Communication is key
Good doctors are good communicators – it’s that simple.
The more traditional “communication skills” teaching has focused on the doctor–patient relationship, yet communication between colleagues in hospital and primary care settings is equally important.
MPS’s experience over many years is that some of the biggest mistakes in hospitals are the result of poor communication. Although there are often many factors leading to adverse outcomes, it is undoubtedly the case that poor communication and handover can result in inappropriate prescriptions, incorrect diagnoses and patients lost to follow-up. These have clear potential for patient harm, and an associated impact on the team arising from complaints, claims and disciplinary investigations.
Developing both your teamwork and communication skills at medical school will stand you in good stead as a doctor. The GMC emphasises this as a key part of a student’s development, stating that: “Medical students need to be able to work effectively with colleagues inside and outside of healthcare in order to deliver a high standard of care and to ensure patient safety.”
Communicating well within a team demands more than merely listening and passing on messages. Doctors must work within their competence, seeking advice and assistance from senior clinical colleagues where appropriate.
On occasion, doctors may need to act to protect patients from potential harm caused by inadequate systems or procedures, or as a result of a colleague’s behaviour, performance or health. MPS recognises that this is never an easy decision. If you need advice on the appropriate action to take, you should usually raise this with your educational supervisor and you can always access expert medicolegal advice via MPS’s helpline.
Real life scenario
Sarah, a final year medical student, was on her elective in South Africa. She had always wanted to pursue a career in emergency medicine, and had arranged a placement in the trauma unit at a major hospital in Cape Town. Before leaving the UK, Sarah had read up on advanced trauma life support techniques and had spent time in her local emergency department.
One evening whilst on call, a number of patients were brought to the department following a road traffic accident involving a minibus and a lorry. Four patients were multiply injured, requiring immediate resuscitation. The two registrars in the department led the assessment of the patients. Sarah was one of three medical students in the department and assisted in the management of one young female, obtaining venous access and taking blood.
After the initial assessment of the patient, it became clear that she would require a chest drain. The registrar asked Sarah if she would insert the drain whilst he continued to attend to other patients. Sarah had never performed a chest drain but had seen it done once before. She agreed to perform the drain, not wanting to pass up the opportunity.
After making a skin incision with a scalpel, Sarah struggled to insert the drain. Sarah applied more and more pressure, but was unable to force the drain through the chest wall. She tried to cut through the intercostal musculature with the scalpel, inadvertently causing the patient to bleed. Fortunately, the nurse recognised that Sarah was out of her depth, and called the registrar urgently.
Having witnessed these events, another medical student expressed concern to her personal tutor. Fitness to practise proceedings were commenced following Sarah’s return to the UK.
An elective period is often a hugely rewarding experience, and students will often find themselves practising medicine in a very different setting to that of their university’s teaching hospitals.
Whilst it can be tempting to gain new clinical experiences, and other healthcare staff may be grateful for your assistance, your patients’ safety must always be your primary concern. Working within your competence, or training within an appropriate environment supported by senior colleagues, will ensure maximum benefit for both you and your patients.
Remember that MPS offers free elective protection and has a team of medicolegal advisers dedicated to assisting our members around the world. Sarah could have requested support by calling the MPS toll-free South Africa central advice line.
To talk to us about electives, advice on good communication or to discuss any issues you might be facing, call our support and advice line on 0800 952 0442