TLE 2 Group_14_Dublin by Eric Clarke https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2 THP7: Reflective report on a clinical encounter en-us 2021-11-09 10:50:17 UTC 2021-11-23 12:26:41 UTC hello@padlet.com https://padlet.net/icons/png/1f34e.png 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? RCSI_MedProf https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1877882385 2021-11-09 10:50:17 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1877882385 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? RCSI_MedProf https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1877882386 2021-11-09 10:50:17 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1877882386 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? RCSI_MedProf https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1877882388 2021-11-09 10:50:17 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1877882388 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908221931 Being disrespectful to the colleagues. By going to another party, you are not acknowledging the problem.

There is an ethical responsibility for self-care]]> 2021-11-23 11:56:05 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908221931 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908222580 Working in Partnership principle of Professionalism is in conflict]]> 2021-11-23 11:56:29 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908222580 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908223830 Prioritising personal life instead of professional responsibilities]]> 2021-11-23 11:57:22 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908223830 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908225548 Risk to patient safety so patient-centred care is compromised. ]]> 2021-11-23 11:58:39 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908225548 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908230346 If it was me who went to the party:
- Apologise for the mistakes done and rectify this. Make sure you balance both personal and professional life. Come in early and communicate well with your colleagues about the morning admission list and etc

If it was me who worked with the colleague that is partying:
- Talk to him/her about the issues at hand and have a polite discussion that it is affecting the work in the hospital]]> 2021-11-23 12:02:00 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908230346 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908230821 individual (micro): 
- uphold self-care 
- maintain professionalism

institutional (meso): 
- ensure work schedule of staff is appropriate, i.e., not overworked 
- set standards for staff i.e., set rules for punctuality 

council/regulatory body/societal (macro): 
- recognise the need for quality improvement when cases of unprofessionalism like this arises

]]> 2021-11-23 12:02:20 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908230821 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908230877 You arrive on time every day going forward
All work complete so theatre lists proceed on schedule
You are communicative about any schedule problems going forward
You prioritise patient safety above your own social life 
Recognise how over-partying can lead to bad health for you, and negative work outcomes]]> 2021-11-23 12:02:22 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908230877 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908232966 All of the above!!]]> 2021-11-23 12:03:55 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908232966 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908235395 If the colleague does not respect his professional responsibilities, then you would report to the higher ups]]> 2021-11-23 12:05:38 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908235395 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908237032 individual (micro):
- patient is the main priority and regardless of any circumstance - to ensure the patient receives best care
- partnership between colleagues is important and should be maintained
- colleague experience and skill is adequate 

institutional (meso): 
- ensure the patient has the same standards of care
- ensure staff get all the training, support 
- ensure workload is balanced - distributed equally

council/regulatory body/societal (macro):
- have e.g., on job training programme to ensure healthcare staff are supported and skills are up to date/adequate

]]> 2021-11-23 12:06:52 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908237032 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908240143 Issues are:
- Working in partnership
- Reflective Practice Continuous Improvement
- Altruism
- Compassion]]> 2021-11-23 12:08:56 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908240143 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908243143 Communicate with the colleague on how they are finding the job and if they need any help with it, or if there are any additional concerns going on.]]> 2021-11-23 12:10:45 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908243143 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908244154 Tell the colleague that if the problem persists, then raise the concerns to superiors]]> 2021-11-23 12:11:28 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908244154 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908246433 The patient gets cared for and the skill of the colleague is up to the level. And that the colleague feels supported.]]> 2021-11-23 12:13:07 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908246433 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908246861 Ask mentor/boss to give colleague more support]]> 2021-11-23 12:13:25 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908246861 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908248462 The situation does not escalate and is resolved before it leads to larger problems that could affect patient health and safety

]]> 2021-11-23 12:14:34 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908248462 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908248858 approach colleagues non-judgementally and with compassion

prioritise patient care

institutions should ensure all employees receive the support and teaching that they need]]> 2021-11-23 12:14:51 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908248858 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908252851 Communication

Working in partnership

Evidence based practice

Reflective practice

Quality improvement

Advocacy]]> 2021-11-23 12:16:54 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908252851 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908262235 Raise your concerns to the superior and the head of nursing staff. Suggest improvements on how the hospital is run.

Having a discussion with the nursing, medical and bed managers on what are the issues at hand causing the delay and problems with handover. ]]> 2021-11-23 12:23:08 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908262235 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908263911 Check-in on the patients: see if they are satisfied with their care and experience; ask them about their previous experience (possibly in this hospital/in other institutions)
This is an important part of QI. ]]> 2021-11-23 12:24:13 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908263911 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908264531 arrive at a new system which results in clear communication about patients and their treatment, does not delay other ward functions, and gives a higher standard of patient care

while discussing the new system, other staff feel listened to and are able to voice their concerns but be open to new suggestions, so that a collaborative discussion takes place]]> 2021-11-23 12:24:39 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908264531 https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908266626 individual (micro):
- Having a clear management plan with specific roles planned out. Respectfully approaching the colleagues to raise concerns on improving the hospital structure

institutional (meso): 
- Having a formal handover forms
- Having a flat management structure

council/regulatory body/societal (macro): 
-]]> 2021-11-23 12:26:04 UTC https://padlet.com/RCSI_MedProf/62sfctucpb5cx8v2/wish/1908266626