Handovers are virtually the only place where the nursing team alone gets together and discusses each patient who is on the ward. They have a critical organisational function, making sure that the oncoming shift of nurses knows what has been happening, what the main risks are, what new patients have been admitted, and what has to happen in the following shift.
However in their report of what has happened during the shift, they will often focus on exceptional behaviour. That is the behaviour of patients which is difficult to manage or which presents risks to the patient or others. As such, they may promote a negative perception of patients.
In order to balance that natural tendency, we suggest that something positive is said about each patient at the handover, and that when difficult behaviour is described, potential psychological explanations are also offered. This will promote the positive appreciation of patients and reduce the likelihood of further conflict.
When giving handover staff should say something positive about what each patient has been doing during the shift, or draw attention to some positive quality they have, or if this is not possible something positive about the way in which staff supported the patient (positive appreciation). In addition, if any difficult or disruptive behaviour is reported, a possible psychological understanding of the patient's behaviour must be offered. The document provided on ‘understanding patient behaviour’ will help in the construction of these psychological explanations.
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