Dealing with Legislation - What Happens when it All Goes Wrong? Flashcards
causes of stress/distress in doctors and dentists: multifactorial
loss of control excessive workload experience of suffering poor self-care maladaptive coping strategies stressful life events
causes of stress/distress in doctors and dentists: stressful work enviromment
excessive demanding workload: emotionally draining, experience of suffering
working patterns: shift, nights, working in isolation, loss of control, time pressures
poor functioning teams
poor communication
bullying and harassment
poor levels of social support at work
common mental health problems in doctors and dentists
stress anxiety inc PTSD depression inc bipolar alcohol and drug problems behavioural addictions eating disorders ADHD ASD
what may contribute to illness and delayed recovery in doctors and dentists?
tendency to conceal or deny problems continue working when ill seek help late bypass formal channels access to prescription drugs working environment
effects of drugs and alcohol and the work
absence
inefficiency
poor decision making
impaired customer relations
alcohol impairs
thinking
concentration
judgement
mood
alcohol productivity problems
inconsistent performance poor quality of work lower productivity more mistakes/accidents
consequences of mental ill health in doctors and dentists
• Poor patient care o Anger, inability to be compassionate, burnout o Fatigue, errors • More time off work • Sick leave, early retirement, suicide • Reduction in morale of work force • Poorly functioning teams • Impact on families
barriers to seeking help in doctors and dentists, mental: work related
difficulty taking time off
heavy workload
barriers to seeking help in doctors and dentists, mental: fear and shame
fear of lack of confidentiality (punitive response)
fear of stigma
concerns about professional future
barriers to seeking help in doctors and dentists, mental: lack of knowledge about what to do
insufficient knowledge about services
experience of how other colleagues have been treated
In order to prevent and aid in the early intervention of poor mental health, medical and dental curriculums should implement
an ability to develop self-awareness, resilience, lifelong learning
prevention/early intervention strategies: individuals
reduce stigma change the culture support mentor coach opportunities for continuing education
prevention/early intervention strategies: organisational
involve doctors/dentists at all levels workplace stress management strategies trust initiatives HEE initiatives college initiatives - startwell and PSS (RCPsych), first five (RCGP)
how does self-awareness enhances resilience?
recognising your own trait patterns
what is resilience?
ability to withstand and bounce back from adversity. Resilient people have the ability to focus on and address the core issues and to find productive solutions. It helps the individual to compartmentalise in order to maintain an acceptable QoL.
capacity for resilience is influenced by 4 character traits:
- self-directedness
- co-operativeness
- harm avoidance
- persistence
capacity for resilience: self directedness
evident in people who are conscientious, resourceful and goal-orientated
accept responsibility for their mistakes, learn from them and move on
capacity for resilience: co-operativeness
accept opinions and behaviours of colleagues even if different from their own
don’t lose sight of their own principles but work to achieve the best outcome for everyone
capacity for resilience: harm avoidance
doctors/dentits with with low harm avoidance are more decisive and less anxious
they can accept uncertainty and a degree of risk
capacity for resilience: persistence
maintenance of behaviour with stamina despite frustration, fatigue or discourageemnt
high persistence associated with perfectionism which leads to burnout or depression
predictors of resilience
personal factors
organisational factors
socio-cultural factors
predictors of resilience: personal
personality
previous adversities
coping strategies
predictors of resilience: organisational
workload
hours
predictors of resilience: socio-cultural
culture within medicine/dentistry
rise of blame and claim culture of litigation
didactic teaching
factors consistently related to resilience:
female work-life balance laughing beliefs self-reflection professional identity
equality act 2010: protected characteristics
age disability gender reassignment marriage and civil partnership pregnancy and maternity race religion or belief sex sexual orientation
successful negligence claim
Successful negligence claim: • Failure in Ones Duty of Care o (Falling below the standard) • ‘Foreseeable’ damage must result o ‘Causation’ o Wilsher v Essex Health Authority
negligence: bolam v friern hospital management committee
the treatment proposed is recognised as proper by responsible medical opinion
negligence: bolitho vs hackney health authority
Lord Brown-Wilkinson held that recognising a ‘responsible body of medical opinion’ required the ‘body’ to apply their minds to the risks versus benefits in any particular case
negligence: hunter v hanley
o Must be a recognised procedure
o Must not have followed that procedure
o No reasonable doctor (dentist) would have done what the defendant did
