template to work from with every patient. You can also get one HERE as part of our free STAT guides.

Read the Oncoming Nurse 

Even though you are going to write down all of those details about the patient, that doesn’t mean that you are going to tell the next nurse all of it. Learn to read their  body language and facial expressions.

If they are a seasoned nurse with lots of experience, they are usually content just getting the basics. They just want to know anything they can’t read in the chart for themselves.

Start with the full report, but if you can tell they aren’t really interested, then condense it down to what you feel are the most important things. 

If the nurse is newer, they usually will want every detail. They will often want more information than you have. “No, I don’t know the age of the patient’s kids.”

Try not to get annoyed by this, as you don’t want to be perceived as a nurse Ratched yourself. Although some things don’t seem important to you, it obviously helps them having this knowledge. Kindly smile at silly questions and tell them you’re not sure. 

Drop the Mic

I’m not sure I’ve ever gotten through a perfect report before. No matter what information I give and how detailed I am, there always seems to be some sort of issue. “Why didn’t I hang the Levophed on the left pump instead of the right? I don’t know, I must be an idiot.” 

You have likely experienced this for yourself a time or two. Don’t take it personally. Just take it in stride and move on with your day. Roll your eyes if you want, just don’t let them see you do it, nurse Ratched.

Don’t worry, it gets easier the more you do it. Don’t be sensitive and don’t appear timid. 

The day you say “do you have any questions?” and they reply “no,” drop the mic and walk out like a boss.

It can be a struggle as a nursing student or graduate nurse. Check out our Nursing Mnemonics e-book to help you along!