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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 mention of the patient name, but the hospital’s initials and the description of the case make it easy to figure out the nurses and physicians being described.

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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 mention of the patient name, but the hospital’s initials and the description of the case make it easy to figure out the nurses and physicians being described.

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Dr Ahmed, a consultant from another department approaches you (as a resident) and wants to check Mrs. P’s chart. Because she is not his patient, you’re uncertain whether you’re allowed to share it with them. But the physician insists you to give him  the chart anyway, as he may have a reason in the near future to see the patient and tells you not to get upset.

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Dr Ahmed, a consultant from another department approaches you (as a resident) and wants to check Mrs. P’s chart. Because she is not his patient, you’re uncertain whether you’re allowed to share it with them. But the physician insists you to give him  the chart anyway, as he may have a reason in the near future to see the patient and tells you not to get upset.

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You are final year medical student making rounds with the attending physician and a resident and consult on Mr. Johnson, a 58-year-old man with bacterial sepsis. You looked up his blood culture results this morning and found 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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You are final year medical student making rounds with the attending physician and a resident and consult on Mr. Johnson, a 58-year-old man with bacterial sepsis. You looked up his blood culture results this morning and found 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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consultant recognizes lapse of professionalism and apologizes to student

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consultant recognizes lapse of professionalism and apologizes to student

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advise consultant to speak to your direct supervisor beforehand, speak to supervisor directly 

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advise consultant to speak to your direct supervisor beforehand, speak to supervisor directly 

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ask my senior if it alright to share this information with this other consultant 

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ask my senior if it alright to share this information with this other consultant 

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superiors can put you in compromising situations that may be difficult to exercise professionalism esp as a subordinate

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superiors can put you in compromising situations that may be difficult to exercise professionalism esp as a subordinate

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inform my patient that their information will be shared and ensure that I have their consent. inquire further as to why dr Ahmed wants the chart, and try to anonymize the information if a consult is needed

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inform my patient that their information will be shared and ensure that I have their consent. inquire further as to why dr Ahmed wants the chart, and try to anonymize the information if a consult is needed

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resident is not exercising honesty and integrity

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resident is not exercising honesty and integrity

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communication is optimized so that the patient receives optimum care while still protecting the patient's privacy

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communication is optimized so that the patient receives optimum care while still protecting the patient's privacy

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consultant follows proper protocol in accessing patient information

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consultant follows proper protocol in accessing patient information

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tell the attending physician that the result is out

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tell the attending physician that the result is out

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Consultant realized chart can only be given if report is being given by the existing attending physician, not the medical student in this case, or if they have questions they can discuss informally with the existing attending physician

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Consultant realized chart can only be given if report is being given by the existing attending physician, not the medical student in this case, or if they have questions they can discuss informally with the existing attending physician

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have a discussion with the resident about his behaviour

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have a discussion with the resident about his behaviour

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resident realizes his mistake and makes effort not to repeat it

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resident realizes his mistake and makes effort not to repeat it

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patient being treated at the soonest possible time 

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patient being treated at the soonest possible time 

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resident is spoken to about their unethical and dishonest behaviour 

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resident is spoken to about their unethical and dishonest behaviour 

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Micro: make sure attendings know not to question medical students or ask them to give charts, if information is needed they can ask the attending or discuss the patient with them

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Micro: make sure attendings know not to question medical students or ask them to give charts, if information is needed they can ask the attending or discuss the patient with them

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promote a culture of openness. If the resident was not able to check the result. He must be able to say that to the consultant. without any reprimand 

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promote a culture of openness. If the resident was not able to check the result. He must be able to say that to the consultant. without any reprimand 

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formal process for requesting and accessing patient information which upholds patients confidentiality and privacy and include consent for access of patients information by healthcare professionals and staff/consent renewal

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Meso: await for formal report to be given to obtain patient information if required ahead of time

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Meso: await for formal report to be given to obtain patient information if required ahead of time

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request made on an institutional and not an individual level

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request made on an institutional and not an individual level

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at the institutional level, it must be made aware that any situation like this could be considered as negligence if the patient is not given prompt care

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at the institutional level, it must be made aware that any situation like this could be considered as negligence if the patient is not given prompt care

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tactfully answer that you were able to check the results and they have been released already/came back positive

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tactfully answer that you were able to check the results and they have been released already/came back positive

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Promote a culture that allows for open communication and constructive criticism as in this case patient care was compromised as proper antibiotics were not given since culture results were not communicated

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Promote a culture that allows for open communication and constructive criticism as in this case patient care was compromised as proper antibiotics were not given since culture results were not communicated

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discipline would be given to the resident who posted this on social media

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discipline would be given to the resident who posted this on social media

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talk to the co-resident about their unethical behaviour and ask them to remove the post before anyone else from the hospital sees it

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talk to the co-resident about their unethical behaviour and ask them to remove the post before anyone else from the hospital sees it

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be aware of what is being posted on social media

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be aware of what is being posted on social media

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advocate for patient's safety if feel that it is being compromised 

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advocate for patient's safety if feel that it is being compromised 

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alert them that the post should be removed

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alert them that the post should be removed

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individual: coping mechanisms to deal with stress and frustrations of the job should be put in place so as to change the use of social media as a place to air grievances

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individual: coping mechanisms to deal with stress and frustrations of the job should be put in place so as to change the use of social media as a place to air grievances

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meso:very strict policies put in place as to social media use in hospital

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meso:very strict policies put in place as to social media use in hospital

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institutional: provide outlets or services that allow physicians and nurses to voice their concerns

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institutional: provide outlets or services that allow physicians and nurses to voice their concerns