SJT 3

Question 1

Work-life balance

Answer 1

• Must be satisfied that when you are off duty, suitable arrangements have been made for your pts’ medical care
• These arrangements should include effective hand over procedures, involving clear communication with healthcare colleagues
• If you are concerned that the arrangements are not suitable, you should take steps to safeguard pt. care
• Not sensible to leave handover info in the pts. clinical notes or in the doctors office as there is no guarantee that this will be reviewed

Question 2

Teamwork

Answer 2

You must work collaboratively with colleagues, respecting their skills and contributions. You must treat colleagues fairly and with respect

You must protect pts from risk of harm posed by another colleagues conduct, performance or health. If you have concerns that a colleague may not be fit to practice, you must take appropriate steps w/o delay, so that the concerns are investigated and patients protected when necessary.

Confrontation - in general, the best option is to discuss your concerns calmly with the individual involved. It is always best to try and find out more information. However, it may be counterproductive to do this if you have already tried, if speaking to the person involved may be inflammatory, if the situation involves a serious breach of pt. confidentiality.

Raising concerns - for serious incidents or repeated adverse events, you have a duty to raise concerns - issues should be escalated ina. step wise manner (SHO > Reg > Consultant/ed./clinical supervisor

Question 3

Learning and procedures

Answer 3

If you have not carried out a procedure before, the most appropriate response will usually be:

• Inform your senior you have not done this before and ask if you can either watch if you have not seen it before, or carry out the procedure under supervision if you have seen it before
• Inappropriate options would be to do the procedure with guidance from the internet/textbook as this is XXX for pt. safety.

**The rule for attempting procedures is see one, do one, teach one.

Question 4

Breaking bad news

Answer 4

As an F1 it is not within your remit or responsibility to break bad news to patients or relatives about significant clinical diagnoses e.g. malignancy.

The best options are to escalate to your senior reg for support and to ensure you provide reassurance to pts/relatives that a member of the team will be addressing their concerns.

Advisable to be bleep free when speaking to pts about sensitive matters so that you are not interrupted - you must hand over your bleep to a suitably qualified clinician and explain your reasons for doing so.

Question 5

Patient harm and duty of candour

Answer 5

Healthcare professionals must:

• tell the pt when something has gone wrong
• apologise to the patient
• offer an appropriate remedy or support to put matters right (if possible)
• explain fully to the pt the short and long term effects of what has happened

Question 6

Translator/Interpreter

Answer 6

• In an acute setting, best to use the language line
• In a non-urgent setting, it can be appropriate to rebook the pt and advise them to come in with face to face interpreter
• It is NOT appropriate to be using family members/relatives as they are not a qualified interpreter and this can give rise to confidentiality issues