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Here’s a brief guide for practising safely when working
out of hours.
The Key to Out-of-Hours by Annmarie McTigue,
Writer – MPS
Here’s a brief guide for practising safely
when working out of hours.
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Get the correct
indemnity. Contact your indemnity provider to check you are paying the
right subscription if you are switching from in-hours to out-of-hours work,
or adding out of hours to your existing practice.
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Collect your
contacts. Ask the co-op or out-of-hours provider to send you a list of
useful contact telephone numbers, eg hospitals, nurses and social workers.
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It’s in the bag.
Make sure your doctors’ bag is up to date with what you will need for
out-of-hours work. See the Drugs and Therapeutics Bulletin or the
NASGP website for full details on what you are expected to carry.
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Back to basics.
You probably will not have the patient’s record and may not know them
either, so it’s back to basics. Make sure that you ask the patient the
questions for the answers you would normally find in their records. Take an
extensive history, ensuring that you know about previous medical history,
any medication they may be taking and any allergies.
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Document
everything. Make thorough and clear notes. Document any examination and
record relevant positive and negative clinical findings. You should also
indicate any decisions or diagnoses that you have made or excluded.
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Follow up.
Document any details required by the patient’s own GP to follow up their
care. Occasionally it may be worth keeping a patient’s contact number and
following them up the next day. This gives you the chance to repeat the
advice you gave to them when you are both more awake, as well as the
opportunity to reflect on their condition and the advice you gave.
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Get your rest.
Make sure you get plenty of sleep before any out-of-hours shifts. You’re
more likely to make an error or be involved in an accident when tired.
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Don’t panic.
It is widely believed that patients are more likely to complain about
out-of-hours services and treatment. However, a recent MPS study of GP
claims was not able to demonstrate any increase in risk profile between
in-hours and out-of-hours work. By following the above steps, you may save
yourself the time and trouble of a complaint or claim.
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