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INTERACTIVE SCENARIOS - PART 3
In this section of the module you can access multiple Interactive Scenarios. Test yourself by scrolling through the scenarios and questions followed by the responses of a supervisor from that health care specialty. There are links to relevant professional regulators for further information. You can also use the examples as the basis for discussion with colleagues at a multi-disciplinary team meeting or development event.
This is PART 3 of 3. Complete the following Scenarios below:
For the last 2 years you have worked with and line-managed, Hilda, an occupational therapy assistant. Yesterday, she sent you an email from a hospital trust account, concerning a work-related issue with kisses at the bottom.
Do you have any concerns about this occupational therapy assistant’s professional behaviour? Yes No Not sure
Make a note of your comments.
Please see below to compare your opinion with our supervisor's answer and comments.
Scenario 13 response
Supervisor answer
Do you have any concerns? Yes/not sure
Supervisor comments: It is inappropriate to add kisses or write ‘Love from’ in a professional communication, even when people may be close enough socially to do so outside work. In a case where you have been line managing someone and they have not done this before, it is possible that it is a simple slip (they may not have been concentrating or thinking clearly when they sent the email). It is also possible that they are doing it to curry favour (e.g. to pre-empt criticism) or to signal romantic feelings. Whatever the possible causes, the first step should be to explain directly to the person that they should not use such expressions to anyone in a professional context. It is likely that this will end the matter: this alone would be likely to end the matter. However, if clear expressions of romantic interest followed, a more senior manager should be informed, as the person’s line management might need to be changed.
Points for reflection
- How do you sign your e-mails?
- What do you think about the use of emojis e.g. smiley faces in work related e-mails?
One of the 5th year medical students often arrives on the ward wearing a very low-cut top and tight trousers.
Do you have any concerns about this medical student’s professional behaviour? Yes No Not sure
Make a note of your comments.
Please see below to compare your opinion with our supervisor's answer and comments.
Scenario 14 response
Supervisor answer
Do you have any concerns? Yes
Supervisor comments: This is not a professional way to dress. The student should not be allowed on the ward in clothes which some people may regard as being sexually provocative. The student needs a conversation to help her reflect on her style of dress and to think about some of the cultural implications for patients and colleagues. It is possible that the student is immature and unaware of these.
It is also possible that the student’s way of dressing is an aspect of a mental health issue that would need to be addressed sensitively and confidentially.
The best person to speak to the student initially would be whoever oversees the ward, or a senior staff member who has a good rapport with the student. They should let the student know that if she continues to dress in this way in a clinical workplace, they will need to communicate their concerns to the student’s medical school tutor.
Guidance from the regulator
Medical students: Achieving good medical practice: https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/achieving-good-medical-practice
Points for reflection
- What are your views on uniforms at work?
- What examples of inappropriate dress have you seen at work?
- How can healthcare professionals express their individuality in appropriate ways at work?
A confused, elderly patient without dentures is given some chewy chocolate bars which are on the top of her locker. One of the support workers takes a bar, eats it, and says ‘want not waste not’ to you (a colleague).
Do you have any concerns about this support workers professional behaviour? Yes No Not sure
Make a note of your comments.
Please see below to compare your opinion with our supervisor's answer and comments.
Scenario 15 response
Supervisor answer
Do you have any concerns? Yes
Supervisor comments: This is an example of theft as the chocolate belongs to the patient and the support worker has apparently taken a bar without the patient’s knowledge or consent. It is possible that the patient’s family had spoken to the support worker and told her to help herself. However, the support worker’s words suggest that this is not the case. It is important to respect patients’ possessions as well as their autonomy. Although the patient appears to be confused this may be temporary and they may later develop the capacity to decide about giving the chocolate bars to whoever they want. Witnessing this puts you in a difficult position. In an ideal world you should report this to the support worker’s line manager. It is likely to lead to an investigation in which you may need to give evidence. It could also lead to a disciplinary procedure and might feel uncomfortable for you. However, you have an over-riding duty of care to the patient.
Guidance from the regulator
Code of conduct for healthcare support workers and adult social care workers in England: https://www.skillsforhealth.org.uk/images/services/code-of-conduct/Code%20of%20Conduct%20Healthcare%20Support.pdf
Protect provides confidential advice to employees who witness wrongdoing or malpractice in the workplace and who are not sure whether or how to raise their concern. The website is: https://protect-advice.org.uk/
Points for reflection
- Can you think of any other examples of theft at work?
The ward pharmacist is often invited to join the Multi-disciplinary team (MDT) ward round on Fridays. You have noticed that the pharmacist keeps laughing behind the consultant’s back every time he slightly mispronounces a word and she often smiles inappropriately when sensitive information is given to patients.
Do you have any concerns about this pharmacist’s professional behaviour? Yes No Not sure
Make a note of your comments.
Please see below to compare your opinion with our supervisor's answer and comments.
