| Course | NSG 123 Medical-Surgical Nursing I |
|---|---|
| Unit | Unit 7 |
| Paper type | SBAR handoff record |
| Length | About 840 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 123 Unit 7
A Shift Handoff and a 0130 Call, Written as They Were Said: One Day After Sigmoid Colectomy, With a Clear Request at the End of Each
Student Name
Department of Nursing, Herzing University
NSG 123: Medical-Surgical Nursing I
Instructor Name
February 27, 2026
A Shift Handoff and a 0130 Call, Written as They Were Said: One Day After Sigmoid Colectomy, With a Clear Request at the End of Each
Context
Day-shift nursing student (with the primary nurse present) hands over to the night nurse at 1900 on the first day after the composite dispatcher's laparoscopic sigmoid colectomy. Later, at 0130, the night nurse calls the covering surgical resident. The structure is the one taught in the course, situation, background, assessment, and recommendation, written as spoken (Haig et al., 2006).
The 1900 Handoff, as Said
Situation: "This is bed 9, the 58-year-old woman who had a laparoscopic sigmoid colectomy yesterday morning for complicated diverticulitis. She's stable, walking, and drinking, but her urine has been on the low side this afternoon and I want you to keep an eye on it."
Background: "She came in eight days ago with diverticulitis and an abscess; it was drained, then got blocked on day 3, and she didn't settle, so she went to surgery. The bowel was joined, no stoma. Drain came out in the operating room. No allergies. She takes lisinopril at home, which is on hold. Her potassium and magnesium were low earlier in the stay and were normal this morning."
Assessment: "Vitals at 1800: temp 37.6, heart rate 96, pressure 116 over 70, breathing 16, sats 95 on room air. Heart rate has crept up from the 80s this morning. Pain 3 at rest, 6 when she coughs, PCA used four times since noon. Abdomen soft, a bit more distended than at lunch, tender around the port sites. No flatus yet. Urine: 35 at 1500, 30 at 1600, 25 at 1700, 28 at 1800, clear but darker. She drank 900 mL today."
Recommendation: "Please check urine every hour for the next few hours. If it's under 30 for two more hours, or her heart rate goes over 100, I'd call surgery rather than wait for morning rounds. Her daughter is staying tonight and knows to call if she seems off."
Night nurse's reply: "Got it. Hourly urine, and call if under 30 twice more or heart rate over 100. Is there a fluid bolus order already?" Student: "No, just maintenance at 75 an hour." Night nurse: "Okay. I'll ask for one if it comes to that."
The 0130 Call, as Said
Situation: "Hi, this is the night nurse on the surgical floor about bed 9, day one after a laparoscopic sigmoid colectomy. I'm calling because her heart rate is 112 and her urine has been under 20 mL an hour for the last two hours, and I'm worried."
Background: "She had complicated diverticulitis with an abscess and had the bowel joined yesterday, no stoma. Home lisinopril on hold. Maintenance fluids at 75 an hour."
Assessment: "Heart rate went from 96 at 1800 to 104 at midnight to 112 now. Pressure 104 over 64. Temperature 38.1. Breathing 20. Urine 18 and 15 mL the last two hours. Her pain is 7 now and she says it's across the lower belly, not just at the ports. Abdomen more distended and tender below the navel. I'm concerned about a leak at the join or bleeding."
Recommendation: "I'd like you to come and assess her in the next 30 minutes. Can you also give me an order for a fluid bolus now, and labs, a blood count, lactate, and a basic panel, so they're back when you get here?"
Resident's reply: "Okay. Give 1 liter of lactated Ringer's over an hour, send a CBC, BMP, lactate, and blood cultures. I'm finishing in the emergency department and will be up in about 20 minutes. Call me back if her pressure drops below 90." Night nurse: "One liter LR over an hour, CBC, BMP, lactate, cultures, and call if systolic under 90. You'll be here in 20. Thank you."
Commentary
What worked in the handoff: the student named a single concern in the first sentence, gave the urine figures hour by hour instead of "on the low side," and set a specific trigger for calling. Structured handoff programs that include this kind of anticipatory guidance, what to watch and what to do if it happens, have been associated with fewer medical errors (Starmer et al., 2014).
What worked in the call: the nurse stated her concern as a concern ("I'm worried"), gave trends rather than single values, named the possibility she feared, and made two concrete requests with a time frame. The resident's read-back and a callback threshold closed the loop.
What could have been better: the handoff did not mention that pain spreading beyond the port sites would be a warning sign, although it was the most telling finding at 0130. Early signs of an anastomotic problem after bowel surgery include rising heart rate, fever, and worsening abdominal pain, and the enhanced recovery pathway expects these to be recognized early (Gustafsson et al., 2019). Adding one sentence about the pain pattern would have given the night nurse a second trigger. The patient is a composite.
