1234

1. Elizabeth is an F2 doctor working in a stroke ward. Her shift finishes at 5pm and it is 4.50pm now. She wants to leave on time to meet some friends immediately after work. The nurse in charge requests that Elizabeth speaks to a patient's daughter on the ward regarding her father's current condition. The patient lacks capacity to make medical decisions. His notes show that some years ago he designated his daughter as his guardian.

How desirable are each of the following responses by Elizabeth in this situation?

A. Tidy up her work area and leave the ward at 5pm

• Extremely desirable

• Slightly desirable

• Neither desirable nor undesirable

• Slightly undesirable

• Extremely undesirable

Answer explanation

This response is extremely undesirable as it is inappropriate for Elizabeth to leave the ward without responding to this request - either by staying behind for a short while, asking the nurse to find someone else, or explaining to the patient's daughter that she will speak to her later or that another doctor will speak to her. The action is clearly an attempt to avoid taking responsibility for this task.

This scenario is connected to the Patient Focus domain - considering Elizabeth's willingness to spend time with patients and relatives and, to a lesser extent, Effective Team Working. In this example Elizabeth is not behaving in a patient focused way and this action scores poorly as a result.

Commitment to professionalism

Coping with pressure

Effective communication

Patient focus

Working effectively as part of a team

1. Elizabeth is an F2 doctor working in a stroke ward. Her shift finishes at 5pm and it is 4.50pm now. She wants to leave on time to meet some friends immediately after work. The nurse in charge requests that Elizabeth speaks to a patient's daughter on the ward regarding her father's current condition. The patient lacks capacity to make medical decisions. His notes show that some years ago he designated his daughter as his guardian.

How desirable are each of the following responses by Elizabeth in this situation?

B. Inform her friends she will be running late, discuss the patient's condition with his daughter, and an available nurse, in a quiet room

• Extremely desirable

• Slightly desirable

• Neither desirable nor undesirable

• Slightly undesirable

• Extremely undesirable

Answer explanation

This response shows good Patient focus as Elizabeth shows courtesy to both her patient, his daughter, and her friends.

This action shows Elizabeth is not only taking time to speak with a relative but also organizing a suitable environment for the conversation which shows Effective communication. The scenario states that the nurse in charge requested Elizabeth speak with this relative and it should be within Elizabeth's remit as an F2 to handle that conversation alone without taking up the time of one of the nursing team.

Therefore this scores less well on Working effectively as part of a team.

Commitment to professionalism

Coping with pressure

Effective communication

Patient focus

Working effectively as part of a team

1. Elizabeth is an F2 doctor working in a stroke ward. Her shift finishes at 5pm and it is 4.50pm now. She wants to leave on time to meet some friends immediately after work. The nurse in charge requests that Elizabeth speaks to a patient's daughter on the ward regarding her father's current condition. The patient lacks capacity to make medical decisions. His notes show that some years ago he designated his daughter as his guardian.

How desirable are each of the following responses by Elizabeth in this situation?

C. Tell the patient's daughter that her father will be fine, and she will speak with her tomorrow.

• Extremely desirable

• Slightly desirable

• Neither desirable nor undesirable

• Slightly undesirable

• Extremely undesirable

Answer explanation

This is dishonest and unhelpful. The man would not be in hospital if there was nothing wrong with him and it is reasonable for a daughter to wish to discuss his condition and care. Dismissing a concerned relative like this so she can leave work more quickly is unprofessional and unkind.

Not only does this action score poorly on Patient Focus but also on Commitment to Professionalism as it is essentially dishonest. A more honest response might be

"I don't have time to speak with you now but I will call tomorrow" which would not demonstrate patient focus but would not compromise professional integrity.

Commitment to professionalism

Coping with pressure

Effective communication

Patient focus

Working effectively as part of a team

1. Elizabeth is an F2 doctor working in a stroke ward. Her shift finishes at 5pm and it is 4.50pm now. She wants to leave on time to meet some friends immediately after work. The nurse in charge requests that Elizabeth speaks to a patient's daughter on the ward regarding her father's current condition. The patient lacks capacity to make medical decisions. His notes show that some years ago he designated his daughter as his guardian.

How desirable are each of the following responses by Elizabeth in this situation?

D. Tell the nurse to ask the on-call doctor to speak to the patient's daugher.

• Extremely desirable

• Slightly desirable

• Neither desirable nor undesirable

• Slightly undesirable

• Extremely undesirable

Answer explanation

This response is slightly undesirable as it creates extra work for Elizabeth's colleagues. The on-call doctor is unlikely to know the patient or family and the family are unlikely to know him / her. It does mean that this concerned relative will be able to speak to a clinician who may be able to answer in general terms.

This action scores poorly for Patient Focus but also for Working effectively as part of a team as she has delegated twice - once to a nurse and then onwards to the on-call doctor. Effective delegation is an important skill but here Elizabeth has delegated her task to someone less equipped to do it.

Commitment to professionalism

Coping with pressure

Effective communication

Patient focus

Working effectively as part of a team

1. Elizabeth is an F2 doctor working in a stroke ward. Her shift finishes at 5pm and it is 4.50pm now. She wants to leave on time to meet some friends immediately after work. The nurse in charge requests that Elizabeth speaks to a patient's daughter on the ward regarding her father's current condition. The patient lacks capacity to make medical decisions. His notes show that some years ago he designated his daughter as his guardian.

How desirable are each of the following responses by Elizabeth in this situation?

E. Ask the patient's nurse to speak to the patient's daughter after telling them what to say.

• Extremely desirable

• Slightly desirable

• Neither desirable nor undesirable

• Slightly undesirable

• Extremely undesirable

Answer explanation

This response is slightly desirable as it ensures that the daughter gets the information Elizabeth would have given; however, it creates a task for the nurse and shows a lack of care for the family on Elizabeth's part.

This action shows some Patient Focus as she has made an effort to ensure the relative gets accurate and timely information. It scores less well for Effective Team Working as she has delegated a task which she could, and should, do herself.

Commitment to professionalism

Effective communication

Patient focus

Working effectively as part of a team

1. Elizabeth is an F2 doctor working in a stroke ward. Her shift finishes at 5pm and it is 4.50pm now. She wants to leave on time to meet some friends immediately after work. The nurse in charge requests that Elizabeth speaks to a patient's daughter on the ward regarding her father's current condition. The patient lacks capacity to make medical decisions. His notes show that some years ago he designated his daughter as his guardian.

How desirable are each of the following responses by Elizabeth in this situation?

F. Speak to the woman very quickly, stressing that she is in a hurry

• Extremely desirable

• Slightly desirable

• Neither desirable nor undesirable

• Slightly undesirable

• Extremely undesirable

Answer explanation

This response is slightly undesirable as it is evident that Elizabeth is not fully focused on the patient's relative and is hurrying the conversation which displays poor patient focus. However, Elizabeth is having a quick conversation with the woman which is preferable to no conversation at all. This would be better if Elizabeth had assured the woman of a more detailed talk the following day.

Commitment to professionalism

Coping with pressure

Effective communication

Patient focus

Working effectively as part of a team