Weekly SJT Sat 20th oct
Ranking Question
You are an FY1 working on a medical ward. The CT1 tells you he has tested positive for chlamydia and that he doesn't have time to go to the GP. He asks you to prescribe him antibiotics
Rank in order the following actions in response to this situation (1 = Most appropriate, 5 = Least appropriate)
A Tell the CT1 that he could go to A&E and take some from the medicine cupboard when no one is looking
B Tell the CT1 to book an appointment to see his GP or local sexual health clinic
C Take a full sexual history from him and prescribe the appropriate antibiotics after confirming this in the BNF
D Refuse politely
E Offer to hold his bleep for a couple of hours whilst he goes to visit the GP
Answer: BDECA
This question assesses your ability to dealing with a difficult situation involving an inappropriate request from a senior colleague. You must refuse his request (D) however helping him by advising him to attend his GP or sexual health clinic (B), which also implies a refusal is a better top choice. The worst choice is to recommend stealing (A) which would call your integrity into question. Offering to hold an SHOs bleep (E) is risky, as a situation you aren’t competent to deal with might arise, however, it is a better option than prescribing the antibiotics yourself (C).
Multiple Choice Question
An elderly patient with dementia has become acutely confused; nurses call you in the middle of your night shift to inform you he has absconded from the ward.
Choose the THREE most appropriate actions to take in this situation.
A Call the police within the first five minutes as per hospital protocol
B Ask the nursing staff to inform neighbouring wards and security staff
C Carry on with your clinical duties and leave this for the nursing staff to resolve as they are better qualified to do so
D Call the site manager and inform them of the situation
E Take no action at this point as he will probably return, but check back in a couple of hours
F Visit the ward to find out further details, including current clinical condition, then inform your SHO
G Call the patient’s out of hours GP to obtain more information about the patient’s history
H Start searching the hospital and then surrounding sites
Answer: B, D, F
This question assesses your ability to prioritise your work-load and put patient care first. As the F1 on nights you will be busy and unable to start searching for the patient yourself (H) as it would jeopardise the care of other patients. Calling the police is not indicated at this time and unsurprisingly there is also no protocol for calling them within 5 minutes (A). The site manager at night is the best person to coordinate the search for the patient (D) and informing the surrounding wards (B) and your senior (F) of the situation is appropriate. Whilst you are going to leave the majority of the search to the nursing and security staff (C) it is more appropriate to ensure the correct people have been informed before carrying on your clinical duties, otherwise you risk a situation whereby the nurses on the ward think you are dealing with the situation when you are not. To do nothing (E) is less appropriate as the patient may need medical attention. The out of hours GP is an emergency service and it would not be appropriate to phone them for this particular situation.
You are an FY1 working on a medical ward. The CT1 tells you he has tested positive for chlamydia and that he doesn't have time to go to the GP. He asks you to prescribe him antibiotics
Rank in order the following actions in response to this situation (1 = Most appropriate, 5 = Least appropriate)
A Tell the CT1 that he could go to A&E and take some from the medicine cupboard when no one is looking
B Tell the CT1 to book an appointment to see his GP or local sexual health clinic
C Take a full sexual history from him and prescribe the appropriate antibiotics after confirming this in the BNF
D Refuse politely
E Offer to hold his bleep for a couple of hours whilst he goes to visit the GP
Answer: BDECA
This question assesses your ability to dealing with a difficult situation involving an inappropriate request from a senior colleague. You must refuse his request (D) however helping him by advising him to attend his GP or sexual health clinic (B), which also implies a refusal is a better top choice. The worst choice is to recommend stealing (A) which would call your integrity into question. Offering to hold an SHOs bleep (E) is risky, as a situation you aren’t competent to deal with might arise, however, it is a better option than prescribing the antibiotics yourself (C).
Multiple Choice Question
An elderly patient with dementia has become acutely confused; nurses call you in the middle of your night shift to inform you he has absconded from the ward.
Choose the THREE most appropriate actions to take in this situation.
A Call the police within the first five minutes as per hospital protocol
B Ask the nursing staff to inform neighbouring wards and security staff
C Carry on with your clinical duties and leave this for the nursing staff to resolve as they are better qualified to do so
D Call the site manager and inform them of the situation
E Take no action at this point as he will probably return, but check back in a couple of hours
F Visit the ward to find out further details, including current clinical condition, then inform your SHO
G Call the patient’s out of hours GP to obtain more information about the patient’s history
H Start searching the hospital and then surrounding sites
Answer: B, D, F
This question assesses your ability to prioritise your work-load and put patient care first. As the F1 on nights you will be busy and unable to start searching for the patient yourself (H) as it would jeopardise the care of other patients. Calling the police is not indicated at this time and unsurprisingly there is also no protocol for calling them within 5 minutes (A). The site manager at night is the best person to coordinate the search for the patient (D) and informing the surrounding wards (B) and your senior (F) of the situation is appropriate. Whilst you are going to leave the majority of the search to the nursing and security staff (C) it is more appropriate to ensure the correct people have been informed before carrying on your clinical duties, otherwise you risk a situation whereby the nurses on the ward think you are dealing with the situation when you are not. To do nothing (E) is less appropriate as the patient may need medical attention. The out of hours GP is an emergency service and it would not be appropriate to phone them for this particular situation.