Collaborating with HCP: SBAR Report – Stroke Nursing Care in ER

00:01 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.

00:24 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.

01:01 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.

01:10 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.

01:18 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.

01:34 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.

01:57 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.

02:23 I have…" what I've done. Well, for him, "I've got him on the monitor.

02:27 He's still on atrial fib. I have him on oxygen.

02:31 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.

02:39 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.

02:57 Now, the recommendation is, "I need you to…" is okay to say.

03:02 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.

03:47 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, background, assessment, 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.