Question 1
A young patient was admitted with an acute severe attack of
asthma. Ventilation was needed and the episode was complicated by a pneumothorax, needing tube drainage. Over the prolonged recovery, the ward doctor developed a friendly banter with and genuine fondness for the patient. The day before the patient was to be discharged they asked the doctor if it would be all right for them to keep in touch via social media.
What is the most appropriate response for the doctor to make?
Question 2
Nursing staff on a medical ward called the doctor to see one of the patients. The patient was known to be confused and in severe pain; the family (who the nursing staff informed the doctor had been ‘difficult’ in the past) were looking very anxious and upset as they had not seen the patient ‘so bad’. On a review the drug
chart, it was clear that when it had been rewritten the day before,
the regular painkiller had not been transcribed, and the patient had gone without three doses of painkiller. The doctor re-charted the painkiller with an extra ‘breakthrough’ dose.
What is the most appropriate next action to take?
Question 3
A doctor, moving from one hospital to another, was surprised to find that the new hospital’s prescribing guidelines did not mention a certain drug that they had seen used effectively in the previous hospital; instead the guidelines advocated a similar,
slightly cheaper but also, in the doctor’s view, inferior drug.
What is the best action for the doctor to take at this time?
