## 3 Findings
### Barriers Hindering Patient and Family Involvement in Bedside Handover
#### 3.3.2 Nursing Barriers  
_Not at bedside_: Patients mentioned that nurses often conducted their handovers either on the other side of the curtains or in the doorway, where patients could overhear the discussions but could not participate as they were not nearby. _Well, I suppose the fact that they didn't come in.... You could hear them doing that. I was in a room where it was a four-person room. And yeah, sometimes you would hear them and transferring information.... sometimes then after they've done that, they would come and see you pretty soon afterwards, but sometimes they didn't come and see you until it was time.... half the time this happened when the curtains were closed, and they would be the other side of the curtain. So, you couldn't see them, you could just hear them discussing you. I think it would be better if they, when they were doing that, if they came in next to your bed.... It would be nice to have participated better because when they're outside the curtain you couldn't saw, shout and ask questions. I mean, I would have had to have got out of bed, got up and spoken to them, or if they came in and were next to me. I could. Then it would then be easier to ask questions._ (Patient 14)  
_Always in the doorway. If they're not really in the room, how can you participate? There was rarely that I got to hand over in the room.... I'd be lying down or sitting up and there'd be a new face like that--I am not being introduced to them or anything like that.... and they weren't in the room._ (Patient 15)  
Patients expressed a preference for nurses to discuss their care in their presence rather than in the hallway or on the other side of a curtain. Patients felt that it was unprofessional for the nurses to conduct handovers in the hallway, which could potentially breach their privacy and confidentiality. However, they did not share the same level of apprehension when the handover occurred at the bedside in a shared room, where other patients and visitors might overhear sensitive information. They acknowledged that ensuring patient confidentiality in a hospital setting, especially in shared wards, was challenging. Despite efforts to respect privacy, the nature of shared wards meant that patients inevitably heard doctors discussing others' medical conditions during rounds. Yet, they thought that the hospital was a private place. _... If I could hear what they were saying about the people in the room next door to me, then probably the people in the room next door to me could hear what they were saying about me.... It just wasn't anything to really be overly concerned about, except that it's not really good for them to have those sorts of discussions where other people can hear, you know.... it wasn't violet speech, but it was a sort of a partial effort to not talk too loud... so, it just did come across as being unprofessional.... I just would have been quite comfortable coming in at that discussion in front of me so I could hear so well. It's like, what's the secret? It's about my care... [so] come in and share because there's something going on I'd like to know about it,... just have that discussion here._ (Patient 18)  
_When you're in a shared room, there is really no privacy, because the curtain doesn't block the sound, so everyone else in that room knows exactly what's going on. But I don't think it matters whether it's on one side of the curtain or the other. Everyone else in that room is gonna hear anyway. I feel like a little bit private, but you know the person next to you that you have all heard how many times you've gone to the toilet. So, I hear that whether they're doing outdoor or just next to the curtain, people will hear it anyway, but [I] prefer they do the same thing next to my bed._ (Patient 20)  
Patients believed that while patient information should be respected in a hospital setting, there should not be unnecessary secrecy, and medical staff could perform theird duties transparently. Their preference remained for the handover to take place in front of them with their active involvement.