Communication in the Kenntnisprüfung

Before an operation, a patient says: “I don’t know how my husband will manage at home without me.” Which answer is active listening in the sense of paraphrasing?

• “Don’t worry, your husband is a grown-up and will manage.”
• “You’re worried about how your husband will cope at home on his own?”
• “Why are you worrying about that now? Better concentrate on the operation.”
• “I know that feeling, my mother had exactly the same fear before her operation.”

Explanation: When paraphrasing, the nurse reflects the statement back in her own words and so checks whether she has understood correctly – the patient feels taken seriously and can keep talking. Reassuring (“don’t worry”) seems friendly, but it trivialises the concern; why-questions and your own stories distract from the other person.

On the first postoperative day, a patient is newly confused, the respiratory rate is 28/min, SpO₂ 89 %. You call the doctor. How is your SBAR handover structured?

• First the history and course of the operation in detail, then the current values, at the end briefly name the problem
• Name the problem and vital signs, then immediately suggest a change in medication; the history is left out
• Your assessment and suspected diagnosis first, then the values and the history, without a request of your own
• Briefly name the problem, then the history, the assessment with current vital signs, and finally a specific request

Explanation: SBAR stands for Situation (who is calling, which patient it is about, what the problem is now), Background (relevant history, operation, medication), Assessment (current vital signs and observations with your own assessment, e.g. “I suspect his breathing is getting worse”) and Recommendation (a specific request, e.g. “Please come within the next 10 minutes”). Starting with the history wastes time and the urgency gets lost; without a clear request it remains open what should happen.