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Shift handover in English: phrases that work

Hand over with I-PASS: illness severity, patient summary, action list, situation awareness, synthesis by receiver. Model handover and phrases.

Checked November 10, 2026

Short answer: A safe handover tells the next nurse how sick the patient is, gives a short summary, lists what must be done and what to do if things change, and ends with the receiver repeating the key points and asking questions. I-PASS (Illness severity, Patient summary, Action list, Situation awareness and contingency planning, Synthesis by receiver) is a structure that both The Joint Commission and the Agency for Healthcare Research and Quality (AHRQ) describe.

Each employer's policy and each regulator's standard decide what is required; this page teaches language, not policy.

What a safe hand-off contains

AHRQ defines it this way: "A handoff is a standardized method for transferring information, along with authority and responsibility, during transitions in patient care." AHRQ adds that your responsibility does not end until the receiver confirms they understand and accept the handoff.

The Joint Commission's Sentinel Event Alert 58, "Inadequate hand-off communication" (2017), explains that harm can follow when the receiver gets wrong, incomplete, late or misunderstood information. It names language barriers as one contributing factor. A typical teaching hospital may have more than 4,000 hand-offs a day, the alert notes.

The alert's seven suggested actions ask organizations to standardize what is handed over and how, to hand off face to face in a place without interruptions, to include the patient and family where appropriate, and to train both senders and receivers. Its minimum content covers who to contact, how ill the patient is, a summary, a to-do list, contingency plans, allergies, code status, medications, and dated labs and vital signs. The full list is in the alert (see Sources).

The National Council of State Boards of Nursing (NCSBN) also lists giving and receiving handoff of care as a tested activity in its 2026 NCLEX-RN Test Plan.

I-PASS, letter by letter

AHRQ lists these parts:

Letter Part What you say
I Illness Severity Stable, "watcher" or unstable
P Patient Summary Summary statement, events leading up to admission, hospital course or treatment plan, ongoing assessment, contingency plan
A Action List To-do list, with timelines and who owns each task
S Situation Awareness and Contingency Planning What is going on now, and the plan for what might happen
S Synthesis by Receiver The receiver summarizes, asks questions and restates the key actions

AHRQ says one standard handoff tool per organization is better than several. Use your unit's tool.

A model bedside handover

Outgoing nurse, to the patient: "Mrs. A, this is your nurse for tonight. We will go over your plan with you."

I: "Mrs. A is a watcher tonight."

P: "She is 58 and was admitted yesterday with cellulitis of the left lower leg. She has type 2 diabetes. No known drug allergies. Full code. She is on cefazolin 2 g intravenous every 8 hours, last given at 14:00. Her 16:00 vital signs were temperature 38.1°C, heart rate 98 and blood pressure 128/76. The red area is marked with a pen line, and it has not spread past the line today. Her pain is 4 out of 10 after acetaminophen 650 mg by mouth at 17:30."

A: "Next cefazolin is due at 22:00. Check her blood glucose at bedtime. Keep the leg raised on a pillow. Check the pen line every 4 hours."

S: "If the redness spreads past the line, or her temperature is more than 38.5°C, call the night physician."

S, incoming nurse: "So Mrs. A is a watcher with left leg cellulitis. Cefazolin at 22:00, glucose at bedtime, leg raised, line checked every 4 hours. I call if the redness passes the line or her temperature is more than 38.5. Did I miss anything?"

Outgoing nurse: "No, that is everything. Mrs. A, do you have any questions for us?"

Phrases by purpose

Opening

  • "I am handing over (number) patients. Let's start with room (number)."
  • "This is (name), who will be your nurse until the morning."
  • "Let's move away from the desk so we are not interrupted."

Illness severity

  • "She is stable."
  • "He is a watcher. I am worried about..."
  • "She is unstable. The rapid response team saw her at (time)."

Patient summary

  • "He is (age) and was admitted on (date) with..."
  • "The main problem today was..."
  • "The plan is..."
  • "His allergies are... His code status is..."

Action list

  • "You need to... by (time)."
  • "The next dose of (drug) is due at (time)."
  • "I have done..., but I did not have time to..."
  • "The (test) result is still pending. Please check it."

Contingency

  • "If... happens, please call..."
  • "If her pain is still more than (number) after..., ask the physician about..."
  • "Watch for... The physician wants to know if..."

Asking for repeat-back

  • "Can you tell me back the main points?"
  • "What will you check first?"
  • "Is anything unclear?"

Questions as the receiver

  • "Can you repeat the time of the last dose?"
  • "Who do I call if...?"
  • "What did the physician say about...?"
  • "When was this lab result taken?"

What to do next

  1. Ask your unit for its handover tool and learn its order.
  2. Write your I-PASS points on paper before each handover.
  3. During the shift, use SBAR: how to call a physician in English and How to write a nursing note in English.

Common questions

Is I-PASS required?

The Joint Commission's alert gives I-PASS as one example of a standard method, alongside ISBAR (Identification, Situation, Background, Assessment, Recommendation). AHRQ calls I-PASS an evidence-based option that many organizations prefer.

Can I hand over in writing only?

Sentinel Event Alert 58 advises against relying on electronic or paper hand-off alone. If you cannot meet face to face, it suggests telephone or video in real time.

English for Nurses is free. All Nursing Exams, NCLEXPace and NPractitioner are run by the same team.

Sources