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You are a new Intern Doctor and have been socialising a lot and staying out late to party. You are tired and have been turning-up late for work and whilst your fellow Intern’s have been covering some of your work it is leading to delays in morning admission clerk-ins, drug-charts and medications and blood tests. Today, you arrive late and are told the morning Theatre List was delayed and a patient cancelled because the Day-case Admission patients were not all clerked-in and ready for Theatre. You are on the early shift again tomorrow but are invited to a great party tonight and wonder what to do?

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You are a new Intern Doctor and have been socialising a lot and staying out late to party. You are tired and have been turning-up late for work and whilst your fellow Intern’s have been covering some of your work it is leading to delays in morning admission clerk-ins, drug-charts and medications and blood tests. Today, you arrive late and are told the morning Theatre List was delayed and a patient cancelled because the Day-case Admission patients were not all clerked-in and ready for Theatre. You are on the early shift again tomorrow but are invited to a great party tonight and wonder what to do?

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You are a New Intern Doctor and have always been competitive in sport and in your studies, for which you achieved individual awards and high-marks.You work with a fellow Intern who you recall had to repeat several exams, unlike you, and appear to take much longer to do the same tasks as you. It is approaching the end of your shift and you have your tasks completed but your colleague has several tasks to complete and one of their patients has become unwell. You wonder should you help them complete their tasks or leave on time?

# data[].attributes.subject
You are a New Intern Doctor and have always been competitive in sport and in your studies, for which you achieved individual awards and high-marks.You work with a fellow Intern who you recall had to repeat several exams, unlike you, and appear to take much longer to do the same tasks as you. It is approaching the end of your shift and you have your tasks completed but your colleague has several tasks to complete and one of their patients has become unwell. You wonder should you help them complete their tasks or leave on time?

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You are a Senior Registrar and your new training attachment is in a small but very busy peripheral hospital. You notice there is no formal handover from the on-call overnight team and the morning ward round is lengthy because you often find rather sick patients newly admitted patients without a clear management and it delays catering of breakfasts and your arrival at morning clinic.You have seen things run much smoother and safer in a previous hospital which had introduced a formal morning handover, but you are only here for 6 months and wonder what you should do?

# data[].attributes.subject
You are a Senior Registrar and your new training attachment is in a small but very busy peripheral hospital. You notice there is no formal handover from the on-call overnight team and the morning ward round is lengthy because you often find rather sick patients newly admitted patients without a clear management and it delays catering of breakfasts and your arrival at morning clinic.You have seen things run much smoother and safer in a previous hospital which had introduced a formal morning handover, but you are only here for 6 months and wonder what you should do?

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Doctor continues to turn up late to work but is blaming external factors for his poor attendance and work ethic. In actuality, it is the own doctor's actions that are costing hi, the quality of his care given

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The delay and and cancellation of procedures are wasting the other professional's time and is effecting the patients ability to receive their care

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Doctor needs to reassess his priorities (alturism) --> need to put patient first and make sacrifices to ensure that the patient is at the forefront of the care

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Have a discussion with the other intern - explain to them that everyone is very busy and has many responsibilities.
Everyone has also been covering for the other intern and has been adding to their individual workload

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Should approach HR team? Explain what is going on to them and try to arrive at a resolution if the intern doesn't change his behaviour

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Changed behaviour - everyone is free to act as they please but it is imperative that despite external endeavours that the colleague attends to clinic at their expected time

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Individual: reflect on his actions

Institutional: the senior doctors can observe the interns and evaluate their actions

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Council: create a set of guidelines that focus on rules and regulations of proper attendance and behaviour

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Believe that the other intern should help out. By not helping out you are putting the patients at risk and ultimately reflecting poorly on the institution if the patient were to start becoming unwell.

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Alturism - sacrifice your time to ensure that the patients are taken care of

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Teamwork and collaboration - important to help out your colleagues but it is imperative to ensure that your colleagues are self-sufficient as well and can still complete the job on their own
Recognize that everyone learns in their own way and can help to teach the colleague how to become more self-sufficient.

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Help/guide the colleague - work through the patient work together to ensure the highest quality care for all the patients

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Reaching a point where all the patients are cared for and your colleague that was struggling with taking care of patients to realize where maybe they are lacking and where they can work on their skills to be able to work more efficiently

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It is important to have a good self-management to not cause burden to colleague and delay work which can have negative impact to patient. Learn to prioritise what's important

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Observe 1, Do 1, Teach 1

Can benefit both involved

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Individual: lend out a helping hand to your friend, not a competition (everyone is trying to learn)

Institutional: assign someone (supervisor) to instruct the interns and act as a point of contact for them to receive support, want to cultivate a healthy environment where people feel okay asking for help

Council: create a new handbook that includes additional training programs

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Ethical practice: as a doctor it is your job to speak up when something is wrong, want the hospital to be working at the highest-level quality as possible

EBP: recognize how the practice of morning handover has been implemented in other hospitals and assess how it can be incorporated into this hospital to help improve their efficiency and care

Hospital is very busy - need to make a proper management to organize everything, problems with trying to assign the new unwell patients where to put them

Advocacy - by bringing up this issue you are advocating for the patients to receiving better care

Good communication with authority to speak about this issue as the registrar is only present in the hospital for 6 months

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Introduce the idea of handover, speak to the staff around and ask them if they know what handover is and how handover is effective at explaining the patients from the evening to the morning staff

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Introduce management skills from their previous hospital and see if the effective management skills from the past can be implemented into the new hospital

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Proper management and organization between the staff

By having a morning handover it informs the morning staff of the patients from the night before, their conditions, what tests they received and their status. This will prevent wasting time and resources and will ultimately improve patient care as the new morning staff will be better informed of the patients from the night before. And then they will be better able to assess the new patients coming in to ensure proper care of them as well

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Individual: be aware of what's lacking in the hospital and be the person who speaks up to management to seek a change

Institutional: bring this idea forward and management if it should be improved or not (PDSA?)

Council: create a new guideline