There is no explicit reference in Good Medical Practice and neither does it seem there is a general duty on all doctors to remain calm. However, it is certainly best practice and wild panic is of course something not normally expected of a doctor in their workplace.
The Tribunal in the case of Dr B also seemed to consider that seniority had a role to play and so a junior doctor faced with an emergency will likely be afforded more latitude. It follows then that there may be circumstances where acting out will fall below the standards expected of a reasonably competent doctor.
Dr B had twenty-four years’ experience as a doctor and more than ten years as a Registrar in Obstetrics and Gynaecology. At the time of the events in question he was a locum Registrar.
The allegations levelled against him were that during a difficult delivery he had shouted at the patient and the other medical workers “We need to hurry up and get the baby out ….We need to get this baby out and you need to get your gowns … Everyone get out, we’ve got to get her to theatre … Keep her legs up, we need to get this baby out”. It was alleged he had failed to remain calm and had barged past the patient’s partner.
It is important to be clear that Dr D did face difficulties not of his own making during the treatment of the patient. Dr B needed to transfer the patient from the delivery room to the theatre because there had been an equipment failure in the delivery room. The first vacuum delivery had to be abandoned because it was unsuccessful.
The evidence regarding the shouting was not quite so clear as you might expect: One of the witnesses suggested it was around 6 out of 10 loud and there was evidence from a third party they had seen Dr B shouting at the midwives though none of them provided any direct evidence to the tribunal. The Tribunal therefore considered that in the heat of the moment Dr B may have wanted things done quickly but that was not the same as shouting.
The evidence from the expert consultant was that Dr B should have remained calm in the circumstances and not remaining calm fell below the standards of a reasonably competent doctor but not seriously below.
The Tribunal did not impose any sanction on Dr B. They also found that though he may have unbalanced the patient’s partner this was accidental rather than deliberate.
Working in trying circumstances tests the very best doctors. Notwithstanding that best practice requires you to remain calm and it is understandable from a patient’s point of view why that is necessary. Equally, this should not lead to regulatory action where there are no other concerns either to patient safety or from a public interest perception.
Please note that the comments in this case review are generic, if you have any fitness to practise concerns please contact us for specific advice on your matter.
