Career advice

Communication: What to do in a crisis

In the second article of a three-part series, health coach Mandy Day-Calder explains how a structured approach to communicating in a crisis can help avoid errors

In the second article of a three-part series, health coach Mandy Day-Calder explains how a structured approach to communicating in a crisis can help avoid errors


Picture: iStock

You probably start most shifts with a work plan based on priorities and available resources. But humans are complicated – sometimes patients’ treatments go according to plan, sometimes they don’t.

The ability to remain calm and communicate well when things go wrong is as quintessential to nursing as a caring nature, but it isn’t always easy. Instead, panic can overtake rational thinking, and what you say or do in haste may not always be what’s best for your patients.

Dealing with any kind of crisis is stressful and this multiplies when someone’s life is potentially in danger. Regardless of how many critical situations you have faced before, the adrenaline surge will set your heart thumping and your mind buzzing.

Focus, clarify

You need to be able to think on your feet, remain focused and communicate quickly with colleagues as well as patients and their relatives.

To avoid any risk of clinical information being missed or misinterpreted it can be useful to follow a structured approach to communicating during a crisis.

A tool called SBAR is a good example. It was originally developed by the US military and is now used in many UK healthcare settings to enhance patient safety. It has been shown to benefit the sender of information as well as those receiving it.

Here’s how it works

  • Situation – Identify what is happening with the patient or on the ward that is a cause for concern. Be concise and stick to facts. If you are talking on the phone state your name and role as well as the patient’s name and date of birth.
  • Background – What is the relevant clinical information? You don’t need to give a detailed medical history, just state what the patient’s presenting condition is and what has led to the current situation, such as recent treatments, results, allergies or observations.
  • Assessment – What do you think the current problem is and why? Give your rationale.
  • Recommendation – What do you think is needed to correct the situation? Be as specific as you can. Do you require anything from the person you are talking to? If so, state what you want to happen and when.

Learn the process

SBAR can be used in a variety of situations and settings, such as in wards, clinics, multi-disciplinary meetings and when communicating with external agencies.

It can help to formulate your thinking, help you feel more prepared and thus reduce anxiety about how you may react in a critical situation. Yet as with any skill it takes practice.

Adopting this approach in ward handovers can be a good way to help you and your colleagues become familiar with the process. If you do find yourself becoming tongue-tied or going off at a tangent, stop, take a deep breath and then simply go back and recap the points you need to get across.


Mandy Day-Calder is a freelance writer and life/health coach

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