N108: Transition to the Registered Professional Nurse Role Study Guide (situation, background, assessment, and recommendations) communication technique provides an organized logical sequence and improved communication process to ensure patient safety. The Joint Commission has added "standardized communication" to the Patient Safety Goals. • S ituation: What is the situation? Why are you calling the physician? What is happening at the present time?What is the acute change? Explain in the fewest words, exactly what the situation is. • B ackground: What is the background information? What are the vital signs and pertinent history? How did the situation come to be? What were the circumstances leading up to this situation? • A ssessment: What is your assessment of the problem? What do you think the problem is? • R ecommendation: What should we do to correct the problem/address the situation? What action/response do you propose? Contracts Contracts are promises enforced by law and to be valid, the following elements of a contract must be in place: • The agreement must be made between two people with capacity. Capacity means that the people must be adults and mentally competent. • One person must make an offer and the other must accept the offer. • Some consideration must have been made for the making of the agreement. This requires something of substance to be exchanged between the people making the contract. Nurses should ensure that any contract they sign contains all of the elements listed above. Veracity is the underlying ethical value enforced in law. In order to be true to another person, promises made to the person or institution must be kept. Any collective bargaining contract must have provisions for grievances, meaning a way that a nurse with a problem can use the chain of command to have the problem solved. Some also contain provisions for the enforcement of practice standards if those standards are not met. Most contracts contain a preamble at the beginning of the document. The preamble specifies the purpose of the contract and the general intent of the parties involved. The body of the contract will contain clauses that set forth the statements of responsibilities of all parties to the contract. The contract must also contain a termination clause that defines how the contract will end or conditions under which the contract will be terminated. Breach of contract is the failure to meet one of the provisions of the contract.