Report is the ten to twenty minutes at the end of a shift where everything you know about five patients has to move into somebody else's head. It is the moment care is most likely to be dropped, and it is almost never taught. What follows is what a nurse to nurse report has to cover, the order that makes it possible, how long it reasonably takes per patient, and the three failures that account for most of what gets lost.
The order does most of the work
Run each patient as situation, background, assessment and recommendation and the report has a shape: who they are and what is happening now, how they got here in one or two sentences, what you think is going on, and what the oncoming nurse should do about it. Without an order, report becomes a recital in the sequence you happen to remember, which is chronological for you and meaningless to the listener. The order also exposes the gap: if you cannot give an assessment for a patient, that is worth knowing before the next nurse discovers it at three in the morning.
What must be said even when time is short
Alerts, changes and outstanding items. Alerts are code status, allergies, isolation and falls. Changes are what is different from the last shift, which is the only part of the picture the oncoming nurse cannot get from the chart. Outstanding items are what you did not finish and what you are waiting on, including the result that has not come back and the call you have not had returned. Everything else can be read; those three have to be said.
How long a nursing report takes, honestly
Two to four minutes a patient, which is where a five patient assignment gets its fifteen to twenty minutes. It is real shift time and it is usually not counted anywhere, which is one reason shifts run over. Put your own per-patient handover figure into the free sheet on this site and it comes off the twelve hours along with the med passes, the assessments, the charting and the interruptions, so what is left is the honest number rather than the rostered one.
The three ways report goes wrong
It is given from memory, so what is not remembered is not handed over. It is given without a written sheet, which is where most of the information loss happens: the handoff sheet guide on this site sets that out with AHRQ's own retention figures. Or it is given as everything, in which case the alerts are in there somewhere and the listener has no way to find them. All three are fixed by the same thing: a sheet in front of both nurses, in a fixed order, with the alerts at the top.
Questions people ask about nursing report
What should a nurse to nurse report include?
Identity and location, the diagnosis in three words, the alerts that must not be missed, what has changed this shift, what is outstanding, and what you recommend the oncoming nurse does about it. Everything else is available in the chart and does not need to be spoken.
Should report be given at the bedside?
Many units require it, and it has real advantages: the patient can correct you, and the oncoming nurse sees them. It changes the sheet rather than replacing it, because what you say in front of a patient is not everything you need to hand over. Keep a line for what is discussed away from the bed.
How do I give report when I am running late?
Give alerts, changes and outstanding items for every patient before you give detail for any of them. A report that covers all five patients shallowly is safer than one that covers two thoroughly and three not at all, because it is the unmentioned patient who comes to harm.