you just come out of the scenario how you feeling
it was quite stressful initially it's quite a new thing for us to go through but
actually now I've done it I'm feeling pretty good actually I thought we did quite well between us really yeah yeah
Yeah yeah I feel ok actually it was better than I expected
so just take me back into the beginning of the scenario and just trying to explain to me what was actually happening.
okay so the scenario I've been given was that my patient was a young lady called Lucy who'd come into the ward
very recently and I was just sort of tasked with going to do a basic assessment
so I introduced myself we sort of had a little chat and explored some of her
concerns and while we were doing that I was going through my A to E assessment and I was trying to be
i was trying to be as systematic as possible to make sure that I caught all of the vital signs and
all of the kinda clinical cues and then
As sort of that progressed I started to have concerns that the things she was
describing the discomfort in her chest
the racing heart coupled with her observations so her blood pressure and
her heart rate were all giving me indications that maybe this was
something that was coming from a problem with her heart
which is when I thought it was best to escalate to Laura who was sort of
My doctor in a scenario
and try and get her assistance to treat what I thought might be a deteriorating problem
do you want just talk me through that phone call then that you had with the doctor
yeah I mean we watched it back on the video and
when I watched my my sort of a handover there on the video I don't think it was as good as it could have been
I think I was quite I was quite a stressed when I made that first phone call
I wanted to get the doctor to the ward as soon as possible so we could start some sensible treatment
and I don't think I'd really taken enough time
to organise my thoughts so that I think what I handed over to you on the telephone
was missing a lot of details maybe not as organise and I don't think I headlined
my concerns soon enough I think my kind of worries and concerns
came towards the end of the phone call
whereas maybe if I was gonna really get
Laura to sort of share my concerns I may be needed to express that early on and then back it up with some sort of hard
evidence from the observations that I collected
So from your point of view Laura what was that phone call like
yeah so I agree with you in some ways I think Paul
I think at the end of the phone call I got that you were concerned about your patient and you wanted me to come
and you told me what her EWS was and that it was five
which is a good thing to do but sometimes it's useful to know why you're scoring a five why the patient's scoring
and what on the specifics because that
might have helped me prioritise a little bit more
but I knew I knew that you wanted me with some urgency yeah but I didn't really know what I was coming into
I mean I really appreciated that Laura got to the ward as quickly as she did
I completely take your point it's really valid that actually I I don't think without those details without sort of
sharing the things that were making me think this was a cardiac issue
I don't think I really gave you an opportunity to sort of share my mental model
so I don't think I prepared you kind of for the patient you were going to face
as effectively as I could have done but
I think hopefully by the time you'd arrived on the ward I've had a little bit more time to think
organise my thoughts on the handover
and actually the bedside handover we did I felt a lot more and comfortable and confident with
yeah I felt a lot better when I got there you I thought you gave me a really good handover
actually it was really really thorough
thank you
and it was more that I just wanted to double check a couple of bits
because in my head I was trying to fill
in my A to E and it was just checking things
because I think from what you showed us on the video I had to I had to check
again about the temperature and the BM
because I couldn't retain that information
so yeah it gave me a really good idea of what I thought we were dealing with
and actually what we could then do about the situation
yeah I think by the time you arrived but I was ready
to give that sort of SBAR structured handover which and maybe could have
could have utilised in the phone call
yeah so that the SBAR would have been useful in the phone call but I think we
had it by the time Laura arrived
so from my point of view watching that scenario
A couple of things that I really picked
Up on you had some really good closed loop communication especially
after you had your handover so Laura you were asking Paul to do to get the GTN spray
and also to do the EC the 12 lead ECG
and you very clear on trying to confirm when you wanted that when Laura wanted that information back
so that was a really good example of how making sure that you
close that loop and that communication and everybody is on the same page of
what people have been expected to do so that's all that was really good
I thought the delegation from Laura was really clear there and
I kind of felt like when when she was kind of
giving me those instructions she really appreciated kind of been shared my idea this was probably something cardiac
so I felt that she kind of was on the same page with me at that point
and all I needed it really was just a bit of clarity
on which of the two sort of vital tasks she would like me to do first because I
knew the ECG was going to be important in terms of kind of furthering the
diagnosis but I also appreciate that the GTN was gonna be really helpful and
Making Lucy feel more comfortable and and ameliorating her symptoms so I just
Needed that little bit of clarity but other than that all the delegation really really very clear
so as a take-home learning point what would you take away from this
I think it's difficult isn't it when you're in a
stressful situation and it feels like there's no time and that everything's
rushed and everything feels like there is a thousand jobs to do and no time to do any of them
but I think actually watching the video it would have
benefited us so much if I just taken a few seconds to organise my thoughts
maybe utilise one of the SBAR sheets that we have on the ward just to
kind of get that handover down before I made the phone call it would
have maybe made Laura’s job easier when she arrived on the ward I think
that would be my take home from this really
anything from your point of view Laura
Yeah I think it's if I receive that phone call and it’s I don't
have the information that I want it's about asking for that so I could have
asked you on the first phone call you said you the EWS was five can
can you tell me what's making them score a five that would have helped me more as
well and that might have even prompted
you to give me more information
possibly yeah yeah
lovely thank you very much thank you thanks very much
Thank you