148H
Building the bridge

What is The Change of Shift?

Why The Change of Shift? Why not have a name with the word ‘Nurse’ or ‘Nursing’?
The Change Of Shift is an all encompassing concept for the profession of nursing. Where we address our professional as well as personal challenges with each other.
For those unfamiliar with the change of shift, it’s exactly what it sounds like. It’s the end of one shift and the start of another. During that time the shift report is given, sometime referred to as ‘report’, ’sign out’ or the ‘handoff’:

 

The transfer of essential information and the responsibility for care of the patient from one health care provider to another is an integral component of communication in health care. This critical transfer point is known as a handoff..
…supports the transition of critical information and continuity of care and treatment.

… the effects of ineffective handoffs: adverse events and patient safety risk

But, this definition, while accurate and literal doesn’t tell the whole story. There is more that happens during the change of shift report. We as humans share personal information with each other, with coworkers.. we relate to each other.
Of course we do our jobs, but we also decompress when we ‘vent’ our frustrations. We not only vent about the shift we just completed, but through socialization we also ‘share our suffering’ about our professional and personal lives.
Lets face it, we have a life outside the walls of our employer.
The Change Of Shift is a changing of the guard. We’re passing on the torch. The next shift is now responsible for saving lives.
The Change Of Shift is a way of passing on the torch.. but also for figuring out how to survive our profession. We go ‘off topic’ we stay ‘on topic’… all during that moment. It’s a fluid event. And it takes place virtually anywhere.
And like I said before The Change of Shift is more than just conveying pertinent professional information.

…. other reported purposes of shift report include education, debriefing, socialization, planning and organization, enhancement of teamwork, supportive functions.

 

The irony? We as Nurses don’t receive formal didactic education, training or direction in conducting this oh-so important event.

…. only 8 percent of medical schools teach how to hand off patients in formal didactic session, creating a large educational gap in new professionals and persistence of traditional models
The intershift handoff is influenced by various factors, including the organizational culture. An organization that promotes open communication and allows all levels of personnel to ask questions and express concerns in a nonhierarchical fashion is congruent with an environment that promotes a culture of safety
Interestingly, one study reported novice nurses seeking information approached those seen as “less authoritarian.

The importance of facilitating communication is critical in promoting patient safety. The shift-to-shift handoff is a multifaceted activity. A poor shift report may contribute to an adverse outcome for a patient.

There are paradoxes in communication and handoffs, especially at shift changes. Many human factors play a role. Human factors (ergonomics) focus on behavior and interaction between human beings and their environment. Human factors engineering focuses on “how humans interact with the world around them and the application of that knowledge to the design of systems that are safe, efficient, and
comfortable.

The handoff poses numerous human factors engineering implications. From the perspective of patient safety, the primary purpose of the shift report or shift handoff is to convey essential patient care information, promote continuity of care to meet therapeutic goals, and assure the safe transfer of care of the patient to a qualified and competent nurse.

 

This is the essence of The Change of Shift and why I chose the name.

As a profession we have molded this moment, this event, into a coping mechanism and buffering tool. A tool that our profession has created both individually and collectively to ensure our patients are being taken care of but to also entrench self-reliance, self-preservation and good ole’ fashion survivability. Painted in the form of laughter, socialization and emotional strength.

Here is affirmation from the original creator of The Change of Shift explaining the chosen moniker:

[time stamp 18:50]

This is my website. This is my vision. This is my goal.
Welcome to The Change of Shift

Change of Shift-NEW11 copy

Cited article: http://www.ncbi.nlm.nih.gov/books/NBK2649/

 

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