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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 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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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.

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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.

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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.

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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.

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Lack of communication as Dr Ahmed did not give a valid reason for checking the chart

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Lack of reflective practice as the consultant undermines with "Fine give me the charts anyway"

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Dishonest about why he needs to use the graph

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Dishonest about why he needs to use the graph

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Lack of integrity

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Not give him the charts and/or ask for a valid reason for viewing them

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If he continues this behaviour report him to someone higher up

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That patient confidentiality would not be breached

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That the consultant would reflect on their own behaviour and recognise what went wrong

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The charts did not go into the wrong hands

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The charts did not go into the wrong hands

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On an individual level patient confidentiality could be breached and you as an individual are put in a difficult position

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Lack of honesty and integrity from the resident's part

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working in partnership - speak up if there's a mistake

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working in partnership - speak up if there's a mistake

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Delay in care

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Patient safety compromised and possible delays in patient care

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Perhaps bring up the matter in an non-conformational way

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Bring up the matter so that the patient gets best possible care quickly

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Promoting advocacy and patient centred care by putting the patient on the right treatment and not supporting an environment where someone is blamed

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Talking with the resident and asking about why he said the results weren't available or why he felt like he could not tell the truth

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Resident would reflect on their own practice

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Safe, supportive, welcoming environment in which you can speak up

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Micro level - patient and best possible care, institutional level - environment in which to raise issues

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Lack of working in partnership as this will put your colleagues/healthcare staff in a bad light and also hinder the hospital's reputation which could lead to lack of trust in the public

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The person who posted it was not acting in a compassionate way

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lack ethical practice, not preserving patient confidentiality

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Bring up the matter with the co-resident first and ask to reflect on their practice and remove the post

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In case the post is not removed report it on the social media website and to hospital management

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Advice the co-resident on e-professionalism and hopefully get him to realise their unprofessional behaviour

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Taking down the post as soon as possible

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Promoting good communication and aspects of e-professionalism so this does not happen again

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Making sure that the patient confidentiality is not breached in this case

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posting about it would not improve the situation

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Advise resident on how to bring matters of concern to light. By reporting etc - not posting on social media

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Micro - individuals that could be recognized from the post, possible patient confidentiality breach, Meso - hospital reputation suffering, Macro - could lead to diminished trust in healthcare on a larger level if the post spreads