How to use this guide
Keep this page open while you are speaking to someone, or download the printable PDF and keep a copy somewhere easy to reach. In pressured moments, short, factual language is enough.
- Preview the online version if you need it quickly.
- Download the PDF if you want something printable and portable.
- Use the triage tool if you need help deciding the next sensible step.
Printable PDF
A cleaner version of the guide for printing, saving, or keeping on your phone.
The 6 Rs in one page
A quick visual version of the guide: notice what changed, say it clearly, and record what matters next.
Use this guide to do five things well: notice change, describe it clearly, ask better questions, advocate without spiralling, and keep a simple record of what happened.
The short version
In pressured moments, you do not need perfect language. You need calm, factual language. Start with what has changed, when it changed, what worries you, and what you need help understanding.
What to notice
- What has changed from this person's normal baseline?
- When did it begin?
- Is it worsening, holding steady, or coming and going?
- Are there changes in breathing, colour, confusion, pain, mobility, appetite, alertness, speech, or behaviour?
What to do first
- Get the basics clear before the room gets noisy.
- Use short, factual language.
- If you are not safe to manage it, say so plainly.
- If it feels urgent or rapidly worsening, escalate immediately.
What to ask
- What concerns you most right now?
- What is the safest next step?
- What should I watch for over the next few hours?
- What would make this urgent, and what do you want me to do if that happens?
What to say clearly
- "This is what has changed from normal."
- "This started at roughly…"
- "I am concerned because…"
- "I need to understand what happens next and what would make this urgent."
An escalation ladder you can actually use
- Step 1: Name the change clearly and compare it with normal.
- Step 2: Ask for the next sensible step and what would make the situation urgent.
- Step 3: Repeat the concern plainly if it is not being understood.
- Step 4: Say directly if the person is worsening or you do not feel safe to manage the situation as it is.
- Step 5: Seek urgent or emergency help when the situation is severe, rapidly changing, or beyond your ability to hold.
What to record
- What happened
- When it happened
- What changed from normal
- Who you spoke to
- What advice or action was given
- What still needs following up
A simple advocacy script
Try this: “I'm not looking to dramatise this. I'm trying to describe a clear change from normal. This started around ____. What I'm seeing is ____. My concern is ____. I need to understand the next step, what to watch for, and what would make this urgent.”
Afterwards
Once the moment has passed, do not skip the recovery piece. Drink water. Sit down. Write the timeline while it is fresh. Note what helped, what did not, and what questions still remain. Good care is not only what happens in the moment. It is also what you learn and carry forward afterwards.
The Ward Wise 6 Rs
Recognise. Respond. Raise. Represent. Recover. Record. Use the framework as your map from first concern to clearer action.