Inspired by hearing talks today #RCPMed2021 by @OrthopodReg on #HammerItOut & @sbattrawden on #BeKind, empathy. I want to tell a story about an incident as a medical Registrar.

This happened the decade before last - many years ago but still upsets me typing it out today. 1/14

I was on a set of busy ward nights. Around 0830 I was fast bleeped to an outlier ward.

A 90 year old pt was unwell - tachycardic & SOB.

ECG revealed VT. 2/14

The ward wasn’t a great environment - it was a day case unit that was bedded due to winter pressures. There wasn’t even oxygen ports on the wall, just small portable cylinders. Nursing staff were all agency / bank and weren’t familiar with the ward layout. 3/14

I made the decision to move the pt to CCU. I called the unit, and informed the nurse in charge. There was a bed available. With the assistance of a nurse we moved the patient to CCU, pushing the bed ourselves. 4/14

As we arrived on CCU, it was around 0855 and the day team had arrived. The day Consultant and day SpR were on the ward.

The SpR was very senior (I was relatively junior). 5/14

The SpR then for 5 mins tore strips of me loudly in front of patients, nursing staff, and the Consultant (who remained silent).

The SpR was angry that I brought an “inappropriate” pt to CCU. They loudly berated me for “abusing CCU beds”. 6/14

I was shaken & upset. I felt humiliated. The nursing staff who I knew well from many calls were stunned.

I went up to the Consultant & asked them “did I do the wrong thing?”They mumbled under their breath about beds not protected & things have changed over the years. 7/14

I pressed the Consultant again: “did I do the wrong thing?”

He sighed & said “no”. I left the unit & went home (no handover those days).

I got home & was really troubled, I struggled to sleep. I posted on facebook (you can tell it was a long time ago!). 8/14

Post nights I knew I had to act. I wasn’t sure what to do. I went to talk to the sister on CCU (who I knew well).

She tells me the CCU SpR had repeatedly humiliated junior on-call SpRs regarding patients accepted overnight. She said “Ajay you must report this”. 9/14

I did complete an incident report. The CCU Consultant who received the report - did not address this with me or the CCU SpR, nor discuss with CCU nursing staff who witnessed the incident. They emailed my CS to complain about my report. 10/14

My CS asked what happened. Despite me saying I was advised to report by senior nursing staff (who’s opinion I valued), CS said I was wrong to report.

Finally the CCU Consultant handling the report was told by CCU nurses what happened & this was addressed with the SpR. 11/14

Much to my dismay, my “indiscretion” in reporting instead of resolving conflict was mentioned on my CS end of rotation report.

This made me feel punished for reporting an incident.

To this day the whole incident rankles & brings back upsetting memories. 12/14

So why tweet this many years later? Well I would like to think this incident wouldn’t happen now - but sadly suspect it could. A question for trainees.... 13/14

𝗖𝗼𝘂𝗹𝗱 𝗮 𝘀𝗶𝗺𝗶𝗹𝗮𝗿 𝗶𝗻𝗰𝗶𝗱𝗲𝗻𝘁 𝗼𝗰𝗰𝘂𝗿 𝗶𝗻 𝟮𝟬𝟮𝟭?

Trainees - If the answer is yes.

𝗪𝗼𝘂𝗹𝗱 𝘆𝗼𝘂 𝗯𝗲 𝗵𝗮𝗻𝗱𝗹𝗲𝗱 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁𝗹𝘆 𝗶𝗻 𝟮𝟬𝟮𝟭 𝗶𝗳 𝘆𝗼𝘂 𝗿𝗲𝗽𝗼𝗿𝘁𝗲𝗱 𝘁𝗵𝗶𝘀 𝗶𝗻𝗰𝗶𝗱𝗲𝗻𝘁? 14/14