Out of Your Depth

This FY1 doctor is currently on call on a night shift in a busy hospital. An FY2 and a registrar are working alongside him. FY1 is midway through his shift when he receives a bleep saying that he is required to take an arterial blood gas (ABG) from a new admission. The patient is a 55-year-old gentleman who has suffered from chronic obstructive pulmonary disease for 10 years. It is believed that he is suffering from type 2 respiratory failure. FY1 tells the patient that he has to take blood to confirm the diagnosis; however, the patient is anxious and agitated. Furthermore, the patient reveals that he has a phobia of needles and does not want the ABG to be done. The FY1 states that there is no other option and the ABG is essential; however, the patient is becoming more hysterical. FY1 is unsure of what to do. He is worried about asking the registrar for help, as the registrar stated during the handover meeting at the start of the shift to only bleep him if it is an emergency. Furthermore, the registrar has a reputation for being an intimidating figure.

• What should the FY1 do in this situation?
• Who would be held accountable if there were complications from the procedure?
• Are junior doctors held to the same legal standard of care as consultants?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Clinical Ethics and Law, Second edition. Carolyn Johnston, Penelope Bradbury, Series editor: Janice Ryme