GP Stage 3 Simulated Consultation - Healthcare Professional 12
You are an SHO on a care of the elderly ward, and one of the healthcare assistants (Megan), has asked to speak to you. You have worked with Megan for three months, and have found her to be reliable and efficient.
You are Megan, a healthcare assistant on the care of the elderly ward. You have arranged to speak to one of the doctors, with the intention of requesting a sick note.
You have had a cough for the last two weeks, and do not believe that this is improving; additionally you feel that it is unfair on the patients if you continue to come in to work. You have not seen your GP about this, and if advised to do so, you feel as though this would be a waste of time as your GP always attributes everything to a virus, suggesting that it will improve with time.
You would like the doctor to write you a sick note for a couple of weeks to aid your recovery. On further probing, you are also upset because a couple of nurses have been mocking you and ‘your poor memory’. You believe they are acting in good humour, although their actions and comments are increasingly upsetting. You are reluctant to discuss any of these concerns with the ward sister as you find her judgemental, and previously when you mentioned some concerns she complained how the quality of healthcare assistants has plummeted and how you ‘need to learn to just get on with your work’.
You do not have any additional concerns about the environment in which you work and generally feel as though the quality of your work is satisfactory. At home, you live with your husband who was forced to recently retire due to ill health. As such, you are responsible for paying the mortgage and monthly bills.
As with many consultations, the initial request and symptoms (of a cough) have a deeper root-cause. In this case, there is potential work place bullying and inadequate support structures to address this. It is unlikely that a sick note will provide a long term solution, and as such deeper exploration of Megan’s concerns is essential.
Equally important is providing appropriate verbal and non-verbal emotional support to an upset Megan regarding the quality of her work. Exploration of wider social circumstances and concerns is important in any comprehensive GP Stage 3 consultation.
Potential solutions include reiterating to Megan your impression regarding the reliable quality of her work, as well as persisting with the suggestion of her seeing her GP to address her wider medical concerns. It would also be important to reassure Megan that the potential work place bullying is unacceptable, and in addition to the Ward Sister, there are additional sources of support such as the Consultant, Ward Manager or Occupational Health.