Random Flashcards
What do you do when a patient is inappropriate (swearing or abuse)?
Use clinical judicion in terms of whether any safety actions need to be taken: If security needs to be called etc.
i) Document the incident (once anything urgent has been managed)
ii) Inform colleagues working with the patient
iii) Complete a clinical incident form
What do you do when there is clinical error Immediately?
The patient’s safety comes first - Assess them and take all steps that will ensure their safety FIRST
then:
i) apologise to the patient
ii) complete a clinical incident form
later:
i) discuss with colleagues/educational supervisor if appropriate
ii) tell ward manager
When you think someone isn’t fit to work what is best thing to do and the worst thing to do?
Best: Confront them immediately about this and advise them to go home.
If they continue - try to get people involved whilst causing the least damage or disruption to services —> get a colleague to talk to them.
Worst: Continue as nothing has happened - This endangers patient safety.
How to approach breaking bad news?
i) Ascertain what the patient already understands. FY1 should not break bad news to patients. —> Ideally a consultant/registrar and as soon as possible. Duty is to be honest and efficient.
BUT - it would be better to wait for a consultant/registrar a few days away than for an FY1 to tell them
Don’t lie to patients
When it comes to handing over an unwell patient to somebody else?
Consultant
Registrar
Registrar - generally they will have more contact time so this is better than a consultant who has little contact time.
Complaint Flowchart
I) responsible clinician
ii) formal complaint - letter, PALS etc.
iii) Local health ombudsman
NEVER them media
NAI in child
i) Senior doctor/nurse in the paeds/ a and e minors department
ii) Paediatric on call team
iii) admit the patient.
Avoid calling the police or confronting the parents early on —> can aggravate the situation
Regarding images/videos of non identifiable/ anonymised images
Does not require special consent
Knife or gun wounds
Police should be informed
Look for suspicions of :
Explore the incident (look for DV)
Make sure no children/vulnerable adults involved
SERIOUS Suicide order of events
Discuss feelings
Crisis Team
Hold patient under MHA
Protective Factors
Self help leaflets etc. not good - if theyre at high risk of suicide dont let teh patient go
When struggling who do you talk to first?
Educational Supervisor
F1
Consultant
Postgraduate Dean
THink about patient care!
Don’t do anything uprofessional
WHen not happy with how youre being treated?
Talk to the perpetrator
Talk to Educational supervisor
Seek advice - BMA
Formal Complaint
When you don’t want to sign a cremation form:
What’s the first thing you should do?
Ask someone who has seen the body to sign the cremation form instead:
Best to not share your objections with the patient’s family considering their grief
What do you do when you discover a drug error?
1) Cross off the drug immediately and provide alternative
2) Assess patient - provide treatment if necessary
3) Apologise and explain fully
4) Inform consultant
5) Reflection and Filling out clinical incident form
What is the yellow card scheme
When to report
Yellow card scheme : MHRA scheme to document RARE and SEVERE reactions. Particularly those that are life threatening or not on the drug information sheet
Report: when sucha reaction happens and reporting should be encouraged to the patient and to the health professional