Scenario 16 response
Supervisor answer
Do you have any concerns? Yes
Supervisor comments: Behaviour like this is unacceptable in any profession. The General Pharmaceutical Council (GPC) code of conduct has seven principles, the third of which is to ‘respect others.’ Mockery of another person’s differences (in this case language) contravenes the principles of diversity. Her conduct in relation to the delivery of sensitive patient information is unacceptable and immature. She is also the sole representative of her profession in that MDT and her behaviour reflects poorly on her profession’s attitude towards patients and diversity. Often behaviour like this is inadvertent and the pharmacist may be completely unaware of how unprofessional she is being. Lapses in professionalism of this sort are often underplayed. They are very common and seldom addressed with the gravity that they require. It is worth noting that there are often many culprits involved in this sort of disrespectful behaviour which may be inherent to the team (“culture”) and lapses in professionalism may be learned. Allied healthcare professionals’ behaviour is often closely scrutinised as they are often “outliers” within an MDT. This makes it even more important that their professionalism is beyond reproach. This behaviour would need to be addressed immediately as it is a serious breach of professional conduct. The supervisor should provide specific examples of the behaviour of concern and explain why it is so serious. The pharmacist should be given the chance to reflect upon and rectify her behaviour otherwise formal performance management is indicated.
Guidance from the regulator
The General Pharmaceutical Council in its Standards for pharmacy professionals (2017) states the need to: 'recognise and value diversity, and respect cultural differences – making sure that every person is treated fairly whatever their values and beliefs.'
In addition, it states that 'Pharmacy professionals must speak up when they have concerns or when things go wrong.'
https://www.pharmacyregulation.org/standards-for-pharmacy-professionals
Points for reflection
- What disrespectful or undermining behaviour have you witnessed at work and what did you do about it?
Also see: E-learning module on: Undermining and Conflict in the Workplace: https://london.hee.nhs.uk/undermining-and-conflict-workplace-home
One of the dermatology consultants is often heard talking negatively about his colleagues in the team. Yesterday he said that he thought Dr Young had a personality disorder and looked like ‘a bit of a drinker on the quiet.’
Do you have any concerns about this consultant’s professional behaviour? Yes No Not sure
Make a note of your comments.
Please see below to compare your opinion with our supervisor's answer and comments.
Scenario 17 response
Supervisor answer
Do you have any concerns? Yes
Supervisor comments: Professional behaviour includes behaving appropriately towards colleagues. If, as a doctor, you have concerns about the health or performance of another doctor, you must not ignore the situation, particularly if it could affect patient safety. It may initially be sensible to speak privately to the individual who is making derogatory comments about a colleague. If a member of staff is concerned that a colleague has health issues that may affect patient care they should consult their supervisor/HR for advice. If the problem persists or escalates it would be necessary to speak to the Clinical Lead or Service Director. It is not appropriate to gossip with others about your opinion or create a rumour regarding a colleague’s behaviour or personality. Victimisation or defamation of a colleague would warrant swift intervention and escalation to a senior supervisor/manager. Further enquiry in indicated.
Guidance from the regulator
The General Medical Council's guide, Good Medical Practice states: 'If you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body or [the GMC]. If you are still concerned you must report this, in line with [GMC] guidance and your workplace policy and make a record of the steps you have taken.' https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-2----safety-and-quality#paragraph-25
It also states that: 'You must not unfairly discriminate against patients or colleagues by allowing your personal views24 to affect your professional relationships or the treatment you provide or arrange. You should challenge colleagues if their behaviour does not comply with this guidance and follow the guidance in paragraph 25c if the behaviour amounts to abuse or denial of a patient’s or colleague’s rights.' https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-4---maintaining-trust#paragraph-59
Points for reflection
- How might you address such concerns about a doctor if you are from a different healthcare profession?
- Who would you speak to and what might you say?
- How would you deal with the situation if you overheard gossip that you thought was about yourself?
Also see: E-learning module on: Undermining and Conflict in the Workplace: https://london.hee.nhs.uk/undermining-and-conflict-workplace-home
You are working as an Associate in a National Health Service (NHS) dental practice. You arrive early for work one day to find your dental nurse scaling and polishing the teeth of her friend in a dental surgery you are about to use.
Do you have any concerns about this nurse’s professional behaviour? Yes No Not sure
Make a note of your comments.
Please see below to compare your opinion with our supervisor's answer and comments.
Scenario 17 response
Supervisor answer
Do you have any concerns? Yes
Supervisor comments: Professional behaviour includes behaving appropriately towards colleagues. If you have concerns about the health or performance of a colleague, you must not ignore the situation particularly if it could affect patient safety. There are two areas of concern in this case. Firstly, the nurse is acting beyond the scope of her professional competence or skills. Secondly, she is using a room and equipment within an NHS practice. Is the manager or lead dentist aware of this situation?
Guidance from the regulator
GDC Standards for the Dental Team (https://standards.gdc-uk.org/)
Standard 7.2 You must work within your knowledge, skills, professional competence, and abilities
7.2.1 You must only carry out a task or a type of treatment if you are appropriately trained, competent, confident, and indemnified.
Points for reflection
- What are the pros and cons of dentists treating family or friends?