- Have information needed in front of you
- Have the information needed
- Chart open
- Patient’s name, allergies, current medications, history
- Be confident
- Practice before you call
- Listen to other nurses when they call
- You are with the patient and know when something is wrong
- Repeat any orders that are given
- Patient safety
- Introduction and what is going on?
- What is the concern?
- The history or why the patient is in the hospital?
- What is the concern?
- Does the provider need to come in?
- Is there something specific you want to ask for, like labs or EKG?
- Or just ask “what would you like me to do?
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell
In this lesson I am going to help you understand best ways to communicate with providers.
This can be the hardest and most stressful for new nurses or new nurses to the unit. I remember the first time I had to call a doctor and it was terrifying. I am going to give you some pointers to hopefully make it less stressful and make you successful in these conversations. There might be several reasons that you have to call a provider. Maybe there is a change in the patient’s status ot for different pain medications whatever it is the best thing you can do is have the information you need and be prepared. So way to be prepared are to have the chart open. You are going to be asked questions and you want to be prepared so have it open so you have the patient’s name, allergies, current medications, and history all easily accessible. Being confident is another important piece. They can tell when you are nervous and uneasy so be confident! You are a nurse and you are caring for a patient and now have a concern so you are advocating for that client. Be confident about it. Confidence will be easier with experience so don’t be afraid to practice the phone call. Run everything through your head that you need to say. When I was a new grad nurse I would listen to other nurses when they would call just see what worked best. Repeat any orders that are given. This is really important and is about patient safety. You could hear wrong or you’ve woken a doctor during the night who might not be thinking clearly so please repeat what ever order they have given even if its something simple. So “you want me to do an EKG and have the hospitalist read the results?” Simple but just as important to repeat as “Give 1 mg morphine IV now”. Let’s look at the SBAR mnemonic for communication. This can be used for nurse hand off but also for talking to the provider. It just helps keep your thoughts together and organized, which can take some of the stress away.
Ok so SBAR this is a great tool that can help you keep everything organized when talking to a provider. S is situation. This is where you can do the introduction and state if there is an imminent concern. So “Hey Dr. Smith this Miriam and Im taking care of Mr. Tuck” and if there was an immediate concern you would add that “Hey Dr. Smith this Miriam and Im taking care of Mr. Tuck who is having chest pain”. B is background. This is the history or why the patient is in the hospital. “Hey Dr. Smith this Miriam and Im taking care of Mr. Tuck who is having chest pain. He was admitted for hypertension and has been taking labetalol to control his blood pressures” Then A is assessment. What is the concern? In this case we have already said the concern because chest pain is an imminent concern but you could add any assessment you have done because of the chest pain. What is his current blood pressure and oxygen saturation. And R is recommendations-. Does the provider need to come in? Is there something specific you want to ask for, like labs or EKG? Or just ask “what would you like me to do? So for this scenario you would say “Hey Dr. Smith this Miriam and I’m taking care of Mr. Tuck who is having chest pain. He was admitted for hypertension and has been taking labetalol to control his blood pressures. His current blood pressure is 190/92 and oxygen saturation of 92% would you like me to give nitroglycerin, perform an EKG and come evaluate the patient?” This is scary, right? Something is going on with your patient and you also have to call and talk to a provider. The first time will be nerve racking but then you will get a good feel for how this best works and it will get easier.
Let’s review everything! When communicating with the provider it is important to be prepared. So this means have the chart open in front of you so that you have all the information you need. Be clear on which patient you are calling about so no room numbers, or only a diagnosis. Say the patient’s name and what they are there for. Be confident in your communication. And repeat any orders that are given to ensure you have heard correctly and to avoid any errors.
Practice using the SBAR tool and practice making these calls. It will help it go better and you feel better. Now, go out and be your best selves today. And, as always, happy nursing.