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Prioritisation Task 1


​You are an FY2 Junior Doctor on a medical ward and you required to leave hospital in 30 minutes to collect your unwell child from school. Outline the order in which you would complete the following five tasks:


  1. You have agreed to meet your registrar to discuss changes to the medical rota
  2. A ward nurse calls you regarding a 57 year old gentleman who is complaining of left sided chest pain.
  3. The pharmacist has bleeped you regarding a possible medication error that you had signed for.
  4. A family member has requested to speak to you to discuss the progress of their relative
  5. Your phone alarm rings with a reminder to purchase flowers for your wife, as it is your wedding anniversary.
​

Average Candidate Response
  • Many students often feel pressured into providing instant answers and don’t use the time provided to assess the options available before providing a response. This often leads to hesitation and pauses between sentences and selection of subsequent tasks. Additionally, a lack of planning may cause candidates to change their prioritisation order half way through the task.
  • Additionally, whilst this case states the need to prioritise the tasks, many students will stop at this alone. It is essential to not only prioritise, but also justify each prioritisation.
​
Excellent Candidate Response
‘BlackStone Tutors 5 Step Approach to Prioritisation Tasks’
  1. Review the options available
  2. Identify your 5 preferred items/the ideal order to complete the tasks
  3. Explain why you have chosen these options/this order (making your explanation as specific as possible to the task, eg. Why some tasks are ranked highly)
  4. Explain why you did not choose the other options/why they are ranked lower
  5. Possible further mentions:
                If additional item/options were permitted, I would also consider taking….
                Alternatively, if the task were based in ………….I would prioritise taking……….
 
This is a challenging task with a number of important medical priorities. My most immediate concern would be the 57 year old patient with left sided chest pain, as these symptoms may represent a heart attack. Without prompt attention, there will likely by a poorer outcome with increased likelihood of morbidity and possibly mortality.
 
The next priority would be to contact the pharmacist regarding the medication error. Addressing this is vital to prevent the patient receiving the incorrect medication. The fact that this has been highlighted by the pharmacist suggests that that this error has been identified prior to patient harm occurring, which is reassuring, and hence why this task is prioritised after the patient with chest pain. In addition to thanking the pharmacist for identifying the error, it would be important for me to reflect on the reasons which contributed to the error, as well as ensuring that I have not made any similar errors when prescribing to other patients on the ward.
 
Following this, I would discuss with the family member the progress of their relative. I recognise that keeping the relative unnecessarily would be inappropriate, unprofessional and likely increase their anxiety. If an available colleague was available at an earlier stage (who knows the patient) I would consider asking their assistance with this task.
 
By this time, it is likely that 30 minutes would have passed and it would be time to collect my child. I recognise that keeping my registrar waiting would be inappropriate and hence before leaving I would try to arrange a mutually convenient time tomorrow or the day after to discuss the required rota changes.
 
Finally, whilst my wedding anniversary is not a clinical priority and hence is ranked lower, it is important not to ignore this, as an unhealthy home relationship may affect my ability to work effectively in the clinical setting. Thus, I would try to purchase my wife an appropriate present or flowers after collecting my child from school.
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