Weekly SJT (Oct 6th)
Ranking Question
You are the medical FY1 on call during the night. Your shift starts at 8.30pm and you have just woken from sleep to find out that it is already 8.15pm. It will take you an hour to get to work.
Rank in order the following actions in response to this situation (1 = Most appropriate, 5 = Least appropriate)
A Get into hospital as quickly as you can, sending a text to the day FY1 apologising for your lateness
B Call in and explain that you are feeling unwell, and therefore wont be able to make it into do the night shift
C Contact the registrar on call, apologise and explain that you will be 45 minutes late
D Contact the FY1 you are taking over from and apologise explaining that you slept in and will be 45 minutes late
E Contact the day team and tell them that you are on the train, but it has been delayed and therefore you will be late
Answer CDAEB
This question assesses your ability to communicate with you colleagues and your ability to act with integrity. The worst options involve a lie (B) and (E) as this does not demonstrate integrity. Between these two bad options, (B) is worse than (E) as it also leaves the hospital without sufficient medical cover at night putting patient safety at risk. The best option is to inform and apologise to the person responsible for the medical take, the registrar on call (C), as he/she can arrange appropriate cover for your lateness. This is more appropriate than simply calling or texting the FY1 as they are not the doctor responsible for the take. Calling them (D) is preferable to texting them (A) as it ensures the message has been received.
Multiple Choice Question
Whilst on the ward a patient informs you they heard another patient fall to the ground whilst using the bathroom. How do you initially respond?
Choose the THREE most appropriate actions to take in this situation.
A Go and assess the fallen patient immediately, taking an ABCDE approach
B Ask the nursing staff to assess the patient and inform you of their findings
C Continue with your ward jobs, this is not part of your role, and finishing the jobs are your priority
D Call the family, they have a right to know what has happened
E If the patient does not need urgent medical assistance ask the nurses to get them back into their bed and take the patient’s observations. Go and complete your assessment after this
F Leave the ward to find your registrar, as the patient may need senior input
G Document your assessment of the fallen patient clearly in the notes
H Fill out an incident form first as otherwise it may get forgotten
Answer: A, E, G
This question assesses you ability to manage patients safely. Patients frequently fall in the hospital although most don’t injure themselves severely. You must assess the patient quickly in case they are severely unwell. This should be done in an ABC manner (A). If the patient is clinically stable, then it is acceptable to ask the nurses to take the patient’s observations and assess them following this (E). Documentation of your assessment is important so that anyone following this patient up can see what has previously happened (G).
It is not acceptable to ignore a potentially unwell patient (C), or delegate assessment to a nurse without ensuring they are stable first (B). Leaving the ward to find senior help without first assessing the patient yourself does not allow the registrar to use your initial information to make a decision about whether they need to attend the patient immediately or not (F).
The question asks for your initial response, therefore filling out an incident form (H), and discussing the case with relatives (D), whilst important are less appropriate initially.
You are the medical FY1 on call during the night. Your shift starts at 8.30pm and you have just woken from sleep to find out that it is already 8.15pm. It will take you an hour to get to work.
Rank in order the following actions in response to this situation (1 = Most appropriate, 5 = Least appropriate)
A Get into hospital as quickly as you can, sending a text to the day FY1 apologising for your lateness
B Call in and explain that you are feeling unwell, and therefore wont be able to make it into do the night shift
C Contact the registrar on call, apologise and explain that you will be 45 minutes late
D Contact the FY1 you are taking over from and apologise explaining that you slept in and will be 45 minutes late
E Contact the day team and tell them that you are on the train, but it has been delayed and therefore you will be late
Answer CDAEB
This question assesses your ability to communicate with you colleagues and your ability to act with integrity. The worst options involve a lie (B) and (E) as this does not demonstrate integrity. Between these two bad options, (B) is worse than (E) as it also leaves the hospital without sufficient medical cover at night putting patient safety at risk. The best option is to inform and apologise to the person responsible for the medical take, the registrar on call (C), as he/she can arrange appropriate cover for your lateness. This is more appropriate than simply calling or texting the FY1 as they are not the doctor responsible for the take. Calling them (D) is preferable to texting them (A) as it ensures the message has been received.
Multiple Choice Question
Whilst on the ward a patient informs you they heard another patient fall to the ground whilst using the bathroom. How do you initially respond?
Choose the THREE most appropriate actions to take in this situation.
A Go and assess the fallen patient immediately, taking an ABCDE approach
B Ask the nursing staff to assess the patient and inform you of their findings
C Continue with your ward jobs, this is not part of your role, and finishing the jobs are your priority
D Call the family, they have a right to know what has happened
E If the patient does not need urgent medical assistance ask the nurses to get them back into their bed and take the patient’s observations. Go and complete your assessment after this
F Leave the ward to find your registrar, as the patient may need senior input
G Document your assessment of the fallen patient clearly in the notes
H Fill out an incident form first as otherwise it may get forgotten
Answer: A, E, G
This question assesses you ability to manage patients safely. Patients frequently fall in the hospital although most don’t injure themselves severely. You must assess the patient quickly in case they are severely unwell. This should be done in an ABC manner (A). If the patient is clinically stable, then it is acceptable to ask the nurses to take the patient’s observations and assess them following this (E). Documentation of your assessment is important so that anyone following this patient up can see what has previously happened (G).
It is not acceptable to ignore a potentially unwell patient (C), or delegate assessment to a nurse without ensuring they are stable first (B). Leaving the ward to find senior help without first assessing the patient yourself does not allow the registrar to use your initial information to make a decision about whether they need to attend the patient immediately or not (F).
The question asks for your initial response, therefore filling out an incident form (H), and discussing the case with relatives (D), whilst important are less appropriate initially.