Supporting nurses in acute and emergency care settings to speak up
Intended for healthcare professionals
Evidence and practice    

Supporting nurses in acute and emergency care settings to speak up

Binx Clarke-Romain Sister, emergency department, Royal London Hospital, Barts Health NHS Trust, London, England

Why you should read this article:
  • To recognise the importance of speaking up in emergency care settings to enhance patient safety

  • To be aware of the barriers that can prevent nurses from speaking up

  • To enhance your knowledge of structured assessment and communication frameworks that can support nurses to speak up

Nurses’ competence and confidence in raising concerns with senior clinicians is integral to patient safety and the quality of patient care. If nurses do not speak up when needed it can contribute to incidences of failure to rescue. There are many barriers to nurses speaking up in busy emergency departments and complex major trauma patient cases. Assessment and communication tools such as the SBAR (situation, background, assessment, recommendation) approach and communication techniques such as graded assertiveness can help to overcome some of these barriers. This article uses a case study to discuss how nurses can respectfully but efficiently escalate their concerns to the trauma team leader. It describes barriers to nurses speaking up and tools that can support nurses to speak up, with a focus on graded assertiveness.

Emergency Nurse. doi: 10.7748/en.2023.e2162

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software


Conflict of interest

None declared

Clarke-Romain B (2023) Supporting nurses in acute and emergency care settings to speak up. Emergency Nurse. doi: 10.7748/en.2023.e2162

Published online: 19 September 2023

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