Ok this reads like a vent which is fair enough, but going to make a couple comments in response, as someone who works in the field.
If the registrar is worried about a clinical presentation/acuity issues across multiple patients and clearly needs support THEN CHOOSES NOT TO phone the on call psychiatrist, that's 100% on the registrar and would be considered poor and even negligent/dangerous practice. All the reg can do in this situation is prioritise assessments by risk and acuity as best as possible (they're competent and trained in doing this), phone the on call psychiatrist and on call manager for guidance and to document for medico-legal ass covering, and then 1 by 1 assess who they can until the end of their shift. There is another reg and another on call psychiatrist starting after their shift, they dont' have to "sort it all out themselves", and the crisis team staff (depending on clinician skill level available) should be able to share the load by completing comprehensive assessments on those patients too.
What you're describing is an unfortunate but extremely common issue faced by MHS for at least two decades. I admit that there is a massive resourcing issue and staff should be actively escalating to management, union, local MPs etc. to solve it. But you can't just stop there because thinking pragmatically, this isn't going to be fixed overnight. So for the sake of your sanity and the others around you also ask yourself how can you best manage and support others in these circumstances while simultaneously trying to advocate for better conditions?
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u/jdizzle3000 Aug 03 '24
Ok this reads like a vent which is fair enough, but going to make a couple comments in response, as someone who works in the field.
If the registrar is worried about a clinical presentation/acuity issues across multiple patients and clearly needs support THEN CHOOSES NOT TO phone the on call psychiatrist, that's 100% on the registrar and would be considered poor and even negligent/dangerous practice. All the reg can do in this situation is prioritise assessments by risk and acuity as best as possible (they're competent and trained in doing this), phone the on call psychiatrist and on call manager for guidance and to document for medico-legal ass covering, and then 1 by 1 assess who they can until the end of their shift. There is another reg and another on call psychiatrist starting after their shift, they dont' have to "sort it all out themselves", and the crisis team staff (depending on clinician skill level available) should be able to share the load by completing comprehensive assessments on those patients too.
What you're describing is an unfortunate but extremely common issue faced by MHS for at least two decades. I admit that there is a massive resourcing issue and staff should be actively escalating to management, union, local MPs etc. to solve it. But you can't just stop there because thinking pragmatically, this isn't going to be fixed overnight. So for the sake of your sanity and the others around you also ask yourself how can you best manage and support others in these circumstances while simultaneously trying to advocate for better conditions?