GP Stage 3 Simulated Consultation - Healthcare Professional 2
You are an FY2 on the geriatric ward. The charge nurse (Alex Smith) would like to speak to you about Jonathan, one of the other FY2 doctors on the ward.
You are Alex Smith, the charge nurse on one of the geriatric (elderly) wards. You have arranged to meet with one of the FY2 doctors, to discuss your concerns about their colleague, Jonathan. Last week, you overheard Jonathan commenting to one of the staff nurses that ‘We waste too many resources on the elderly’ and that we ‘should allow some of them on their way.’
You have not discussed your concerns with anyone else or taken any action, and felt that it would be best to discuss with the other FY2 ward doctor, seeing as they are close friends. You are concerned that Jonathan’s views may impact his clinical care, to the detriment of your patients. Reassuringly, you have not seen any actions from Jonathan that have provoked clinical concern, or any evidence of patient harm. You are reluctant to speak directly to Jonathan about what you heard, and would prefer for the other FY2 doctor to discuss the matter with Jonathan and the consultant.
At home, you live with your husband and elderly bed-bound mother. You worry that Jonathan’s views may be more widespread and may impact the care that your mother may receive (and other elderly patients), if they were to be admitted to hospital. Whilst these comments have upset you, you do not feel that it has affected your ability to complete your clinical commitments or work alongside Jonathan on the ward.
This case requires careful probing to reveal deeper concerns, as well as ensure that patients are not presently being put at risk. Whilst good candidates will address the opinions of Jonathan and how this may impact patient care, excellent candidates will further explore how these comments have affected the charge nurse and potentially impact her ability to work effectively as part of the MDT.
Appropriate solutions include apologising to the charge nurse for the hurt and distress that these comments may have caused, as well as offering to speak to Jonathan in order to explore the comments further and their potential context and implications. It would be important to also agree an appropriate follow up with the charge nurse in order to review the findings as well as potentially any further concerns.