SBAR + Nursing

When I first began my nursing career, I was terrified to call/speak to the doctors. I felt inferior to them. Not because I had a negative situation with one, but because I was not confident in the knowledge that I gained in nursing school.


I just kept asking myself how could I call a doctor when I did not even know why my patient was receiving Arimidex. 

During my orientation, I wanted to give up. I found every excuse to not call the doctor. I would ask my preceptor to call for me while I went and gave a pain medication. OR I would tell myself that this could wait until the doctor would round knowing that I had no idea when that would even be. I let my fear stop me from becoming a strong and confident nurse. 

Over time it did get easier... maybe it was from building relationships with the doctor or maybe it was because I never gave up studying and continuing to learn about my patient population. One thing I have learned that made it easier to communicate with doctors was actually using SBAR. Now when I learned SBAR in nursing school, I sort of found it challenging and a "joke". At the time, I did not understand how useful it is in providing organized and concise information. Now I use it on a daily basis to communicate to a number of medical professionals.

SBAR is easily broken down to situation, background, assessment, and recommendation.  Here is an example of how I use it in practice:

(Situation) Hi Dr. John, this is Megan from 4t. I am calling regarding your patient in 42. (Assessment) Mrs. Jacobs was admitted for chemotherapy-induced nausea with metastatic breast cancer. (Situation) She currently takes Arimidex at home and her home medication reconciliation has not been completed. (Recommendation) Would you like to continue her home dose of 1 pill by mouth every morning? 

Doesn't seem simple when it is put together? Here is another example:

(Situation) Hi Dr. John, this is Megan from 4t. I am calling regarding your in 16. (Assessment) Mr. Clause was admitted for UTI from chronic indwelling foley on the 16th. (Situation) His morning labs revealed that his CRP is elevated and lactic came back at 2.0. His maximum temperature over the last 12 hours has been 100.3. (Recommendation) He currently does not have any fluids running, would you like to add IV hydration and repeat lactic in four hours?

Now you may not always know what to recommend or what the problem is with your patient and that is okay! You can always call the doctor and tell them what you see and say "I'm not sure what is going on. Would you like to come see the patient?". Most doctors appreciate you calling concerned and will not hesitate to order any labs/tests and come see their patients. Always trust your gut feeling! And when in doubt document that you called the doctor and inform the charge nurse of your concerns. You never know when you will have to call a Rapid Response Team. 

Hope this helps!