Meeram Flashcards
You are a female F1 and a patient who has been making inappropriate comments asks to see you for a private discussion:
A. See the patient, but take a member of nursing staff with you.
B. Refuse to see the patient and ask a nurse to bleep the registrar to review the matter, as you are busy with other patients.
C. Refuse to see the patient as you are concerned about your own safety.D. See the patient, but be prudent in informing him his behaviour is inappropriate and if it continues you will arrange for another member to the team to take over his care
E. Inform your registrar and ask them to see him instead
ADEBC
Nurse hands you a patient as you are leaving the hospital
A. Arrange for the patient to be admitted as an inpatient overnight as a precaution
B. Phone the on call team on your way out of the building
C. Tell the nurse it is not your responsibility and that she should bleep the on call team
D. Quickly assess the patient to determine if it was a simple faint and if so let them go home
E. Do an initial assessment of the patient and once stable hand over to the on call team
EBCAE
Admitting the patient who has almost certainly had a simple faint (Option A) may be expensive, but is safe for an inexperienced F1. However it would have been better to use one of the earlier handover options so that if possible the patient could go home as planned provided it is safe.
Allowing the patient to go home after a cursory glance after your hours of work is cheap, but if there has been any surgical complication that is the real cause of the faint that you are unaware of (such as internal bleeding) then option D may be dangerous.
You are concerned that your fellow FY1 is making drug errors.
A. Inform the patient of the drug error and reassure them it has been corrected
B. Go to his clinical supervisor
C. Do nothing for now as you do not believe patient safety has been compromised
D. Take him aside and discuss the prescriptions as there may be a reason behind his decision
E. Ask the nurses to keep their eye out for his drug charts and double check his prescriptions as you believe he is making mistakes
DBEAC
What do you need for viral serology tests following a needle stick injury?
Consent
Should not be obtained by you, should be someone else
What procedures can an F1 consent for?
Ones they can carry out themselves
Not others
Better to ask your registrar who is busy in theatre to consent or an F2 colleague from a different ward
Registrar
You are out of depth and your patient is in shock and deteriorating?
A. Ask for the advice of the critical care outreach team who are on the ward
B. Ask another FY1 on the ward for help and decide what to do together
C. Carry on managing the patient as best you can
D. Call the on call consultant
E. Put out a peri-arrest call
AEDBC
A - The critical care outreach people are the most appropriate to contact in this situation, especially as they are on the ward.
E: if the critical people are not on the ward, a peri-arrest call will get them to the ward. Shock is a medical emergency, so this is appropriate
Colleague is watching porn in the office
Do nothing
Call the Police
Report to the GMC
Do nothing > GMC > Police
It isn’t illegal
Compare clinical and educational supervisors?
Clinical supervisor (consultant) - every rotation (4 months urology/endo/acute) - seek advice about clinical matters on the ward - signs of your procedures
Educational supervisor - stays with you throughout the year - first port of call for personal issues/team problems - signs you off for GMC registration
What supervisor should you speak to if you feel you are not getting enough teaching sessions on a rotation?
Clinical supervisor
What is the next level up from Educational supervisor
Post graduate dean
E.g. for west London (followed by GMC)
What does a family member need to turn off a patients ventilator?
LASTING power of attorney
A normal power of attorney can only act while you have capacity
Is it better to tell someone over the phone that the patient is okay or that you cannot disclose any information
You cannot disclose any information
–> giving patient info otherwise
Can you detain a patient
No
Must get an F2
In general which supervisor should you go to first?
Clinical then Educational (they are a step up)
