Nurse Contributions to Daily Rounds

Models of rounding are different across institutions and nurses do not always participate or feel involved during daily rounds.

The purpose of this analysis was to examine nurses' contributions during family-centered rounds in a children's hospital.

This study is a secondary analysis of 50 video-recorded conversations between families of pediatric patients and clinicians during daily rounds in a Midwest children's hospital. Children were patients of one of the 4 participating medical teams: 2 general pediatric hospitalist services, the pulmonary service, or the hematology/oncology service. Data were analyzed using conversation analysis and content analysis. We identified and categorized the "action" of nurse utterances or what they were "doing" in the conversation.

Nurses contributed to daily rounds to accomplish a variety of actions. Although it was most common for nurses to provide information and assessments, nurses were also active in making recommendations and correcting information that was shared. Nurses also asked clarifying questions, either for themselves or on behalf of the family. However, when solicited to ask a general question or add information at the end of the conversation, nurses most often passed on the opportunity to participate, or at times, first denied having questions before asking a question or adding information.

Nurse contributions to daily rounds demonstrate that a normative role for nurses is to provide information or assessments, with limited question-asking. We also found that nurses displayed their role as an advocate by asking questions to the team on behalf of the family.