References
Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., Rockall, T. A., Young-Fadok, T. M., Hill, A. G., Soop, M., de Boer, H. D., Urman, R. D., Chang, G. J., Fichera, A., Kessler, H., Grass, F., Whang, E. E., Fawcett, W. J., Carli, F., ... Ljungqvist, O. (2019). Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World Journal of Surgery, 43(3), 659-695. https://doi.org/10.1007/s00268-018-4844-y
Haig, K. M., Sutton, S., & Whittington, J. (2006). SBAR: A shared mental model for improving communication between clinicians. Joint Commission Journal on Quality and Patient Safety, 32(3), 167-175. https://doi.org/10.1016/S1553-7250(06)32022-3
Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., Noble, E. L., Tse, L. L., Dalal, A. K., Keohane, C. A., Lipsitz, S. R., Rothschild, J. M., Wien, M. F., Yoon, C. S., Zigmont, K. R., Wilson, K. M., O'Toole, J. K., Solan, L. G., Aylor, M., ... Landrigan, C. P. (2014). Changes in medical errors after implementation of a handoff program. New England Journal of Medicine, 371(19), 1803-1812. https://doi.org/10.1056/NEJMsa1405556
What the NSG 123 Unit 7 instructions ask for
Unit 7 centers on two pieces of spoken communication written down: a shift handoff and a call to a provider. Expect to give context, write the handoff as it would be said, write the call with a clear request and comment on what worked. Many versions ask whether to use SBAR or I-PASS and how long a handoff should be. Some sections require one format or the other. Lead with the main concern. Give numbers rather than impressions. End with a specific request, such as a fluid bolus and labs, not a vague one. Include read-back of orders received. Commentary should be honest about what could have been clearer. Keep the patient consistent with earlier units.
How this NSG 123 Unit 7 example is built
The record opens with context: who is handing over, to whom and when. The handoff is written in quotation marks, divided by SBAR headings, with the main concern first. The call is written the same way, with the request stated plainly at the end and the provider's response and read-back included. The commentary section lists what worked, such as numbers given with trends, and what could improve, such as stating the last urine time. Writing the words as said lets the grader judge tone and clarity. The two communications use the same patient and concern, so the reader can follow the issue across the shift.
NSG 123 Unit 7 rubric: what full points look like
Herzing's rubric for a handoff record usually covers structure, clarity of the main concern, use of data, a clear request, read-back and reflection. The opening concern and the closing request are read first, because a listener who misses either may miss the problem. Structure points reward correct use of SBAR or I-PASS headings. Data criteria look for numbers and trends, such as urine output over the last four hours. Read-back earns credit for closed-loop communication. Reflection points go to commentary that names what could improve, not only what worked. Words written as said, in quotation marks, are expected. A brief background, not a full history, is usually credited. Haig's SBAR paper and Starmer's I-PASS trial support the format.
NSG 123 Unit 7 help: mistakes that cost points
Handoff records in Unit 7 often slip by burying the concern in the middle of a long report. Another frequent problem is a request that is vague, such as please come see the patient. Students often give impressions, such as output is low, rather than numbers. Read-back is missing. The commentary only praises. The record summarizes rather than quoting. Background runs too long and crowds out the assessment. Allergies and code status are forgotten. The time of the last void or last pain dose is left out. Finally, end every call with a specific request, because graders reward communication that tells the listener exactly what is needed and by when.
Get a NSG 123 Unit 7 example written to your instructions
Send the Unit 7 instructions and the rubric from your NSG 123 classroom, with the report structure your section teaches. We write a custom example that quotes every turn, runs the report in that structure, ends the concern on a stated request and keeps the reply and the commentary where they belong. First custom sample free, back in 24 to 48 hours.
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NSG 123 Unit 7 questions, answered
How long should the quoted report be?
Long enough to be complete and short enough to be a handover, which usually means each part of the structure gets a sentence or two. Padding shows immediately in quoted speech, since nobody talks that way at a change of shift. Where a length is set, meet it by filling the thin parts rather than repeating the strong ones.
Which report structure should I use?
The one your classroom teaches, and send it with the instructions so the example matches. Sections use different frameworks and different names for the same parts, and a record built on another shape can be marked down even when everything in it is present. Where the instructions are silent, name the structure you followed above the transcript.
Does the record have to include a concern?
Read the instructions, since some assignments ask for a routine handover only. Where a concern is included, the graded sentence is almost always the request: what you are asking the other person to do, said plainly. Keep the whole exchange constructed, and do not model it on a real conversation you took part in.
Where can I find a free NSG 123 Unit 7 sample paper?
Read the NSG 123 Unit 7 handoff and call record free here, both written as said with commentary. A record for a different situation can be written on request.
How do I use SBAR to call a provider?
State the situation and main concern, give brief background, share your assessment with numbers and end with a specific request, then read back any orders. This sample calls about low urine output after colectomy.