Difficult situations Flashcards
You are by yourself in the department and are contacted by theatres about an urgent brain frozen section. You cannot get in touch with the neuropathologist or any other pathologist in the department. What do you do.
Find out what they want the frozen section for, and is it absolutely necessary
Are there any alternative diagnostic methods e.g. lumbar puncture
Is there a risk of TB or infectious disease (cannot do frozen)
Can attempt to interpret the frozen to level of my ability but I may not be able to give you a diagnosis
I can only work within the limits of my capability and competence
You are in the department and several consultant staff have gone off sick, leaving you with many tasks. How do you prioritize them
Patient safety is paramount
Work with the remaining staff in the department to organize tasks into urgent and important, urgent but not important, important but not urgent, and non-important non-urgent.
Delegate tasks to other team members, within their competence
Alert clinicians if a service is not going to be available e.g. no neuropathologist or renal pathologist for urgent bxs, MDT attendence
Urgent and Important: e.g. frozen sections, urgent biopsies
Urgent but not important: MDTs
Important but not urgent: Cut-up of specimens, reporting
Not important and not urgent: travel (cancel or postpone)
You are feeling overworked, how do you cope with the workload
Review the situation
Is patient safety at risk
Speak to colleagues: can they help with the workload
Identify problem: is there too much work or are you not managing it adequately
Time management
Prioritize urgent and important tasks
How do you deal with a poorly performing trainee
Speak with the trainee and express my concern
Listen to how he/she feels about the problem
Identify weakness points
Set out a plan for improvement
Reassess after a period of time to see if there is improvement
Speak to other consultants about how they feel about the trainee’s performance
Involve the educational supervisor
On MDT review you disagree with the report of a senior consultant. What do you do?
Speak to the consultant and review the case together
If there is no agreement between you, seek a 3rd opinion in the department or send for an external opinion
If there are persistent mistakes and patient safety is at risk, this needs to taken higher: departmental head, divisional lead, trust level
A consultant colleague comes into the department smelling of alcohol. What do you do.
Patient safety is at risk: politely ask them to go home until they sober up
Arrange cover
Ask if they have reported any cases. Review recent cases reported by them
Offer support but don’t collude - ask if they feel they need help with alcohol
Report to line manager, Head of department, Clinical Director, always follow Trust guidelines
You feel a colleague is not doing their fair share of work. What do you do
The colleague may be in difficulty, there may be a personal or home problem
Need to deal by open communication, not make the person feel bullied or victimised
See if issue arises spontaneously, if not speak to them about it
Firstly, appreciate their contribution to the team
Address the issue and listen to their response without judgement
Make them aware of the impact on patient care, colleagues, the service
Negotiate an action plan
Be supportive and patient
If they do not agree with my views, to speak to my colleagues and see if another person can try speaking to them
