SBAR handover, prioritisation, teamwork, supervision
SBAR exam question:
Situation — what is happening now · Background — relevant history · Assessment — your clinical judgement · Recommendation — what you want the clinician to do
When multiple patients deteriorate simultaneously: assess in order — Airway → Breathing → Circulation → Disability → Exposure. Address the most life-threatening problem first.
Registered Nurse · Doctor · Physiotherapist · Occupational therapist · Dietitian · Social worker · Pharmacist · Speech and language therapist · Psychologist. Each has a distinct, non-overlapping scope.
Structured support for newly registered nurses, typically 6–12 months. Preceptor is an experienced nurse — not a line manager. It is not the same as mentorship or supervision.
Regular, structured reflection with a supervisor. Not managerial appraisal. Aims to improve practice quality and support wellbeing. All nurses should have access to clinical supervision.
No mandatory nurse-to-patient ratio exists in England (unlike Scotland and Wales). However, the NMC Code requires you to escalate in writing if you believe staffing is unsafe and patients are at risk.
Records must be: accurate, factual, contemporaneous (written as soon as possible), signed and dated, legible, free from abbreviations unless approved, stored securely.
Concern → Line nurse in charge → Senior nurse/ward manager → Nurse Practitioner/Doctor → Consultant → Medical Director. At each step, document that you escalated and the response received.