Possible stations – with a patient
- Concerned about a test
- Try to find the underlying reasons for their concern
- Wants a sick note because of problems at work
- Wants to self-discharge because they need to care for a partner at home
- Wants to die
- Wants to lose weight because a relative died recently of obesity-related health problems
- Wants to make a complaint
- Don’t forget to mention the patient advice and liaison service (PALS)
- You can say you are sorry they feel that way/went through that but generally don’t apologise/admit guilt
- Feels another doctor examined them inappropriately/didn’t offer chaperone
Possible stations – with a patient’s relative
- Carer struggling
- Social services can do a care assessment to provide money/respite/help
- Charities (e.g. carersuk.org and carerssupport.org.uk) offer help and support groups
- Health visitor for children
- Stress they’re not alone
- Concerned about social care arrangements for elderly relative
- Social services can arrange care
- There are also private care organisations
- In a crisis, doctors can refer to the rapid response team for short-term care
- Carer says patient has stopped taking their medication and wants to know how to make them take it
- Is concerned their relative may have cancer because they know someone else who had similar symptoms and then died of cancer
Possible stations – with a colleague
- Another member of the team is not pulling their weight, is always late, makes mistakes, or smells of alcohol etc.
- Options include speaking to the culprit directly (usually best initially), and then considering speaking to their senior (offer to be present)
- If patients are/may be at risk, you must take action and inform a senior. You should tell the culprit you are doing so.
- Being bullied by another member of the team
- Could they approach the perpetrator? Can they speak to their supervisor/senior/human resources? Offer to be present if possible.
- If they have tried to resolve it but had no success, they may need to make a formal complaint
- Screen for depression (but remember you are not their doctor and should direct them to their GP if needed)
- Issues at home affecting work
- A colleague who is stressed
- Shaken up by something that has happened (e.g. a patient died)
- They will need ongoing support – can they speak to their supervisor or occupational health? Offer to be present if possible
- A colleague has made a mistake
- Have a non-judgemental attitude
- Emphasise the ‘no blame’ culture when mistakes are admitted
- Incident reporting can help everyone learn so the same mistake doesn’t happen to others
- Honesty is the best policy
- A health visitor concerned about a child abuse within a family without any evidence because he/she missed a similar problem previously
Aims of the station
- Be non-judgemental
- Empathise
- Listen!
- Pick up on cues and show you have heard them
- Address their ideas, concerns and expectations (ICE)
- Suggest possible solutions
