SBAR Nursing Communication Foley Follies (Video Explanation).

What is SBAR?  SBAR nursing communication is one popular method of transferring patient care information between physicians and other healthcare professionals.  Frequently taught to nurses, SBAR stands for Situation, Background, Assessment, Recommendation.   SBAR nursing techniques are easy to learn and easy to implement.  This communication method is highly respected by doctors, nurses and patients as a way to verify that vital information is being shared between hospital team members.  Hour after hour, day after day, month after month, year after year, SBAR has proven itself to be the preferred communication method of choice.  SBAR communication techniques help foster a culture of safety in a very dangerous hospital environment.   Nurses love it because they use the process to fill vast amounts of free time during their shift.  Hospitalists and other physicians love it because it interrupts their busy workflow to divert their complete and undivided attention toward 13 minute patient care presentations.  Patients love it because they...  Just.  Don't.  Know.  Any.  Better.

In an effort to make an already unbelievably awesome nursing documentation and handoff tool even better, I am recommending all hospitals implement my modified SBAR approach immediately. It's called SBARTS and it's fantastic.  That's right folks, since SBAR is amazing, SBARTS promises to turn daily communication between nurses and doctors into one giant Happy Hospital.  SBARTS stands for:

• Situation
• Identify the person to whom you are speaking.
• Identify yourself, occupation and where you are calling from.
• Identify the patient by name, date of birth, age, sex, reason for admission.
• Identify what is going on with the patient.
• Background
• Give the patient's presenting complaint.
• Give the patient's relevant past medical history.
• Brief summary of background.
• Assessment
• Vital signs.
• List if any vital signs that are outside of parameters; what is your clinical impression.
• Severity of patient, additional concern.
• Recommendation
• Explanation of what you require, how urgent and when action needs to be taken.
• Make suggestions of what action is to be taken.
• Clarify what action you expect to be taken.
• Ten
• A number right before 11 and right after 9.
• As in, the patient has 12/10 pain.  
• Seconds
• 1/60 of a minute.  In other words.  A very short period of time.
• As in, this will just take ten seconds. 

From here on out, I implore all hospitals to please consider using Happy's modified 10 second SBARTS nursing communication process.  Otherwise, you may, as a patient, doctor or nurse, find yourself in the middle of a raging case of SBAR nursing follies.  Er, I mean Foleys!  Please enjoy this Happy Hospitalist original GoAnimate movie about the unappreciated and unintended consequences and dangers of aggressive SBAR.  Happy's SBART could have fixed this.  If only I had gotten to them sooner, all this nonsense could have all been avoided.  In this video, by the book new nurse graduate SBAR nursing techniques failed to pick up on surrounding patient and doctor distress signals with devastating consequences.  And by devastating, I mean bad patient satisfaction scores, also known as:  The Only Thing That Matters These Days.

Here is a scene by scene transcript of the video:

Patient: Help me! Help me! I can't Pee! I need a Foley now! Nurse! Nurse! Please help me!
Nurse: NOBODY makes it through my shift without peeing!
Nurse:  Must.  Call.  Doctor.  Stat!
Doctor:  I think I hear my phone ringing.
Doctor:  What could they possibly want at 2:00 in the morning?
Doctor:  This is Dr.  Just Say What You Need Now.
Nurse: Thank you doctor Just Say What You Need Now. Is this Dr. Just Say What You Need Now?
Doctor:  *standing*
Doctor:  *golfing*
Nurse: Hello? Is this Dr Just Say What You Need Now? Please answer. I cannot move forward with my SBAR script without a response.
Patient:  Please hurry!  The pain is unbearable!
Doctor:  Just Say What You Need Now.
Nurse: Great then. This is nurse Page It. I'm calling from the low pain threshold floor. I have Mr. SBAR Tragedy. He has 22 grandkids and he likes gladiator movies. Do you remember?
Patient: Nurse! Nurse! It's hurting bad! Hurry! Hurry! I need a catheter now!
Doctor:  *weeping*
Nurse: Doctor? Just Say What You Need Now? Are you listening to me? Hello? Hello?
Doctor:  *baffled*
Nurse: I'm calling about Mr SBAR Tragedy. You remember him? He's the white haired man with the large belly in room 12. He also had that skin cancer removed from his ear in 1958.
Doctor:  *losing it*
Nurse: He also had bunion surgery 14 years ago and he uses a walker. CBS is his favorite television station. Does not any of this help you remember him?
Doctor:  *put a fork in him*
Nurse: He's the one with the problems peeing. Does none of this ring a bell doctor? Doctor? Doctor? Are you still there?
Doctor:  *he's done*
Nurse: I am worried, doctor. Very worried. Mr SBAR Tragedy is having severe pain and I need a Foley catheter stat!
Doctor: Why!  Didn't!  You!  Just!  Ask!  Stick a foley in it. We're done here!
Patient:  What!  Friggin!  Took!  So!  Long!
Administrator: I got a complaint in the mail today from Mr SBAR tragedy. The ONLY explanation I can come up with is a failure to AIDET.  His.  Ass.



If urine for some more good humor, check out these Happy Hospitalist original crude medical ecards:

"If I don't make it to your room before you pee all over the floor, it's because I was filling out a form to have the cleaning lady clean the pee off your floor."

"Communication is vital in hospital care.  And by vital, I mean vital signs.  Vital signs are to doctors like lunch breaks are to nurses.  Really important."

"Try giving me a verbal order again and I will SBAR your ass into submission."

"We really do tell nurses to page us out of your room when you think you have a right to more than five minutes of our time."

This post is for entertainment purposes only and likely contains humor only understood by those in a healthcare profession. Read at your own risk.  If you are offended, learn my SBARTS method instead, then come back and I guarantee you'll laugh your ass off. 

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