SJT Flashcards
If patient is undergoing tests and is found to be pregnant and husband is in waiting room - what is the most important consideration you have?
consent
who does the GMC recommend resolving conflicts with in the first instance?
the person in question
if unsure whether patient is abusing pain meds like codeine, what is best mx plan?
limited 7 day supply then review if can’t be certain of abuse
how to address colleague who isn’t pulling their weight?
address this with them in the first instance
then raise with clinical supervisor
then look at why it is an issue - are you too busy with your rota
you notice a drug error (eg pt has too much warfarin tablets): what 3 things to do?
make sure correct dose given
raise with nurse dispensing
apologise for mistake
why never prescribe or give a tablet to give a partner/family member you don’t know/never met?
allergies to meds
accepting gifts: GMC states:
do not ask for or accept from pts, colleagues, or others any inducement/gift/hospitality that may be seen to affect the way you prescribe for/treat/refer/organsie care for pts
gift limit usually:
£10
GMC recommend the following when things go wrong:
offering an apology to the patient, putting the situation right (in this case, repeating the sample) and explaining what has happened and the short and long-term implications of the mistake.
duty of candour (4):
Tell the patient when something has gone wrong
Apologise to the patient (or carer or family member where appropriate)
Offer an appropriate resolution
Explain the potential short and long-term effects of the error
is saying sorry legal admission of liability?
no
never prescribed a rare drug before: who to seek advice from? (no guideline on intranet)
senior medical colleague
pharmacy
BNF
can f1s request scans and imaging out of hours?
not without consultant signing off, no
maintaining trust (domain) - key points:
Show respect for patients
Treat patients and colleagues fairly and without discrimination
Act with honesty and integrity
drug error: key thing to do:
cross it out and prescribe appropriate alternative
yellow card forms (drugs): what are they used for?
to report suspected adverse drug reactions to the BNF (particularly regarding drugs new to the market). These are not used for reporting prescribing errors
how do you cooperate with complaints procedures?
respond fully, promptly, and honestly to complaints.
if late, and bottom two choices are do nothing and hope no one notices vs ask f1 colleagues to lie and say you are busy, what is worse?
do not ask colleagues to lie as unproffesional in 2 aspects, not just one
GMC guidance: doctor’s health:
you should not rely on your own judgement of the risk posed by your health to your patients
consult your GP / occ health
breaking bad news to family - what to do with bleep?
give to reg on call keep but only respond to emergencies/arrests keep and respond to all calls give to staff nurse leave at nurses station
conidentiality: situation when you can breach it eg husband has HIV no plans to tell partner
remember you have to break confidentiality, so all options that have this should be prioritised
You are a foundation year one doctor on a Care of the Elderly ward. You have noticed that Gladys, an 80-year-old lady who is recovering from a hip fracture, has not been eating her meals. She has severe dementia and has not been able to understand and retain other information during her admission.
senior nurses first consultant review dietician review (after consultant review) then suggest to her to eat more do nothing
with safeguarding issues - what is key things to do:
contact child protection officer/safeguarding lead first
as best to not be only person who knows what’s going on
good practice to inform the parent what you are going to do
better to tell senior than tell nobody
with procedures eg LP you havent done before ->
PATIENT SAFETY first
willingness to learn
honesty, candour - admit to consultant and pt before you haven’t done one
get someone who has done one to do it before you
