Supporting Colleagues After Incidents

SJT Textbook: Supporting Colleagues After Incidents

Supporting Colleagues After Incidents MSRA

This guide covers the compassionate side of error management in Supporting Colleagues After Incidents MSRA scenarios. In the Professional Dilemmas paper, you must demonstrate the ability to care for the “Second Victim”—the clinician traumatised by their own mistake.

🎥 Video Lesson (YouTube)

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🎯 THE CORE PRINCIPLE

After incidents, staff can become “second victims”: distressed, guilty, and less able to practise safely. Supporting colleagues means combining immediate humane care with fair, structured processes that ensure candour and learning. The goal is not to shield people from accountability, but to create conditions where they can be honest, recover, and contribute to improvement.

A just culture distinguishes between human error, risky behaviour, and reckless acts, and responds in a fair, consistent way. It focuses on systems and context as well as individual choices. Under PSIRF, staff should be engaged compassionately in reviews, with attention to welfare as well as learning.

In the MSRA SJT, strong answers show you checking welfare, arranging safe cover, involving seniors, enabling a supported candour conversation, signposting wellbeing and supervision, and feeding learning into LFPSE/PSIRF processes. Weak answers blame, shame, or ignore distress, or bypass candour and learning altogether.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Check your colleague’s immediate welfare and ability to continue safely; remove them from frontline tasks if they are distressed.
2. Arrange safe clinical cover and escalate to an appropriate senior to protect patients and support the colleague.
3. Offer a brief, structured debrief to explore what happened, validate feelings, and identify initial support needs.
4. Enable duty of candour by helping plan the conversation with the patient and family, and offering to attend if appropriate.
5. Ensure the incident is logged (e.g. LFPSE or local system) and that the colleague knows how it will be handled under PSIRF.
6. Use just-culture language that avoids blame, focusing on systems and contributory factors while facts are established.
7. Signpost to formal support: wellbeing services, Occupational Health, peer support, and educational or clinical supervision.
8. Agree clear follow-up: when you or a senior will check in again, and what further support or adjustments may be needed.
9. Challenge punitive behaviours (gossip, accusatory emails) and redirect towards fair, confidential processes.
10. Feed learning actions into governance with owners and timelines, so the event leads to practical, monitored improvements.

Good options combine welfare, fairness, candour and learning: they protect patients, support colleagues, and route incidents through just, proportionate processes.

💬 MODEL PHRASES (Use These in SJT Logic)

* “We will be open with the patient and family; I can help plan and support that conversation with a senior.”
* “I have logged the incident and we will use a fair, systems-focused review rather than blaming individuals.”
* “There is support available for you as well as for the patient; let us link you in with supervision and wellbeing services.”
* “I will check in with you again later this week to see how you are coping and to update you on the learning actions.”

Check-in • Arrange cover • Review/debrief • Enable candour • Support • Track actions • Apply just culture • Feedback/follow-up

📋 QUICK FAQ

Is it acceptable to remove a colleague from clinical duties after an incident?
Yes, if they are distressed or unsafe to practise, you should arrange competent cover and escalate to a senior. This protects patients and the colleague, and is a supportive, not punitive, step.

Does supporting a colleague mean avoiding accountability?
No. A just culture supports staff while still distinguishing between human error, risky behaviour and reckless acts. Support, fair process and learning can coexist with appropriate accountability.

Who should lead the candour conversation with the patient and family?
Usually a senior or the most appropriate responsible clinician. Trainees may take part, but should be supported and prepared; they should not be left to apologise alone if this is outside their competence or confidence.

What documentation is needed?
Record objective facts of the incident, welfare measures (e.g. removal from duty), arrangements for candour, incident logging (such as LFPSE reference), and agreed learning actions with owners and timelines.

What can I signpost a distressed colleague to?
Options include a debrief with the clinical or educational supervisor, Occupational Health, wellbeing hubs, pastoral or peer support, and temporary adjustments to duties if needed for safety.

