SJT Flashcards
Who is the first person you contact if someone else has made a prescription error?
Person who wrote up the prescription.
If an allied healthcare professional has informed you of something e.g. an error made by your consultant, should you ask them to call the consultant themselves or should you pass on the information?
You should generally pass on the information yourself, as the HCP has already contacted a member of the team i.e you.
If you need to change the management plan for a patient, for whatever reason, should you do it immediately or contact a senior?
If you need to change the management plan for a patient you need to communicate this to the senior members of the team (i.e. consultant.)
If a patient does not want to go home, but was declared MFFD can you keep them in hospital? What should you consider before discharging?
Can’t just keep them in hospital, if it seems as though their medical situation has changed you should review them, and consider involving seniors before discharging.
What are the factors to consider when a question involves working late consistently?
If working late consistently and you are tired all the time, or you r wellbeing is suffering this is a concern for patient safety, should be top concern.
You also have a right to finish on time, as per contract and they consider this important.
What is a more pressing patient care concern, a possibly incorrect prescription or a patient beckoning to speak to you?
The medication review is more pressing than the patient beckoning (still important though)
What’s more pressing, a pt beckoning, a learning opportunity (theatres) or a nurse who is concerned about the functioning of another doctor?
Pt beckoning most important - PT CARE FIRST.
Learning opportunity is more important than the nurse, unless her concerns are urgent.
Should you spend time with patients, so they have someone to talk to if they are lonely?
This is only appropriate if you do not have more pressing jobs to do, it can be done by others.
If you don’t know the protocol for prescribing Abx, who/where should you get help from, in order of preference.
Hospital intranet should have the info, or may have printed out soemwhere on ward.
Senior colleagues next port of call (your team first (reg) then could try others including microbiology team.
BNF is next, good but doesn’t take into account local policy
National guidance is LAST resort
DO NOT ask a nurse
Is it an F1s responsibility to break bad news?
No, should ask senior to do it.
Who are the most appropriate people to alert regarding an infection control issue with an F1 colleague?
Should always speak to colleague first
Nurse in charge of ward has a big role in ensuring infection control.
Your Spr isn’t too appropriate
Infection control team only if this is a repeated offence, with serious issues
If you have made a medical mistake what are the things you should do?
FIRST ensure patient does not come to harm
Inform your team
Apologise and inform patient if they are in a position to understand what happened/in their best interests.
Can explain cause of mistake.
You can seek advice from peer (but should be senior before F1 colleague)
What is more important when a team is not functioning well with you, documenting what is happening or steps to improve the situation?
Documenting is LESS important than any steps you can take to improve the situation.
If you feel like your educational needs are not being met in your job what is a good thing to ask your consultant to get them met?
Spend time in theatre/clinics
Apart from spending time in theatre/clinics (most important) how else can you seek to improve your educational aspect of your job (if you spend all you tie doing one activity)?
Can ask to help F1 colleagues, as long as you aren’t jeopardising own team.
Is taking on a role in the junior doctors committee beneficial to your learning? What time can you put towards doing it?
NOT beneficial to your clinical learning, needs to be done in your OWN time.
What is more appropriate, handing over task to a nurse or to your colleague?
Nurse is much less reliable, and should not be done.
If a patient is discussing their concerns with care with a relative is it important to discuss their concerns with the relative?
Not really very important if you can discuss the concerns with the patient, and try to sort the problem first.
If a colleague is not accepting your handover (which is appropriate) what should you do?
First of all need to try to solve problem, need to be assertive with colleague, and tell em to do their work.
Should NOT rely on nurses to handover info
Should NOT stay on ward in own time unless emergency.
What can/should you do if a pt speaks another language?
Best thing - if available - is another doctor who speaks that language (?HCP)
Can use NHS language services too, not quite as good as another doctor who is there, takes a while etc.
Should get senior advice, make your team aware
DO NOT try to communicate yourself if you do not speak the language.
Should you offer a pt the offer to self-discharge if it is taking a long time?
Not really, it is risky, maybe only if emergency sit.
Should you discharge a patient yourself as an F1?
Nope never.
Can you facilitate a discharge through the phone?
Yes, but it’s not ideal, should try to get senior help first.
What is the general rule for procedures you can’t do?
- Tell senior you can’t do it
- Get senior help, tackle it as is safest.
- Observe a senior
- Be observed (not really appropriate)
Last is anything that compromises pt care, such as not doing it or doing it alone.
What is better in a prescription query (senior) contacting a pharmacist or waiting for senior to get back in a few hours (before prescription due)?
Contacting a pharmacist is better than waiting for senior
best to contact the senior immediately of course.
