Psychosocial concerns

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

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

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