The Secret To Making Your Rounds 10x Better (hint: communication)

Successful rounds begin with good communication with your Nurses, CNA, Physicians, and Family.

Communicating with the Nurses during rounds:

✔ During your first rounds, it is essential that you give each nurse a report, based on the report you received from the previous shift supervisor. You can also first ask the nurse to tell you what is going on with the residents. 

✔ Next, you or the charge nurse can edit the report by adding additional information that was found. 

✔ Always ask the charge nurse if there is anything you should know based on the exchanged report. 

✔ Inform the charge nurse of your expectations/follow-ups for the day. For example, let’s say you have a patient that has been spiking a temperature with minimal relief from interventions, the charge nurse needs to make sure that they notify you if the patient continues to spike a temperature. This way you can reassess the patient for more appropriate interventions.

Communicating with the CNA’s during rounds:

The CNA’s are at the forefront of providing patient care. How we communicate with them matters. 

💡 It is important that nurses give reports to the CNA’s before they start their assignments for the shift.

✔ Discuss any critical patients on the CNA’s assignments, and make sure that they understand the patient’s current status and needs. 

✔ Emphasize the importance of the CNA notifying the nurse in a timely manner, with any changes in the patient's condition.

 ✔ Allow the CNA the opportunity to add to the report. You will be surprised by the good information that they have to offer. 

✔ Encourage the CNA’s to promptly assist each other. There is no need for a patient to wait two hours to get out of bed because the CNA is waiting for help.

Communicating with the Physician during rounds:

✔ The best time to communicate with a Physician is face to face when they are present on the unit during your rounds. 

🛑 Stop dodging when you see a Physician on the unit during your rounds. Sometimes we dodge because we are afraid that the Physician may ask us questions related to our residents that we may not know the answer. Instead of running away, you should make all necessary efforts to know your patient's current clinical condition, and know the Physician’s scheduled days to visit. 

💡 Anticipate your patient’s need and be prepared to answer any question that the physician may present to you. For example, if you have a patient on a CHF program, you should anticipate that the Physician will ask you about the patient's weight and respiratory status.

Communicating with the Resident Families during rounds:

🛑 Why is it that when we see certain family members approaching down the hall, we attempt to disappear? We make up excuses like calling the charge nurse and saying, “If they [the family members] ask for me, please tell them that I am sending a patient to the hospital”. When in actuality, you are sitting in the supervisor’s office with the door closed flipping through a magazine. Is this the best approach or are we making the situation worse? You know that the longer they wait for you to finish sending the non-existent patient to the hospital, the more anxious that they’ll become. In addition, this behavior makes your staff lose respect and confidence in you, question your work ethic, and wonder if you will be able to assist them if they get into serious issues with family members. So be careful how you communicate with the team and other stakeholders. 

✔ You’d rather take a moment to speak with family members. Speaking with family members increases their trust you,your team, and the facility. It also helps to avoid them calling the state for a minor issue that you could resolve in 5 minutes.