I was revisiting the officially sanctioned SJT questions while prepping for a teaching session for med students and stumbled upon this:
You are working on a busy paediatric ward. Your shift was meant to finish at 7pm, but it is now 9pm on a Friday, and you are still trying to complete some of your routine tasks from the day. This has happened on a number of occasions in the last month and you feel exhausted as a result. Your workload is also having a negative impact on your social life.
Rank in order the importance of the following considerations: A. The impact on your own wellbeing if you are not able to take time to rest B. The risk to patient safety if working whilst tired C. Your right to finish at the designated time D. That your consultant may give you a poor reference if you are not completing your tasks E. That you are repeatedly disappointing your friends by not attending social events with them
This scenario is about maintaining a good work life balance to work effectively and provide good patient care. As a doctor, the care of the patient is your main concern (B). Your own health has to be looked after in order to provide good patient care (A).
I don't know what or why but that's bugging me somewhat. To clarify, the question is not asking whether we should simply leave at 7pm and go home, but rather what has to be our first consideration.
Of course, A leads to B, but why is the patient our main priority? Yes – they are absolutely important, and they definitely are one of the priorities, but why can't we openly acknowledge that we are humans too. Is it not the ethos of a doctor, a nurse, a physio, a pharmacist etc etc to accept that we, as individuals, come before patients? Can we not put ourselves first, and then think about the patient? We're seeing increases in healthcare professionals with mental illnesses, and suicides/self-harm across all grades. No one (save firefighters) would be expected to jump into a fire to save a human, and yet why are we expected to become patients before we put us as first, even in an exam?
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