MSRA Professional Dilemmas 5

Question 1

A patient tells you in confidence that they intend to seriously harm another named person. What is the most appropriate action?

Accepted Answer

Consider breaching confidentiality to protect the third party and seek senior advice

Answer

Keep it confidential under all circumstances

Answer

Tell the named person directly yourself immediately

Answer

Dismiss it as the patient is just venting

Question 2

You discover that a widely used ward protocol appears to be outdated and potentially unsafe. What is the best action?

Accepted Answer

Raise it with the relevant senior or governance lead with supporting evidence

Answer

Change your own practice quietly without telling anyone

Answer

Continue following it to avoid conflict

Answer

Tell patients the protocol is dangerous

Question 3

A patient does not speak English well and you are unsure they understood the consent discussion. What should you do?

Accepted Answer

Arrange a professional interpreter before proceeding

Answer

Use a family member to translate quickly

Answer

Proceed and assume they understood

Answer

Use simple gestures to confirm consent

Question 4

You are offered a place at a conference funded by a pharmaceutical company that makes a drug you prescribe. What is the most appropriate response?

Accepted Answer

Declare the potential conflict of interest and follow trust policy

Answer

Accept without telling anyone

Answer

Refuse all educational opportunities

Answer

Accept and increase prescribing of their drug

Question 5

During a busy shift you realise you cannot safely complete all your tasks alone. What is the most appropriate action?

Accepted Answer

Prioritise by clinical urgency and ask a senior for help

Answer

Attempt everything quickly and hope for the best

Answer

Complete only the easiest tasks first

Answer

Leave the tasks for the next shift without handover

Question 6

A patient's family pressures you to withhold a serious diagnosis from a competent patient. What should you do?

Accepted Answer

Explain the patient has a right to know and discuss it with them sensitively

Answer

Withhold the diagnosis as the family requested

Answer

Tell the patient bluntly without preparation

Answer

Document the diagnosis but never mention it

Question 7

You notice that handovers between shifts on your ward are frequently incomplete, risking patient safety. What is the best action?

Accepted Answer

Raise the issue constructively and suggest a structured handover process

Answer

Accept it as how things are

Answer

Only ensure your own handovers are complete

Answer

Blame the previous shift each time