NURSING ROUNDS

A small group of the staff members, not more than five and a leader or

teacher visit, the bedside of clients. Nursing superintendents, ward sisters taking

rounds of the hospital wards. It helps the nursing members know about all the

patients in the wards, their problems and ways of solving. It is an extension of the

clinic method.

PROCEDURE FOR CONDUCTING NURSING ROUNDS:

1. Students have to be given information about ward rounds, so that, it will

help them, to prepare themselves for the learning experience.

2. Students will be following nursing rounds, the clinical instructor or ward

supervisor will stop briefly at the bedside of each patient for a short

discussion of the most significant nursing problem.

3. The instructor may instruct any nurse in the group to tell what she knows

about the client and his nursing care.

4. The student who is taking care of the patient for a week or so, he has to

present the case to the total group of the students so that all the students

will be aware about the case and its total condition. If any cardinal

manifestations are identified, with the client’s permission they can

 demonstrate to the total group. The presentation of the background

information is followed by additions and suggestions from the group.

5. Case presentation should be short and relate to only to problem or

situation of immediate interest.

6. The contents to be discussed in nursing rounds are carefully selected,

well organized, clearly and interesting presented, for each client only 3to

4 minutes have to be spent.

TYPES:

A. Giving the transfer report at the change of shift.

B. One used to acquaint the staff with all patients on the division for better

understanding and more purposeful care may be achieved for each patient.

PURPOSES:

a. To demonstrate important clinical manifestation in clients.

b. To clarify terminology used and studied.

c. To compare client’s reaction to disease.

d. To demonstrate the effects of drugs.

 e. To illustrate skillful nursing care.

f. To compare methods of meeting the needs.

g. To illustrate successful improvisation.

h. Rounds are useful in situations, where assignments are made to provide

continuity of care.

i. Instructional purposes for student nurses.

j. To learn about disease, pattern of care, treatment.

k. To acquaint nurses with all patients. Nursing rounds purpose should be

explained to all the students and they are directed towards the improvement

of nursing ability.

l. The client should always be introduced to the group, encourage question and

comments with almost consideration for the feelings of client.

At the completion of nursing rounds all the staff members should meet in the

conference for summary and further explanation.

DISADVANTAGES:

a. Requires very careful planning.

 b. A small group of students, can be taken at a time.

In the hospital nursing rounds is mainly concerned with judging the

adequacy of nursing care received by the patients and it is conducted under the

leadership of senior nurses or nurse administrators with the active participation of

nursing teachers, staff nurses and nursing students.

As a clinical teaching method, nursing rounds is a modified compact version

of the bedside clinic. In bedside clinic, a detailed discussion regarding the nursing

care of a single patient is carried out by taking 30 to 40 minutes, where as in

nursing rounds only a few minutes is spend with each patient. In short, nursing

rounds is intended to discuss briefly the nursing management of all patients in the

ward by sparing few minutes for each patient. The ideal duration of nursing rounds

in a ward is 43 minutes and the time is sufficient to know all patients in the ward.

The patients dignity have to be preserved throughout the rounds. The time of the

rounds should be informed to the students if there is no stipulated time for daily

rounds.

In nursing rounds, the nursing teacher or head nurse who knows the details

of the patient briefs the nursing care. The staff nurse or the nursing student who

has been taking care of the patient for a few days are allowed to contribute some

genuine points and have to answer the questions of the group. The group then
discuss the nursing care aspects in brief and the senior nursing personnel in the

group or the nurse administrator concludes the discussion by giving some opinions,

needed guidance and instructions. One staff nurse records all the instructions and

suggestions given by the administrator in the nursing rounds register maintained in

the ward. Then the group move towards the next patient. Group members have to

encourage students for actively participating in the discussion. Nursing rounds

focus mainly on the nursing care and in the nursing care only the cardinal aspects

are discussed. For instance , the importance of maintaining an intake output chart

in the case of a patient receiving diuretics is highlighted. In the same manner, the

necessity of accurate assessment and recording of the pulse rate is stressed in the

case of a patient receiving digoxin.

Demonstration of nursing care by senior members during the nursing rounds

will help students to develop psychomotor skills and inculcate proper attitude

among them. By attending nursing rounds, students are motivated to learn more

about the nursing management of patient in the ward by referring related literature

and through discussion with experts. Moreover, interaction with senior members

promotes team spirit and professionalism.

The authors believe that the unique feature of nursing rounds is its ability to

nurture the discriminating power of students. Through nursing rounds, students

develop an ability to discriminate or classify the patients into high risk, risk and no
risk categories depending on the severity of illness. When students are assigned to

a number of patients at a time or when they become staff nurses, this

discriminating power will help them to identify patients who required constant or

immediate attention.