Okay. This part is going to be
fun because it's your
chance to practice. What I'm going to
do is to introduce you to what
SBAR means. Now, you may already
be familiar with SBAR, so good,
you're already a pro. But for the rest of
us, if it's new to you, I want you to
understand that this is a really quick tool,
a good tool for you to have in your
pocket when you're going to talk
to health care providers.
Whether you're calling them on the
phone or talking to them face-to-face,
we know that time is tissue. So, the
more effectively and
efficiently you communicate what
the problems are with the patient,
you're going to help them get treatment
quicker. Okay. So, S stands for situation,
B stands for background, A
stands for assessment,
and R stands for your recommendation. Okay.
Things I would say in situation I would
introduce myself. Now, in ER, you probably
know the physician. You'll be talking
to them face-to-face, but even in ER,
you sometimes call a
primary care physician who's
not physically in the ER.
So you want to introduce yourself, you want
to let them know who you're calling about
by using the patient's full name, and let
them know why you're calling. That's it.
Now, let's move on to background. Now,
you let them know the patient was
admitted at what time or what date
and what their diagnosis was.
Let them know what operation or
procedure they've had. Well,
we haven't had any yet, have we?
But his condition has changed
in the last number of minutes. You want
to let them know what the last set of
observations or vitals were, and the
patient's normal condition.
Okay. If I'm going to do the background for
Mr. Johnson, I'm going to let him know that
what time they came to the unit. We haven't
had any procedures yet, right?
We know if there's any changes in his condition
from when the ambulance people
brought him and to now, to my assessment.
I'm going to give him the last set
of vitals, temperature, pulse, respiration,
and what heart rhythm he's in.
I'm going to let them know what's different
now. He normally doesn't have any speech,
and he had equal strength in both sides.
Now we know that he's got a
different type of problem. Now I'm going
to offer a solution. See, it's
okay for you here to say, "I think
the problem is…"
because if -- with Mr. Johnson, I would say,
"I think he's having some type and event."
He'd be either having a TIA or
he's having a stroke.
I have…" what I've done. Well, for him,
"I've got him on the monitor.
He's still on atrial fib. I have
him on oxygen.
I'm not exactly sure what the problem
is, but I am uncomfortable with
what I'm assessing." So, those are
common things that you can say.
You're offering up to the physician,
this is the piece of the assessment
I'm concerned about. What I would probably
be most concerned about with
Mr. Johnson is his weakness. Yeah. I'm really
concerned about that right-sided
weakness, his difficulty with speaking, and it
seems to be he's becoming more confused.
Now, the recommendation is, "I need
you to…" is okay to say.
You might say, "Please come and see the
patient in the next few minutes."
Those are just some options for you. And
then you can follow up with, "Is there
anything you want me to do in the meantime?"
Okay. Now, if I'm in ER,
and I've done my job of always
communicating to the physician
efficiently and effectively, and
we have a trust built up,
this physician likely won't even go in and
see the patient. They'll just say,
"Hey, go ahead and get him a CAT scan.
If you're seeing this and this,
you think it's a stroke, let's get him right
now a CAT scan or an MRI of the head."
See, that's the super cool part when
you're used to working on a team,
things can happen very quickly. The physician
knows that you know how to assess a
patient. They'll take your information,
and they'll order the next step.
So that's what SBAR is. Now,
what I want you to do
is to pause the video, and I want you
to practice being the ER nurse
talking to the physician. So, don't skip this
step because it doesn't have to be scary
talking to a physician. In fact, physicians
will like to talk to you
when you're bringing them useful
information. So pause the video
and walk back through situation,
and recommendation of Mr. Johnson.
Be sure to use his vital signs
and what you've observed in his neuro
assessment that you did,
and be very clear and specific. Practice
saying the whole thing out loud.