In the course of a shift, nurses walk a lot. The long corridors, the equipment that was forgotten but was needed in the room at the end of the corridor, answering the persistent alarm that keeps going off in the room on the other side of the ward.
Nurses exchange information between incoming and outgoing nurses at least three times a day. The name of this exchange varies but it means the same thing. It can be handover, hand off or bed side shift report. It is done at a change of shift and sometimes on an ad hoc basis.
Nurses regularly provide advice about habits to help their patients stay healthy. The advice always includes eat a healthy diet, exercise regularly, keep a healthy body weight, reduce alcohol consumption and don’t smoke. That advice is willingly received or ignored dependent upon the patient’s personal circumstances. And let’s face it, nurses are just like their patients.
At handover, the outgoing nurse mentions that just prior to coming into handover, a patient had a high blood pressure (BP) reading. She had taken the blood pressure only once. Previously the patient’s blood pressure was within normal range. In the middle of a busy round, the incoming nurse passes on the information that the patient had a high blood pressure reading. Without any further information and because the round was leaving the room, the patient is quickly written up for hypertensive medication.
A perennial discussion about the appropriate management of pain relief in patients occurs on most wards every day. Mrs Jones has buzzed again. When you go in, she requests additional pain relief. She feels that the amount prescribed is not enough. This leads to the inevitable discussion about whether more analgesia will lead to addiction in this patient.