Hungover/drunk colleague Flashcards
When you are in the hospital mess you hear a CT1 telling another SHO about how hung-over he is from a late party the night before. You notice he is walking unsteadily and slightly slurring his words.
How would you proceed?
SPIES(R)
Seek information
* I overheard the CT1 saying that they are hung-over and their appearance suggests that they are still intoxicated. It would be important to establish if my suspicions were correct asap and then to remove them from the clinical environment.
Patient safety
* Patient safety is the first priority, so the CT1 should be kept away from the clinical environment. I would politely ask them myself in a non-confrontational manner that they need to leave. An alternative would be to ask a senior member of the team to have that conversation with you.
Initiative
* I would make arrangements to cover the CT1s shifts without giving the full reason for why they needed t oleave. If able to, I would volunteer myself to cover some of their duties. It would be also important to review any patients or jobs performed by the CT1 that day for any errors.
Escalate
* This situation would need escalating to my registrar and the consultant to be dealt with. Still, I would keep those aware of the CT1s behaviour to the absolute minimum.
Support
* I’d try to establish whether this is a one off or whether the CT1 has any dependency or psychosocial issues, requiring further support.
* I would also try and support the team the CT1 works for if possible, to help cover clinical duties in their absence.
* Any pts affected should be offered an apology, without mentioning incriminating information
Reflect
* I would reflect on this situation and review my own practice
Who may be able to give you advice regarding how to deal with this situation?
Senior colleague whom I would escalate to
Medical Indemnity organisations e.g. MPS, MDU and the BMA provide anonymous advice over the phone
Educational supervisor - although ideally the number of people aware of this issue should be kept to minimun
The colleague admits to having drank heavily the night before but explains it was his birthday, and he will pay you £300 to not mention his ‘hangover’ to anyone. How would you proceed.
Decline this bribe and discuss the matter in a non-confrontational manner why I would need to escalate the matter to a senior.
I would stress that patient safety is at risk in this situation, and that reporting to a senior is in **their best interests **and that I am duty-bound to do so. I would explain that I would not share this information with anyone else other than my senior, at this time.
The colleague becomes very upset and admits that a close friend was recently diagnosed with terminal cancer, how would this change my management of the situation.
My initial management regarding removing him from clinical environment and escalating it to my senior would remain the same.
However, I would now be very concerned about the CT1’s emotional and psychological well-being. I would offer my sympathies and deal with the situation as sensitively as possible.
I would offer my support to them, while also suggesting they seek support from their GP or counseling, notify occupational health and raise this issue with their educational supervisor.
They may also need support from alcohol dependency services.
The colleague is very concerned that if you escalate this issue they will not be able to practice medicine again. What would the likely outcome of escalation be?
- The CT1 would have a professionalism meeting with their clinical supervisor
- The decision for further escalation (from clinical director to GMC) would be made by the consultant / CT1’s clinical supervisor - this would depend on the severity of the situation
The likely outcomes are
* Formal warning
* Referral to GMC for review
* Suspension
The colleague would definitely require referral for appropriate services for psychological and addiction support.
