Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)
The Call That Gets Them There
You have completed your ABCDE assessment.
Your NEWS2 score is 7. The patient is deteriorating.
You pick up the phone and call the registrar on call.
Hi, sorry to bother you — I have a patient here who is not doing very well. Could you come and have a look when you get a chance?
The registrar does not come for forty minutes.
And the panel scores you as a safety risk.
Here is what happened: you made a call. But you did not make an escalation.
SBAR is the NHS's mandated structured communication tool for clinical escalation.
SBAR stands for: S — Situation: Who you are, who the patient is, and what is happening right now. B — Background: Relevant clinical history, diagnosis, current medications, recent observations. A — Assessment: Your clinical assessment — including your NEWS2 score and your working hypothesis. R — Recommendation: What you are asking the receiving clinician to do — and your expected timeframe.
The R is where most candidates underperform. They state the situation and the assessment — and then ask a vague question. What do you think I should do? or Do you think you could come?
A high-scoring SBAR ends with a clear, confident, clinical recommendation — not a question.
Here is a complete SBAR script for the deteriorating patient scenario:
S: This is [your name], staff nurse on [ward name]. I am calling about [patient name], date of birth [DOB], in Bay 3. I am concerned about this patient — they have acutely deteriorated in the last 30 minutes.
B: This is a 67-year-old patient admitted two days ago with community-acquired pneumonia, currently on IV amoxicillin and oral clarithromycin. They have a background of COPD and hypertension. An hour ago their observations were within normal limits.
A: Current observations: respiratory rate 25 — scoring 3 on NEWS2 — oxygen saturation 91% on 4 liters via nasal cannula — scoring 2 — heart rate 112 — scoring 1 — systolic BP 95 — scoring 2 — new confusion on ACVPU — scoring 3. Total NEWS2 score is 11. I have applied high-flow oxygen, established IV access, and taken bloods including blood cultures. I am concerned this patient may be developing sepsis secondary to their pneumonia.
R: I am recommending urgent review within the next 10 minutes. Based on this patient's NEWS2 score of 11, I believe they may need escalation to HDU and I want your clinical assessment before their condition deteriorates further.
That SBAR does four things simultaneously: it gives the doctor everything they need to prioritize this call, it demonstrates your clinical reasoning, it evidences your knowledge of the sepsis pathway, and it positions you as a confident clinical leader.
That is what the panel is scoring. Not the call. The quality of the communication.
Need the SBAR Command Script DM me "SBAR" directly
Post 4 arrives at 2:00 PM
#SBAR #NHSInterview2026 #ClinicalCommunication #PatientSafety #EscalationProtocol #Band5NHS #Band6NHS
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