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Why is nurse physician communication important?
- Patient Safety
- Job Satiation
- Job Stress
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Central elements of communication
- Mutual Trust
- Respect
- Shared Decision making responsibilities
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How can nurses improve nurse/physician relationships?
- Nurses must be able to approach physicians as equal professional colleagues
- Collegial
- respectful
- problem solving manner: nurse must assume responsibility for the quality of relationships with physicians
- Team strategy
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Empowering nurses are:
- secure in their knowledge and clincal expertise
- up to date with advances in their specialty
- Continuing education
- specialty certification
- professional organizations
- go to conferences
- informal collaborative work groups
- Serve on interdisciplinary committees: Nurses who take pride in their expertise
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Stereotypes are rapidly changing from
- hierarchiacial to autonomous
- team approach
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How to approach a physician
- Topic: appropriate for physician, appropriate question/discussion
- timing
- SBAR
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SBAR is:
- Situation
- Background
- Assessment
- Recommendation
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Situation (SBAR)
- Describe current situation using concise factual descriptions.
- Change in conditions, vital signs
- Abnormal lab values
- patient falls
- medication reaction
- blood transfusion reaction
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Background (SBAR)
- Provide supporting background information leading to the current event
- Admission diagnosis
- Recent vitals
- Recent lab values
- recent results
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Assessment (SBAR)
- Sate your interpretation of the situation
- Use critical thinking to analyze the situation
- use correct medical terminology
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Recommendation (SBAR)
- Give your recommendation for follow up or treatment
- Medications
- Treatments
- Test education
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Where is SBAR used?
- Shift report
- Calling MDs
- Documentation
- Transport reports
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Scenario
•Mrs..
Anne Smith
•82 years old
•Admitted from home
•Diagnosis pneumonia
•Over the last hours she has become SOB with a respiratory rate of 32. Her SpO2 (on 2 L
of O2) has dropped from 96% to 88%
- S = Situation: Dr.Green, This is Mary Jones from Five West. I am calling you about Anne Smith. Are you familiar with the patient? She is SOB with a resp. rate of 32 and an O2 sat. of 86 on 2L. I have placed her on a non-rebreather mask and her sats are now 94%.
- B=Background: She is 82 y.o., Full code, Admitted to the hospital yesterday with pneumonia, She has received 2 does of Levaquin since admit, Her VS10 minutes ago were 36.5, 75, 22, 138/60 and 95% on 2L.
- A=Assessment: I believe she is developing respiratory failure
- R=Recommendation: I would like to an order for a chest x-ray, ABGs and an Albuterol nebulizer treatment.
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