“Transition in and between Discourse Communities: One Nurse’s Struggle”

by Terri Cole | Xchanges 9.2

Change of Shift and Genre of the SBARP

Sherwood Hospital’s change-of-shift report is known as the SBARP-Verbal Communication for Transfer of Care. Essentially, a change-of-shift report (or CoSR) is “information exchange” (Staggers and Jennings, 2009, p. 393) between caregivers; the information concerns the patient’s care and history and the exchange occurs between the nurse entering a shift and the nurse leaving a shift. Generally, this exchange is conducted by the nurse reading what he/she wrote on the CoSR and verbalizing what is written to the nurse entering the shift, who is then supposed to take notes on the information being represented.

Sherwood Hospital’s SBARP technically consists of six pages. The first page (front and back) is the one the nurse actually takes notes on and consists of nineteen sections. Each section consists of a heading with a small narrative space underneath contained by bold black lines. The additional five pages are called “Rounds,” which is basic patient information attached to each SBARP.

Although structure and delivery of the change-of-shift report varies from hospital to hospital, studies on the CoSR suggest overall concerns regarding communication and information validity. Scholars Staggers and Jennings (2009) and Anderson and Mangino (2006) document the multiple distractions from sounds of alarms, phones and conversations taking place around nurses trying to give report, as well as issues arising as a result of location. Nurses on Lena’s unit are supposed to deliver their report in the break room, which is directly near the secretaries and also consists of people eating/talking on their break, and others giving reports.

Even for experienced nurses, CoSRs can be frustrating due to myriad distractions and because of the lack of structure and content. Athwal, Fields and Wagnall (2009) describe shift reports as “problematic because the lack of structure lent itself to storytelling about the events of the shift. To compound the situation, each oncoming nurse had a different way and speed of writing down information. Experienced nurses also verbalized frustration with the new nurses because they did not know what was important to present in report or what was important to write down when receiving report” (p. 144).