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GP Stage 3 Simulated Consultation - Healthcare Professional 8


You are an SHO on a surgical ward and have just commenced a new rotation. One of the nurses, Alex would like to speak to you about Norman, one of your new FY1 colleagues.



You are Alex, one of the nurses on the surgical ward. You have arranged to speak with one of the senior house officers (SHO) regarding one of the more junior doctors, Norman. You are concerned regarding Norman’s personal hygiene and feels that his odour is disturbing patients and other staff. A number of other staff, who would prefer not to be named have expressed similar concerns to you. Having not worked with Norman previously, you are reluctant to discuss the matter with Norman directly, and feel that this would be better received from another doctor.

You do not presently have any concerns regarding Norman’s clinical ability/skills and do not feel that patients’ medical care is currently being compromised. Although you do fear that if the situation persists, patients and staff may refuse to be treated by Norman or work alongside him. Furthermore, you believe that Norman’s self-neglect may be a sign of deeper issues at home which may need to be addressed. You heard from a colleague that Norman’s father recently tried to take his own life, although you have not verified this information. In yourself, you are well and do not have any additional concerns at home or work.



The key to this consultation is establishing whether there is an immediate risk to patients as well as a possible longer term risk. It is clear that there is no immediate risk to patient welfare; however it is equally important to elicit Alex’s longer term concerns which may progress towards compromised patient care. Furthermore, through sensitive probing, doctors may establish the underlying reason for Norman’s self-neglect (family circumstances) which may require more pressing attention than the initial malodourous concerns. Ensuring that Alex has no personal concerns at home and at work is also essential in completing a comprehensive healthcare professional consultation.

Appropriate solutions include agreeing to discuss the concerns directly with Norman as well as your corresponding senior (eg. Clinical Supervisor). Arranging a follow up meeting with Alex would be important to ensure that all concerns have been appropriately addressed.


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