What is better in a prescription query (senior ?mistake) a. leaving the prescription be or b. changign the prescription to something you know is safe and standard?
Changing it is better than leaving it. Always put options that tackle the problem higher up.
If you have made a communication error to a pt, what are the steps you should take?
Pt care is first, sort problem and care first if this is offered
Apologise first of no pt care issue.
Can explain what happened.
Offer complaint procedure after these steps.
Is it better, in a communication/medical mistake to explain what happened and why or offer complaint procedure?
Better to explain what happened before offering complaint procedure.
Colleague has left you with work, which was their responsibility and fucked off for their own learning (theatre/clinic) what are appropriate steps to take, in order?
Always address immediate problem, and pt care, so try to bring them back
Try to address the problem for the future
After addressing problem for future, include other appropriate actions such as writing list of jobs for them to do.
Do not refer to line manager with a single incident.
If a nurse/HCP is worried about a patient, who the stem suggests is not critically ill (but not 100%) what is the most important rule/action to bear in mind?
Best to get more information about the patient and their state before doing anything else, e.g. ask for obs.
If an F1 colleague is not completing their clinical role adequately and this is happening repeatedly, who is the best person to talk to?
Always talk to colleague first
after that if they are repeatedly not completing their role then you can talk to CLINICAL supervisor
Educational is not relevant (they do pastoral and educational needs)
If you have been informed by another (F1) colleague that an F1 is acting inappropriately what are the best steps for YOU to take?
You are not directly involved here, and it is your colleagues responsibility to talk to them first.
Advise colleague to seek advice from educational supervisor THEN F1 colleague
Don’t report them to a senior if it is an isolated occasion.
Pt is unwell with condition that you are confident to manage, nurse is not confident in you and wants you to get your reg, what should you do?
Pt care is first, you should initiate treatment first
You should then consider reassuring the nurse, you can do this by calling the reg, this is probably helpful anyway and appropriate.
You can then explain that you are confident in managing the condition, and have before.
Should not compromise care by going elsewhere to find reg, or professional relationship with the nurse.
If a pt deteriorates and you are very new, not confident, what can you do to help with the situation?
Get some help from nursing staff
then you should probably escalate within your team.
If there is a disagreement in the team with the consultant decision what actions should you take?
Always seek to solve problem first, and put pt care first, should discuss this with the consultant, then suggest the disagreer discusses with consultant
Ultimately should do what consultant says but always discuss first.
If a pt does not seem to understand what they have consented for what should you do/who should you discuss with first?
Pretty big medico-legal problem - Consultant should know first when there is a big issue even if the reg consented (can tell them after consultant)
There is a query over consultant prescribing who is more important to talk to, another (uninvolved doc) or the nurse who will be dispensing the meds?
The nurse is more important to speak to.
With what issues is it most appropriate to speak to colleagues?
Professional issues most appropriate, F1 colleagues or educational supervisor.
Whats worse in GMC eyes, texting a colleague or informing a nurse?
Texting is worse, they really don’t like it.
If you need info/help then should you ask consultant to come back to ward?
Not really - should inconvenience them as little as possible - call them.
What is more important when you need to discuss a patient with wider team (palliative, in hosp), the MDT or the GP?
MDT is initially more important that the GP.
If there is a query as to the conduct of a colleague who should you speak to, in order?
The colleague first, of course
Then educational supervisor
Then colleagues
If a sentence uses the word complain, should you use it as an option?
Probably not, sounds unproductive and unprofessional
You are at home and need to hand over important urgent info to colleague, what steps should you take?
Contact your team first, F1 then up the chain to reg, depends on info, but if about tasks then not consultant
Then contact an F1 colleague not on your team
Then go in yourself (using your own time not really appropriate).
COns wants PM on pt, family don’t really. What is more important, your own learning (e.g. asking consultant) or gettign senior help to solve issue?
Solving issue comes up higher than your own learning.
When is it a good idea to have a chaperone?
Intimate exam
Pt/relative very upset
If a pt or relative is upset about something, should you wait for senior help before talking to them?
No, if they are very upset, you should talk to them first.
If a nurse/HCP has a problem with the medical decision of another F1 who should you speak to first?
Always the F1 who has made the decision first.
If there is a conflict of medical decision between you and another doc, who can you contact, if unsure?
Should contact other doc first
Should contact YOUR reg if you are unsure about anything.
Who has responsibility for infection control?
EVERYONE, however nurse in charge of ward has special interest, and obvs infection control.
What’s more important possible conflict with a HCP or you leaving slightly later than expected?
Conflict is more important to consider
