Working with doctors Working for patients

 

Introduction

Nurse Bhogal is on his way back from the ward where Dr May is following up on post-operative patients. He stops to talk to Dr Rosin in the corridor.

(The story so far...)

Dr Rosin is consultant in a busy obstetrics and gynaecology unit. Dr May is a junior doctor beginning a six-month post within a specialty training programme. His manner towards patients and colleagues is causing problems and he has recently been the subject of a complaint.

Charge Nurse Bhogal

Nurse Bhogal

Dr Rosin, I'm glad I caught you. I was just on the Cavendish ward while one of your juniors - Dr May, I think his name is - was following up on post-op patients.

Dr Rosin

Dr Rosin

Simon May? Yes, he was on Cavendish today. Why - did something happen?

Charge Nurse Bhogal

Nurse Bhogal

Well to be honest I think he's got a bit of an attitude problem. He really looks down his nose at the nurses, treats us like we're there to serve him and we're getting thoroughly fed up with it. He just doesn't listen to us or treat us like fellow professionals, when most of us have far more experience than him.

Dr Rosin

Dr Rosin

Oh not again... Okay, thanks for telling me. I'll have another word with him.

Charge Nurse Bhogal

Nurse Bhogal

I think you should, and the sooner the better. It's really dented the team's morale. And you know, his attitude towards patients isn't much better: Vanessa spent a good 20 minutes today trying to comfort Mrs Kadiri after he made some insensitive remark.

What should the doctor do...? (Select A,B or C)

A

Allow Dr May to continue working but arrange to speak to him later that day about his attitude, and monitor his practice more closely?

B

Speak to Dr May immediately and suggest that he consider further training in communication skills and team-working before continuing with the post?

C

Raise his concerns directly with the Deanery with whom Dr May's training is co-ordinated and request that he is removed from the post in his team?

Dr Rosin

See what the doctor did

Dr Rosin spoke to Dr May and with advice from the Deanery they agreed that Dr May would undergo remedial training in communication skills and team-working before continuing with the post in Obstetrics and Gynaecology. However, after completing the training, Dr May did not return to Obstetrics & Gynaecology, but switched to a trust-grade post in a non-clinical specialty, where he would not be directly responsible for patient care.

References

7. All doctors have a duty to raise concerns where they believe that patient safety or care is being compromised by the practice of colleagues or the systems, policies and procedures in the organisations in which they work. They must also encourage and support a culture in which staff can raise concerns openly and safely.
Raising and acting on concerns about patient safety, paragraph 7

20. Concerns about patient safety can come from a number of sources, such as patients' complaints, colleague's concerns, critical incident reports and clinical audit. Concerns may be about inadequate premises, equipment, other resources, policies or systems, or about the conduct, health or performance of staff or multidisciplinary teams. If you receive this information, you have a responsibility to act on it promptly and professionally. You can do this by putting the matter right (if that is possible), investigating and dealing with the concern locally, or referring serious or repeated incidents or complaints to senior management or the relevant regulatory authority.

21. If you are responsible for clinical governance or have wider management responsibilities, you have a duty to help people report their concerns and to enable people to act on concerns that are raised with them.
Raising and acting on concerns about patient safety, paragraphs 20-21.

6. It is essential for good and safe patient care that doctors work effectively with colleagues from other health and social care disciplines, both within and between teams and organisations. Whatever the composition of the teams you work in, you must respect and value each person's skills and contribution.

7. You must tackle discrimination where it arises and encourage your colleagues to do the same. You must treat your colleagues fairly and with respect. You must not bully or harass them or unfairly discriminate against them. You should challenge the behaviour of colleagues who do not meet this standard.
Leadership and management for all doctors, paragraphs 6-7)