TLE 3 Group_2_Dublin by Eric Clarke https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh THP_12_Case scenario discussion on themes of professionalism in practice en-us 2021-11-09 12:13:23 UTC 2021-12-01 13:02:54 UTC hello@padlet.com https://padlet.net/icons/png/1f353.png 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. RCSI_MedProf https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1878028863 2021-11-09 12:13:23 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1878028863 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. RCSI_MedProf https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1878028866 2021-11-09 12:13:23 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1878028866 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. RCSI_MedProf https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1878028869 2021-11-09 12:13:23 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1878028869 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922640875 Confidentiality - Dr Ahmed is not the patient's consultant and it would be a breech of confidentiality to give the patient's information to another doctor without the patient's consent. We have consent to the patient's information, not Dr Ahmed]]> 2021-12-01 12:36:57 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922640875 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922642476 Integrity - doing the right thing and not giving Dr Ahmed the charts even though no one is watching to make sure that the patient's privacy is protected]]> 2021-12-01 12:38:03 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922642476 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922642608 Wouldn’t give them the chart 
Explain that it isn’t personal and that there are rules you have to follow ]]> 2021-12-01 12:38:08 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922642608 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922644220 Advocacy - by protecting the patient's information you are advocating for their confidentiality]]> 2021-12-01 12:39:02 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922644220 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922648704 Person would understand why you refused permission 
You could communicate effectively about it 

]]> 2021-12-01 12:41:51 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922648704 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922649987 Individual - move forward explaining that providing the patient's charts is a breech of patient confidentiality
Institutional&Council - if it gets to the point where Dr Ahmed continues to ask for the chart then more strict provisions may have to be taken to ensure the confidentiality of the patient]]> 2021-12-01 12:42:39 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922649987 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922656679 Partnership - need to work with the physician, need to speak up and advise that the cultures are back, possibly results can be reviewed together to see next steps for the patient]]> 2021-12-01 12:46:42 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922656679 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922660568 They check the result when you alert them 
They review it on time as sepsis is time dependent 
Ensure your approach is appropriate with good communication ]]> 2021-12-01 12:48:47 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922660568 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922660591 Advocacy - advocate for the patient by saying that the results are back/available, not advisable to without information about sepsis (time-sensitive matter)

]]> 2021-12-01 12:48:48 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922660591 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922661678 Go forward saying that results are available/back for review without giving/drawing on any conclusions]]> 2021-12-01 12:49:26 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922661678 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922667888 Individual - advise that the results are back in interest of wanting to provide the best care for the patient
Institutional/Council - resident possibly doesn't feel like they are in a safe environment to disclose that they didn't have time to check results (this then puts a patient with a possible life threatening illness at risk)]]> 2021-12-01 12:53:03 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922667888 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922675969 Breech of confidentiality - even though no specific name of the patient was used they could figure out that the case is about them, physicians and nurses can also be identified by the case]]> 2021-12-01 12:57:26 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922675969 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922677713 Possibly reach out to this co-resident and advise that it may be best to take down this negative comment about the patient's situation. It reflects badly on the care of patients and is a situation that could be easily identified]]> 2021-12-01 12:58:22 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922677713 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922679528 Working in partnership - passive aggressive behaviour shown (instead of running to social media to share this negative experience speak to the individuals responsible in person)]]> 2021-12-01 12:59:20 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922679528 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922680901 Take down the comment and have better communication]]> 2021-12-01 13:00:03 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922680901 https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922686351 Individual - recognize that they can't discuss their work and concerns like that online, everyone can interpret different situations online differently (everyone doesn't have the full story)
Institutional - make sure that the environment is one that is supportive, positive and welcoming to open communication to discuss any issues that arise instead of sharing them on social media for everyone to see
Council - have a concrete set of rules and guidelines that detailed what is allowed and what isn't allowed to be shared online, if sharing online occurs make a distinctive guideline of what is okay and what is not okay, and what is allowed and what isn't allowed. ]]> 2021-12-01 13:02:54 UTC https://padlet.com/RCSI_MedProf/bd87mra5t5rfwavh/wish/1922686351