# data[].attributes.body
Kat is a 3rd year Resident who is known by her juniors and co-workers for her very strong personality. She was originally very timid and shy but residency has taught her that unassertiveness and indecisiveness are two of the worst traits a doctor can have. She believes that being scolded or shouted at comes with the training.
One day, nearing the end of her tour of duty in the Intensive Care Unit, Kat was awakened by a sudden phone call. She was being summoned by the Senior House Officer (SHO) because of an incident involving their department the night before. Apparently, her juniors refused to attend to an elderly patient who was brought to the emergency room by his children. The patient’s relatives told the junior residents that their father suddenly lost consciousness shortly after leaving the bathroom. They immediately brought him to the emergency room using their family friend’s tricycle.
After catching a glimpse of the patient, instead of checking his vital signs, they immediately told the patient’s relatives to seek consult somewhere else because they are unable to manage the case. The SHO was confused as to why the junior residents turned away the patient when he knows that they are usually hardworking and have handled more toxic patients before. Kat refutes him saying that her juniors rarely contribute anything useful to the management of their patients. Taken aback by her statement, the Senior House Officer tried to investigate further and learned that the junior residents have refused patients before, but only when Kat was on duty.

# data[].attributes.body
1. There was a problem with the training program that made Kat acting this way
2. Interpersonal problems between the residents which could make the patient in harm
3. Kat was not properly oriented before coming into residency program
4. Kat was probably in rebellion (?) to the training program

# data[].attributes.headline
There are some inconsistencies in Kat's orientation:  she knows unassertiveness and indecisiveness are not good, but these are in contrast to the thinking that being scolded and shouted at come with the training. It's as if you could be assertive and decisive at a certain level (senior), and yet be ready to be shouted at (if junior).

# data[].attributes.subject
There are some inconsistencies in Kat's orientation:  she knows unassertiveness and indecisiveness are not good, but these are in contrast to the thinking that being scolded and shouted at come with the training. It's as if you could be assertive and decisive at a certain level (senior), and yet be ready to be shouted at (if junior).

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The internal dynamics of the residents put the patient at risk.

# data[].attributes.subject
The internal dynamics of the residents put the patient at risk.

# data[].attributes.body
1. They could all have been summoned (individually and Jointly) --> by the SHO (a. Investigation of what happened b. re orientation of the hierarchy c. setting of ground rules)

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Dr Maglaya:  fear in the junior residents

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Dr Maglaya:  fear in the junior residents

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Individual investigation of what happened and re orient the team of the demeanors while obn duty

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Individual investigation of what happened and re orient the team of the demeanors while obn duty

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Dr. Maglaya: walang mapagsumbungan. They didn't know who to turn to.

# data[].attributes.subject
Dr. Maglaya: walang mapagsumbungan. They didn't know who to turn to.

# data[].attributes.body
anxieties and interpersonal traits

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There may be no clear cut lines or definitions how things are.  No "onboarding manual."  So junior residents may harbor negative feelings towards Kat, but cannot speak up or stand up to her. So the internal micro-aggressions are displaced toward the patient when she is the one  on duty.

# data[].attributes.subject
There may be no clear cut lines or definitions how things are.  No "onboarding manual."  So junior residents may harbor negative feelings towards Kat, but cannot speak up or stand up to her. So the internal micro-aggressions are displaced toward the patient when she is the one  on duty.

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1. Creation of Grievance committee

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Institutional policy from highest levels: define the reach of psychological safety, applications, how implemented across all levels

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Institutional policy from highest levels: define the reach of psychological safety, applications, how implemented across all levels

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Cultivate the culture of a "flat" organization - we will listen to anyone who would like to speak up.

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Cultivate the culture of a "flat" organization - we will listen to anyone who would like to speak up.

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It is a brave paradigm to take on, but it would be great to start somewhere.  

# data[].attributes.subject
It is a brave paradigm to take on, but it would be great to start somewhere.  

# data[].attributes.body
1. there was a similar situation during the residency training period wherein you were endorsed as a junior resident Not to refer toxic patients and try to "troubleshoot" prior to referring the patient to the more senior resident/s. This prompted the residents to refuse toxic patients