Esam 68 years old male patient, diagnosed with chronic Asthma, he is smoker (usually 20 cigarettes daily) for more than 40 years. He is obese (weight 117kg), hypertensive and diabetic patient also. He was admitted many times to the hospital for respiratory distress and breathing difficulties.

Esam is a handyman and working in private company as a truck driver, he is not well-educated (he completed primary school only), on assessment, we noticed that Esam has unhealthy life style (no regular exercise, eating “junk food” and smoker).

The nurse “Kate” assessed Mr. Esam on admission and noted “the patient is fear, anxious, restless and worried about his status. His facial expression indicated that, additionally, he is keeping ask me about his diagnostic test results.

Esam worried also about his family, his wife is sick at home, his older son left the school and start working to help him in the living cost. His daughters are studying at the school. He has many monthly bills (electricity, rent, school…. etc.) as said. His older daughter with him in the hospital and told her father “please dad; stop smoking, eat healthy food and do some exercise”. She is crying, looks worry and keep moving in the room.

The nurse informed Esam that the doctor is planning for bronchoscopy for him and he has to sign the consent form for the procedure. Esam asked many questions about the procedure (complications, management, cost and length of stay at hospital). The nurse “Kate” responded to him and said “you are asking too many questions, this is not my responsibility to answer you, once your doctor is coming; go and ask him, I am busy and have many patients to look after them, time is running and I must finish my tasks”.

By the end of nursing shift and during handoff, the patients repeated the same questions. The nurse “Kate” responded and said” I told you before, your doctor will answer you, how many times I should repeat that”. Another Nurse “Alia” said “don’t worry sir, once I finish the handoff, I will come and explain everything for you, calm down and don’t worry, it is an easy procedure and your doctor is expert”, she is smiling. Suddenly, the patient develops sever cough, tachypnea and low oxygen (hypoxia) and Alia is going to call the doctor after finish assessment using SBAR.

By the end of nursing shift and during handoff, the patients repeated the same questions. The nurse “Kate” responded and said” I told you before, your doctor will answer you, how many times I should repeat that”. Another Nurse “Alia” said “don’t worry sir, once I finish the handoff, I will come and explain everything for you, calm down and don’t worry, it is an easy procedure and your doctor is expert”, she is smiling. Suddenly, the patient develops sever cough, tachypnea and low oxygen (hypoxia) and Alia is going to call the doctor after finish assessment using SBAR.

1. The head nurse assigned you to look after Mr. Esam. Using the SBAR tool, and based on the above scenario, list 5 situations & 5 background data. a. List five situations data

b. List five background data

2. Based on the above scenario, discuss five nonverbal communication methods the nurse Kati used.

3. Discuss five communication errors the nurse “Kate” used in the above scenario.