1. LaComb, Amy BS, RN, C
  2. Taylor, Jerry BSN, RN
  3. Tobin, Sue RN, CPCC

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Diana J. Mason is right-nursing needs to reclaim patient "hand-offs" ("Shift to Shift,"Editorial, September). As a new nurse eight years ago, I learned to do walking rounds at Bassett Healthcare in Cooperstown, New York. I learned so much from those rounds: the importance of adequate assessments, of being accountable to the next shift, and of care planning. Since then, I have worked in many other facilities, none of which have used walking rounds. Instead, the trend is toward having taped reports, having no overlap in shifts, or both. Because of this, the plan of care can be unclear.


I work in a drug rehabilitation center and have argued with my supervisor and the director of alcohol services about patient "hand-offs." At one time, a physician came to the morning report, but that has since changed. I told them that whether or not a physician was present, we needed to have a morning report in order to figure out what must be done for the day, discover whether any critical issues had occurred during the evening shift, and discuss how to handle these issues. I also said that an evening report with all staff is important, so that we know what happened that day. This was not well received-I am handing in my resignation.


Name and location withheld on request


I too am an advocate of the face-to-face report. I remember listening to report every day on my 3-to-11-pm shift as a new graduate in 1974. I learned so much by asking questions of the RN and the LPNs who had worked for several years on the unit. Their experience helped me through many difficulties with patients and families. I have been at the same institution for 30 years, and I am now the house manager on the same shift. These days, we rely on taped reports, and every day I hear someone say, "I didn't get that in report." When nurses from the shift coming on sit down with nurses from the shift going home, there's a bond that develops. We don't see that anymore. Perhaps nurses should look at what worked in the past and try it again.


Your message that "We are, after all, a part of the patient's story" needs to be heard by those who undermine communication in our field.


There's only so much time on my shift, and the art of patient care takes at least three times that amount. Some places have adopted taped reports in order to relieve half of the nurses on the floor so they can care for patients and interact with patients, families, pharmacies, and physicians. Thus, direct, nurse-to-nurse communication becomes less important.


I have a hard time cutting short my patient care. I believe our reports are like a chapter in the story of the patient, and good books don't have missing chapters.


Amy LaComb, BS, RN, C


Ogdensburg, NY


Jerry Taylor, BSN, RN


Elizabethtown, KY


Sue Tobin, RN, CPCC


Plymouth, MA