# data[].attributes.headline
You are reviewing your recent social media messages and notice that a co-resident has written a highly negative comment about a patient’s situation. There was no specific patient name, but the hospital’s initials and the description of the case make it easy to figure out the nurses and physicians that were being described.

# data[].attributes.subject
You are reviewing your recent social media messages and notice that a co-resident has written a highly negative comment about a patient’s situation. There was no specific patient name, but the hospital’s initials and the description of the case make it easy to figure out the nurses and physicians that were being described.

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Dr Ahmed a consultant from another department approaches you (as a resident) and wants to check Mrs. PJ’s charts. You reply, that she is not their patient, and you’re uncertain whether you’re allowed to share it with him? He replies, “Fine but, give me the charts anyway, I may have a reason in the near future, so don’t get upset”, physician replied.

# data[].attributes.subject
Dr Ahmed a consultant from another department approaches you (as a resident) and wants to check Mrs. PJ’s charts. You reply, that she is not their patient, and you’re uncertain whether you’re allowed to share it with him? He replies, “Fine but, give me the charts anyway, I may have a reason in the near future, so don’t get upset”, physician replied.

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You are final year medical student making rounds with the attending physician and a resident on Mr. Johnson, a 58-year-old man with bacterial sepsis. You looked up his blood culture results this morning and found that they were positive, but your resident was unable to check the culture results himself before rounds. When asked by the attending physician, the resident replies that the culture results are not yet available.

# data[].attributes.subject
You are final year medical student making rounds with the attending physician and a resident on Mr. Johnson, a 58-year-old man with bacterial sepsis. You looked up his blood culture results this morning and found that they were positive, but your resident was unable to check the culture results himself before rounds. When asked by the attending physician, the resident replies that the culture results are not yet available.

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Confidentiality- giving this doctor the charts is a breech of confidentiality
Poor communication and not working in partnership- the phrase 'don't get upset' is quite hurtful
Ethics- unethical to pressure the registrar when he doesn't have a good reason to get access to the information

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Ask the consultant in charge of the patients care if it's allowed
Deny the chart to the consultant until you get permission and tell them if that future need does arise then they can come back then

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Patient confidentiality is maintained
Other staff members backing up the decision of that resident and protecting them from any repercussions from the consultant
Consultant becomes aware that their behaviour is unacceptable

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Power imbalance is present between the resident and consultant so that makes it more difficult to resist their demands

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Micro- protecting that single patient's information and maintaining confidentiality
Meso- lack of patients' trust in their doctors in this hospital
Macro- Public becomes untrusting in the medical profession as a whole

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May raise the issue of the consultant's hurtful language and a more senior member of staff could have a 'cup of coffee intervention' with them to discuss their language and the way they interact with their juniors

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Power imbalances can make it difficult to do the right thing

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Resident is not being honest and showing a lack of integrity
Need to be able to communicate efficiently using critical language because sepsis is incredibly time sensitive- you have the responsibility to tell the consultant the results but avoid putting blame on the resident
Working in partnership by not throwing your colleague under the bus
Advocacy to get the best care for the patient by acting quickly

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Without putting blame on the resident, say that you saw the blood results and that they were positive

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Sepsis 6 is carried out immediately and the relationship between the whole team is maintained

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Language can be very important in the way you handle time sensitive information

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Micro- patients not getting best care just because staff are saving face
Meso- could result in lack of trust within teams
Macro-

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The culture the consultant was creating could have been one where the resident felt they would not be excused for not having looked up the results already- this is poor for team dynamics

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Confidentiality of the patient's case
Lack of compassion and empathy by making a negative comment

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Contact the individual immediately and ask them to take the post down, explaining how easy it is to figure out the staff members and therefore the patient, and that they shouldn't do it again

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Person who is posting learns from their mistake and doesn't do it again

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If the person refuses to take down the post then report it

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Micro- upset patient
Meso- bad for the hospital's reputation
Macro- loss of trust in the medical community or additional constrictions put on HCP's use of social media