How should I respond to gossip or blame about the colleague?
Discourage gossip, redirect colleagues to formal processes, and emphasise just-culture principles that focus on systems learning and fair treatment. Escalate persistent punitive behaviour to appropriate leaders.

📚 GMC ANCHOR POINTS

• Promote a culture that protects patient safety and supports learning when things go wrong (GMC Good medical practice 2024).
• Be open and honest with patients when things go wrong and help colleagues meet this duty (GMC candour guidance).
• Treat colleagues with respect, kindness and fairness; support teamwork and raise concerns about bullying or blame cultures (GMC Good medical practice 2024).
• Take part in quality improvement and governance activities after incidents (GMC Good medical practice 2024, improvement duties).

💡 MINI PRACTICE SCENARIO

An FY1 has given an incorrect insulin dose. The patient is monitored and remains stable. The error is discovered promptly and corrected. The FY1 is tearful, shaking, and repeatedly says they are “not safe to be a doctor”. The ward is extremely busy.

Best action: Move the FY1 to a quiet space, arrange safe cover for their patients, check their welfare, and organise a brief debrief with a senior. Support a timely, coached candour conversation with the patient and family, ensure the incident is logged, and signpost wellbeing and supervision, with a planned follow-up.
Why: This protects patients and the FY1, enables candour and learning, and uses a just-culture, welfare-conscious approach rather than blame or minimisation.

🎯 KEY TAKEAWAYS

✓ Welfare and safety checks come first when colleagues are distressed.
✓ Just culture separates fair accountability from blame and shame.
✓ Colleagues should be supported, not left alone, to fulfil candour duties.
✓ Incident logging and PSIRF-aligned learning must still happen.
✓ Signposting to supervision and wellbeing is part of safe, professional support.
✓ Gossip and punitive emails are red flags; redirect to fair, formal processes.

🔗 RELATED TOPICS

* → Learning from Adverse Events
* → Reflective Practice After an Error
* → Disclosing Mistakes and Duty of Candour
* → Patient Safety Incident Reporting (LFPSE and PSIRF)
* → Speaking Up and Raising Concerns

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

You are a CT1 on a medical ward. An FY1 has prescribed an incorrect dose of warfarin. The error is spotted at the final check before administration and the dose is corrected. The patient is stable and unaware of the near miss. The FY1 is visibly shaken and says they feel sick and cannot think straight. The nurse in charge says “we are already short; they just need to get on with it”.

Options:
A. Tell the FY1 to carry on with the list of jobs and to “be more careful next time”.
B. Move the FY1 to a quiet room, arrange immediate cover for their patients, and check whether they feel able to continue clinically.
C. Help the FY1 contact the consultant or registrar to organise a supported candour conversation with the patient and family.
D. Send a group email to the whole department naming the FY1 so others can “learn from their mistake”.
E. Log the incident in LFPSE and explain to the FY1 how it will be handled under PSIRF, emphasising fair, systems-focused review.
F. Tell the FY1 not to record anything because “it will only get them into trouble”.
G. Suggest that the FY1 writes a reflection that focuses on how irresponsible they were, without mentioning any system factors.
H. Offer information about wellbeing support, Occupational Health, and arranging supervision time to debrief further.

Example SJT — Rank 5 (best → worst)

You are an ST3 GP trainee. A receptionist mistakenly filed abnormal results in the wrong patient’s record, causing a delay in follow-up. The error is discovered; the affected patient has now been brought in and reviewed, and is stable. The receptionist is upset and fears they will be “sacked”. At the subsequent practice meeting, several approaches are suggested.

Options:
A. Meet privately with the receptionist, check their welfare, explain that the practice will use a just-culture approach, log the incident, review the filing process, and introduce a double-check system with training and follow-up.
B. Publicly criticise the receptionist at the full practice meeting as an example to others.
C. Tell the receptionist it is best not to mention the error in any formal system to avoid trouble.
D. Ask the receptionist to phone the patient and apologise alone without any preparation or senior support.
E. Acknowledge the error briefly, tell everyone to “be more careful”, but make no changes to systems or training.