Ethical Scenarios: Professionalism

Question 1

How do you cope with stress

Answer 1

Personal

Clinical

Academic

Management

Question 2

Your boss is drunk/colleague is depressed

Answer 2

Immediate
Patient safety: Ensure patient safety, someone is there to cover the patients on the ward, as you figure out what is going on.

Colleague safety: approach in non-judgement way, in a private setting/confidential. Have an open, affirm, summarizing, reflective approach.
Try to confirm/observe/clarify, may have to use another colleague to gain more information.

Subsequent action
Initiative: encourage colleague to seek help from their support systems mentor/friends/SOT/director/GP/ DHAS
Offer to be there whilst they meet up, (1, 1+1, myself)

Escalate: inform boss of what has happened, notify colleague that you would have to escalate/report.
Document any concerns, and seek advice from medicolegal organization

Support: provide further support

Prevention: think about the reasons this may have happen, local - bullying, personal reason, departmental - hours too long/ not enough supervision/too many nights.

Question 3

You’ve just done night shift and your boss asks you to do a morning list due to short staffing.

Answer 3

Seek information:
Clarify that they know you’ve done night shift and have not been sleeping. Find out if they really need you.

Patient safety:
Discuss that working fatigued is not safe for the patient.

Initiate:
Graded assertiveness, PACE
Negotiatie safe practice? opportunity for a nap, non-clinical role

Escalate:
Call direct/DA/

Support
Debrief, seek your own colleague/Mentor/SOT/ GP

Question 4

Registar is drinking heavily and using drugs, binging before coming to work what is your approach?

Answer 4

Concerns: patient safety, impaired colleague
Impaired colleague is practicing profession that departs from expected standards set out in the code of conduct.

Patient safety: need to ensure that the colleague is not practicing impaired.

Colleague

• seek more information, clarify from trust, need to confirm
• Speak about it in a confidential, private setting
• Probe for reasons why this is occuring thinking about work, personal life.
• Encourage them to seek help from resources mentor/colleague/SOT/ DHAS/ANZCA DPS/ Medicolegal/GP
• Provide them with support if needed

Escalate
- if continuining behaviour have to use graded assertiveness.

Prevention
- thinking about this in the future and how we prevent this, is it a local, departmental issue

Question 5

You or your colleague is beeing bullied?

Answer 5

Bullying is any repeated unreasonable behaviour diret to ward a person

Question 6

Fellow registrar is engaging in sexual relations with the supervisor of trainining for extra exam questions?

Answer 6

Sexual misconduct, colleague’s wellbeing

Seek more information
- Clarify information

Colleagues safety

• Is my colleague feeling safe, is there any reasons why they are doing this? thinking about personal, work
• Stressors from personal life and work
• SOT what is going on with them as well?

Initiative

• Discuss this is a private confidential way,
• Outline concerns, power play
• Encourage them to seek help from colleague/director/ DHAS/ Anzca DPS/ GP/
• If feel comfortable offer them to be a support person

Escalate

• give the colleague some time, check back later on
• in the mean time seek advice from your supports
• if still persistent, nothing done, time for you to escalate to SOT/Director
• Seek further advice from DHAS if needed

Support
-offer support to colleague during the whole process

Prevention
- Think about preventative techniques